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Carbamazepine Extended-Release Capsules (Carbatrol) and Nefazodone

Determining the interaction of Carbamazepine Extended-Release Capsules (Carbatrol) and Nefazodone and the possibility of their joint administration.

Check result:

Carbamazepine Extended-Release Capsules (Carbatrol) <> Nefazodone

Relevance: 10.10.2022 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Using carBAMazepine together with nefazodone is not recommended. Combining these medications can alter the blood levels and effects of both medications. Specifically, nefazodone levels may significantly decrease, which may make the medication ineffective in treating your condition. At the same time, carBAMazepine levels may increase, and you may experience more frequent and/or severe side effects such as headache, nausea, vomiting, dizziness, confusion, slurred speech, visual disturbances, tremors and/or incoordination. Your doctor may be able to prescribe alternatives that do not interact. 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.

Professional:

CONTRAINDICATED: Coadministration of carbamazepine and nefazodone may result in significantly decreased plasma concentrations of nefazodone and its active metabolite, hydroxynefazodone, and increased plasma concentrations of carbamazepine. The proposed mechanism is carbamazepine induction of nefazodone and hydroxynefazodone metabolism via CYP450 3A4, and nefazodone inhibition of carbamazepine metabolism via the same isoenzyme. In 12 healthy subjects administered carbamazepine 200 mg twice daily with nefazodone 200 mg twice daily to steady state, an approximately 85% reduction in peak plasma concentration (Cmax) and nearly 95% reduction in systemic exposure (AUC) were reported for both nefazodone and hydroxynefazodone, which would likely lead to therapeutic failure in a clinical setting. Carbamazepine Cmax and AUC were increased by 23%. Case reports have described carbamazepine toxicity following the initiation of nefazodone therapy, necessitating a reduction in carbamazepine dosage or discontinuation of nefazodone.

MANAGEMENT: Concomitant use of nefazodone and carbamazepine is considered contraindicated.

References

Yong JN "Nefazodone and neurotoxicity." J Clin Psychiatry 58 (1997): 365
Roth L, Bertschy G "Nefazodone may inhibit the metabolism of carbamazepine: three case reports." Eur Psychiatry 16 (2001): 320-1
"Product Information. Serzone (nefazodone)." Bristol-Myers Squibb, Princeton, NJ.
Ashton AK, Wolin RE "Nefazodone-induced carbamazepine toxicity." Am J Psychiatry 153 (1996): 733
Nemeroff CB, Devane CL, Pollock BG "Newer antidepressants and the cytochrome p450 system." Am J Psychiatry 153 (1996): 311-20
Laroudie C, Salazar DE, Cosson JP, Cheuvart B, Istin B, Girault J, Ingrand I, Decourt JP "Carbamazepine-nefazodone interaction in healthy subjects." J Clin Psychopharmacol 20 (2000): 46-53

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)?

Nefazodone

Generic Name: nefazodone

Brand name: Serzone

Synonyms: n.a.

What is Nefazodone?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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