Drug interactions
Carbamazepine + Quinine
Severity: Major
Carbamazepine and Quinine: major interaction.
Last updated Sources: US FDA label
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 the metabolism of quinine and can markedly lower its concentrations, risking treatment failure in malaria. Quinine may also modestly raise carbamazepine levels in some patients.
What this interaction means in plain words
Carbamazepine and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Carbamazepine induces CYP3A4, increasing hepatic clearance of quinine.
What to do
Prefer an alternative antimalarial where possible; if quinine is used, monitor clinical response and carbamazepine levels and watch for 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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine 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 Quinine?
MediHelp rates the interaction as major. Carbamazepine and Quinine 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 the metabolism of quinine and can markedly lower its concentrations, risking treatment failure in malaria. Quinine may also modestly raise carbamazepine levels in some patients.
How serious is the interaction between Carbamazepine and Quinine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative antimalarial where possible; if quinine is used, monitor clinical response and carbamazepine levels and watch for signs of toxicity.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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