Brivaracetam Intravenous and Carbamazepine Extended-Release Capsules (Carbatrol)

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

CarBAMazepine may reduce the blood levels of brivaracetam. This may make the medication less effective in some patients. Brivaracetam may also affect the blood levels of certain epilepsy medications like carbamazepine or phenytoin. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration with potent inducers of CYP450 isoenzymes may decrease the plasma concentrations of brivaracetam, which is partially metabolized by CYP450 2C19. In healthy study subjects, administration of brivaracetam with the potent CYP450 inducer rifampin (600 mg/day for 5 days) resulted in a 45% decrease in brivaracetam systemic exposure (AUC). When given with the enzyme-inducing antiepileptic drugs carbamazepine, phenytoin and phenobarbital, the AUC of brivaracetam decreased by 26%, 21%, and 19%, respectively, without significant effects on pharmacologic response based on a population pharmacokinetic/pharmacodynamic analysis of placebo-controlled phase 3 studies. Conversely, concomitant use of phenytoin with a supratherapeutic dose of brivaracetam (400 mg/day) resulted in a 20% increase in phenytoin peak plasma concentration (Cmax) and AUC. Following administration of carbamazepine with brivaracetam dosages of 50 mg/day, 100 mg/day and 200 mg/day, no significant pharmacokinetic changes were observed for carbamazepine, but the plasma concentrations of carbamazepine epoxide (an active metabolite associated with neurotoxicity) increased by a mean of 37%, 62% and 98%, respectively. Coadministration of brivaracetam 200 mg twice daily and carbamazepine 300 mg twice daily for two weeks increased the AUC of carbamazepine epoxide by approximately 160% in 13 healthy male subjects. No safety risks were observed with these increases. Brivaracetam is a moderate reversible inhibitor of epoxide hydrolase, the enzyme that catalyzes the hydrolysis of carbamazepine epoxide to an inactive metabolite.

MANAGEMENT: The potential for diminished pharmacologic effects of brivaracetam should be considered during coadministration with potent CYP450 enzyme inducers. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate whenever a CYP450 inducer is added to or withdrawn from therapy. For patients receiving concomitant carbamazepine or phenytoin therapy, blood levels should be monitored following initiation or discontinuation of brivaracetam. Dosage reductions for carbamazepine and phenytoin may be required if tolerability issues arise.

Brivaracetam Intravenous

Generic Name: brivaracetam

Brand name: Briviact

Synonyms: Brivaracetam (oral/injection), Brivaracetam

What is Brivaracetam Intravenous?

Carbamazepine Extended-Release Capsules (Carbatrol)

Generic Name: carbamazepine

Brand name: Carbatrol, Epitol, Equetro, Tegretol, Tegretol XR, Tegretol, Tegretol XR

Synonyms: Carbamazepine, CarBAMazepine

What is Carbamazepine Extended-Release Capsules (Carbatrol)?