Carbamazepine Extended-Release Capsules (Carbatrol) and Diacomit

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.

Using stiripentol together with carBAMazepine may alter the blood levels of both medications. Specifically, the blood levels of stiripentol may decrease, which may make the medication less effective in treating seizures and epilepsy. At the same time, stiripentol may cause the blood levels of carBAMazepine to increase. You may be more likely to experience side effects of carBAMazepine, including central nervous system effects such as dizziness, drowsiness, confusion, difficulty concentrating, and motor impairment. Talk to your doctor if you have any questions or concerns. 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. You should avoid or limit the use of alcohol during treatment with these medications. Do not engage in activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. 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.

GENERALLY AVOID: Coadministration with potent inducers of CYP450 1A2, 2C19, and/or 3A4 may significantly decrease the plasma concentrations of stiripentol, which has been shown in vitro to undergo phase I metabolism via these pathways. Pharmacokinetic studies have not been conducted. In a retrospective analysis of 220 stiripentol serum concentrations derived from 75 patients in three German epilepsy centers, concomitant use of phenobarbital or phenytoin (n=7) was associated with a 63% decrease in stiripentol serum concentrations.

GENERALLY AVOID: Coadministration with stiripentol may increase the plasma concentrations of other anticonvulsants that are metabolized by CYP450 2C19 or 3A4 such as carbamazepine, phenobarbital, phenytoin, and primidone. Stiripentol itself is metabolized by these pathways and has been reported to also inhibit multiple CYP450 isoenzymes in vitro, thus both competitive and noncompetitive inhibition may occur. In a small pharmacokinetics study (n=6), stiripentol 1200 mg/day and 2400 mg/day reduced carbamazepine elimination clearance by 39% and 71%, respectively, in one subject, and phenytoin elimination clearance by 37% and 78%, respectively, in five subjects. Phenytoin toxicity was observed in two subjects. Stiripentol 2400 mg/day reduced phenobarbital elimination clearance by 33% and 39% in two subjects.

MONITOR CLOSELY: Coadministration of stiripentol with other anticonvulsants may increase central nervous system adverse effects such as somnolence, dizziness, confusion, difficulty concentrating, and impairment of psychomotor skills.

MANAGEMENT: Concomitant use of stiripentol with potent CYP450 inducers such as carbamazepine, phenobarbital, phenytoin, and primidone should generally be avoided. If coadministration is required, patients should have plasma anticonvulsant concentrations monitored and dosage adjustments made accordingly. Patients should also be monitored for increased adverse effects such as dizziness, drowsiness, lethargy, confusion, diplopia, nystagmus, ataxia, dysarthria, hypothermia, and hypotension.

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)?

Diacomit

Generic Name: stiripentol

Brand name: Diacomit

Synonyms: n.a.

What is Diacomit?