Drug interactions
Escitalopram + Phenobarbital
Severity: Moderate
Escitalopram and Phenobarbital: 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
Phenobarbital induces CYP2C19 and CYP3A4, both of which metabolize escitalopram, so escitalopram concentrations may fall and efficacy may be lost. Additive sedation can also occur.
What this interaction means in plain words
Escitalopram and Phenobarbital 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.
Why it happens
Induction of CYP2C19 and CYP3A4 increases escitalopram clearance.
What to do
Monitor for loss of antidepressant response and titrate escitalopram within the licensed maximum. Watch for excess sedation, and reassess the dose if phenobarbital 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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Escitalopram with Phenobarbital?
MediHelp rates the interaction as moderate. Escitalopram and Phenobarbital 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. Phenobarbital induces CYP2C19 and CYP3A4, both of which metabolize escitalopram, so escitalopram concentrations may fall and efficacy may be lost. Additive sedation can also occur.
How serious is the interaction between Escitalopram and Phenobarbital?
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 for loss of antidepressant response and titrate escitalopram within the licensed maximum. Watch for excess sedation, and reassess the dose if phenobarbital is stopped.
What other medicines interact with Escitalopram?
MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.
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