Carbamazepine Extended-Release Capsules (Carbatrol) and Vytorin

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.

Ask your doctor before using carBAMazepine together with simvastatin. Using these medications together can make simvastatin less effective. 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 carbamazepine may significantly decrease the plasma concentrations of simvastatin and its pharmacologically active acid metabolite. The proposed mechanism is carbamazepine induction of the intestinal and hepatic CYP450 3A4 metabolism of simvastatin and simvastatin acid. In 12 healthy volunteers, pretreatment with carbamazepine for 14 days (200 mg once daily for 2 days, then 300 mg twice daily) decreased the mean total area under the serum concentration-time curve (AUC) of simvastatin and simvastatin acid by 75% and 82%, respectively, compared to administration of simvastatin (80 mg single oral dose) alone. In the presence of carbamazepine, the mean peak concentrations (Cmax) of both simvastatin and simvastatin acid were reduced by 68%, and the half-life of simvastatin acid was shortened from 5.9 to 3.7 hours. The interaction was apparent in every subject of the study.

MANAGEMENT: Given the magnitude of the interaction, the pharmacologic effect of simvastatin may be significantly reduced during concomitant administration with carbamazepine. Therefore, concurrent use should preferably be avoided. If the combination is prescribed, the dosage of simvastatin may need to be increased. Alternatively, use of another HMG-CoA reductase inhibitor (i.e., statin) that is not significantly metabolized by CYP450 3A4 may be considered. As carbamazepine is known to induce other CYP450 isoenzymes besides 3A4, the statins least likely to interact may be pravastatin, which is metabolized by non-CYP routes, and rosuvastatin, which is only about 10% metabolized.

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)?

Vytorin

Generic Name: ezetimibe / simvastatin

Brand name: Vytorin

Synonyms: n.a.

What is Vytorin?