Drug interactions
Carbamazepine + Riociguat
Severity: Moderate
Carbamazepine and Riociguat: moderate interaction.
Last updated
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, a strong CYP3A4 inducer, may lower riociguat exposure and reduce its effect on pulmonary hypertension. The magnitude has not been well defined.
What this interaction means in plain words
Carbamazepine and Riociguat can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Carbamazepine belongs to Central Nervous System; Riociguat belongs to Cardiovascular.
Why it happens
Carbamazepine induces CYP3A4 (and CYP1A1), increasing riociguat clearance.
What to do
Monitor blood pressure and clinical response, and consider riociguat dose titration based on tolerability and efficacy. Reassess dose if carbamazepine is stopped to avoid hypotension.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Other interactions of Riociguat
- Avanafil + Riociguat Contraindicated
- Dipyridamole + Riociguat Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Isosorbide mononitrate + Riociguat Contraindicated
- Nitroglycerin + Riociguat Contraindicated
- Riociguat + Sildenafil Contraindicated
Frequently asked questions
Can I take Carbamazepine with Riociguat?
MediHelp rates the interaction as moderate. Carbamazepine and Riociguat can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Carbamazepine, a strong CYP3A4 inducer, may lower riociguat exposure and reduce its effect on pulmonary hypertension. The magnitude has not been well defined.
How serious is the interaction between Carbamazepine and Riociguat?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and clinical response, and consider riociguat dose titration based on tolerability and efficacy. Reassess dose if carbamazepine is stopped to avoid hypotension.
What other medicines interact with Carbamazepine?
MediHelp also lists interactions of Carbamazepine with, for example, Artemether / lumefantrine, Cabotegravir, Delamanid. The full list is on the Carbamazepine page.
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