Drug interactions
Carbamazepine + Zonisamide
Severity: Moderate
Carbamazepine and Zonisamide: 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 shortens zonisamide half-life and lowers its concentrations through enzyme induction. Seizure control may be reduced unless the zonisamide dose is adjusted.
What this interaction means in plain words
Carbamazepine and Zonisamide 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; Zonisamide belongs to Central Nervous System.
Why it happens
CYP3A4 induction by carbamazepine increases zonisamide metabolism.
What to do
Titrate zonisamide to clinical response and consider higher doses. Reassess the dose if carbamazepine is stopped.
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 Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide Moderate
Frequently asked questions
Can I take Carbamazepine with Zonisamide?
MediHelp rates the interaction as moderate. Carbamazepine and Zonisamide 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 shortens zonisamide half-life and lowers its concentrations through enzyme induction. Seizure control may be reduced unless the zonisamide dose is adjusted.
How serious is the interaction between Carbamazepine and Zonisamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate zonisamide to clinical response and consider higher doses. Reassess the dose if carbamazepine is stopped.
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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