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Carbamazepine Extended-Release Capsules (Carbatrol) and Trazodone Tablets

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

Check result:
Carbamazepine Extended-Release Capsules (Carbatrol) <> Trazodone Tablets
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 traZODone together with carBAMazepine can alter the blood levels and effects of both medications. Specifically, traZODone levels may decrease, which may make the medication less effective. At the same time, carBAMazepine levels may increase, so you may be more likely to experience side effects such as headache, dizziness, nausea, slurred speech, vision problems, tremors, and incoordination. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor 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.

Professional:

MONITOR: Coadministration with carbamazepine may decrease the plasma concentrations of trazodone and its active metabolite, meta-chlorophenylpiperazine. The proposed mechanism is carbamazepine induction of trazodone metabolism via CYP450 3A4. In six depressed patients treated with trazodone 150 mg to 300 mg daily, plasma concentrations of trazodone and meta-chlorophenylpiperazine were reduced by 76% and 60%, respectively, following administration of carbamazepine 400 mg/day for four weeks. A pair of case reports also suggest that trazodone may inhibit the metabolism of carbamazepine, possibly by competitive inhibition of CYP450 3A4 metabolism. In the first report, a 53-year-old white male had an increased carbamazepine concentration-dose ratio from 0.89 to 1.12 two months after beginning trazodone treatment. The patient did not exhibit any signs or symptoms of carbamazepine toxicity. In the second report, a 77-year-old female experienced ataxia and severe tremor in association with increased carbamazepine serum levels from 8.4 to 11.6 mg/L three days after the addition of trazodone 100 mg/day and escitalopram 10 mg/day. Carbamazepine levels returned to normal a week after the discontinuation of trazodone while escitalopram was continued.

MANAGEMENT: Pharmacologic response to trazodone should be monitored more closely whenever carbamazepine is added to or withdrawn from stabilized therapy, and the trazodone dosage adjusted as necessary. Similarly, it may be appropriate to monitor carbamazepine levels and pharmacologic effects following initiation, change of dosage, or discontinuation of trazodone therapy. Patients should be advised to contact their physician if they experience potential signs and symptoms of carbamazepine toxicity such as nausea, visual disturbance, dizziness, or ataxia.

References
  • Otani K, Ishida M, Kaneko S, Mihara K, Ohkubo T, Osanai T, Sugawara K "Effects of carbamazepine coadministration on plasma concentrations of trazodone and its active metabolite, m-chlorophenylpiperazine." Ther Drug Monit 18 (1996): 164-7
  • "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals, East Hanover, NJ.
  • Romero AS, Delgado RG, Pena MF "Interaction between trazodone and carbamazepine." Ann Pharmacother 33 (1999): 1370
  • Sanchez-Romero A, Mayordomo-Aranda A, Garcia-Delgado R, Duran-Quintana JA "Probable interaction between trazodone and carbamazepine." Pharmacopsychiatry 44 (2011): 158-9
Carbamazepine Extended-Release Capsules (Carbatrol)

Generic Name: carbamazepine

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

Synonyms: Carbamazepine, CarBAMazepine

Trazodone Tablets

Generic Name: trazodone

Brand name: Desyrel, Desyrel Dividose, Oleptro

Synonyms: Trazodone, TraZODone

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.