Drug interactions
Carbamazepine + Risperidone
Severity: Major
Carbamazepine and Risperidone: 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 lowers plasma concentrations of risperidone and its active metabolite, which may reduce antipsychotic efficacy and lead to relapse. Stopping carbamazepine later may cause risperidone levels to rise.
What this interaction means in plain words
Carbamazepine and Risperidone 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; Risperidone belongs to Central Nervous System.
Why it happens
Induction of CYP3A4 (and P-glycoprotein) by carbamazepine, increasing risperidone clearance.
What to do
Monitor clinical response and consider increasing the risperidone dose when carbamazepine is started. Reduce the risperidone dose again if carbamazepine is withdrawn.
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 Risperidone
- Ibutilide + Risperidone Contraindicated
- Risperidone + Vandetanib Contraindicated
- Adagrasib + Risperidone Major
- Amiodarone + Risperidone Major
- Amisulpride + Risperidone Major
- Amoxapine + Risperidone Major
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 Risperidone?
MediHelp rates the interaction as major. Carbamazepine and Risperidone 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 lowers plasma concentrations of risperidone and its active metabolite, which may reduce antipsychotic efficacy and lead to relapse. Stopping carbamazepine later may cause risperidone levels to rise.
How serious is the interaction between Carbamazepine and Risperidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response and consider increasing the risperidone dose when carbamazepine is started. Reduce the risperidone dose again if carbamazepine is withdrawn.
What other medicines interact with Risperidone?
MediHelp also lists interactions of Risperidone with, for example, Ibutilide, Vandetanib, Adagrasib. The full list is on the Risperidone page.
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