Drug interactions
Carbamazepine + Posaconazole
Severity: Major
Carbamazepine and Posaconazole: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Carbamazepine induces posaconazole metabolism and can lower antifungal levels, risking treatment failure. Posaconazole may in turn raise carbamazepine levels and cause toxicity such as dizziness, ataxia and diplopia.
What this interaction means in plain words
Carbamazepine and Posaconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Carbamazepine belongs to Central Nervous System; Posaconazole belongs to Anti Fungals.
Why it happens
Carbamazepine induces UGT and efflux transport lowering posaconazole, while posaconazole inhibits CYP3A4 metabolism of carbamazepine.
What to do
Avoid the combination unless benefit outweighs risk. If used, monitor posaconazole trough concentrations and carbamazepine levels and signs of toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Posaconazole?
MediHelp rates the interaction as major. Carbamazepine and Posaconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Carbamazepine induces posaconazole metabolism and can lower antifungal levels, risking treatment failure. Posaconazole may in turn raise carbamazepine levels and cause toxicity such as dizziness, ataxia and diplopia.
How serious is the interaction between Carbamazepine and Posaconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination unless benefit outweighs risk. If used, monitor posaconazole trough concentrations and carbamazepine levels and signs of toxicity.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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