Carbamazepine Oral Suspension and Kaletra Oral Solution

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.

Talk to your doctor before using lopinavir together with carBAMazepine. Combining these medications can decrease the blood levels of lopinavir, which may make it less effective in treating HIV infection. Contact your doctor if your condition worsens or you develop new infections during treatment with these medications. Lopinavir in combination with ritonavir may also increase the blood levels and effects of carBAMazepine. Contact your doctor if you experience increased side effects such as drowsiness, tiredness, dizziness, unsteadiness when walking, nausea, and vomiting. 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.

ADJUST DOSING INTERVAL: Coadministration of lopinavir-ritonavir with carbamazepine may result in decreased plasma concentrations of lopinavir and increased plasma concentrations of carbamazepine. The proposed mechanism involves carbamazepine induction of lopinavir metabolism via CYP450 3A4 and conversely, lopinavir-ritonavir inhibition of carbamazepine metabolism via the same enzymatic pathway. Clinical studies have shown that potent CYP450 3A4 inducers can significantly alter the plasma concentrations of lopinavir, possibly by overriding some of the boosting effects of ritonavir and enhancing the clearance of both lopinavir and ritonavir. In 12 healthy volunteers, administration of lopinavir-ritonavir (400 mg-100 mg twice daily for 22 days) with potent CYP450 3A4 inducer phenytoin (300 mg once daily on days 11 through 22) decreased lopinavir peak plasma concentration (Cmax), systemic exposure (AUC), and trough plasma concentration (Cmin) by 24%, 33%, and 46%, respectively. Ritonavir Cmax, AUC, and Cmin were also reduced by 20%, 28%, and 47%, respectively, although only the change in Cmin was statistically significant. In addition, in one case report a 50-year-old HIV-positive male who had been stabilized on carbamazepine (400 mg three times a day), developed excessive drowsiness within 9 days of starting an antiretroviral regimen containing lopinavir-ritonavir (400 mg-100 mg twice daily), tenofovir, and lamivudine. The carbamazepine serum concentration was found to have increased from a pre-antiretroviral treatment level of 10.3 mg/L, up to 15 mg/L by day 9 of the concomitant antiretroviral treatment regimen. However, symptoms resolved when the carbamazepine dose was reduced to 400 mg twice daily, and carbamazepine serum concentrations measured on day 11 had fallen to 7.4 mg/L.

MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, caution is advised if lopinavir-ritonavir is prescribed with carbamazepine. Once-daily administration of lopinavir-ritonavir should be avoided when used concomitantly with carbamazepine. An increase in the dosage of lopinavir-ritonavir may be necessary, although dosage adjustment has not been evaluated in clinical studies. Close clinical and laboratory monitoring of antiretroviral response is recommended following the addition or discontinuation of carbamazepine in patients already receiving lopinavir-ritonavir as part of their HIV treatment regimen. Likewise, if lopinavir-ritonavir is added to stable carbamazepine therapy, serum drug levels and pharmacologic effects should be closely monitored and the carbamazepine dose adjusted accordingly. Patients should be advised to contact their doctor if they develop signs of carbamazepine toxicity such as ataxia, disorientation, dizziness, nausea, vomiting, and visual disturbances.

Carbamazepine Oral Suspension

Generic Name: carbamazepine

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

Synonyms: Carbamazepine, CarBAMazepine

What is Carbamazepine Oral Suspension?

Kaletra Oral Solution

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: Kaletra

What is Kaletra Oral Solution?