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Equetro and Norvir

Determining the interaction of Equetro and Norvir and the possibility of their joint administration.

Check result:

Equetro <> Norvir

Relevance: 23.07.2022 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 ritonavir may increase the effects of carBAMazepine. Contact your doctor if you experience shallow breathing, fast heartbeat, nausea, vomiting, urinating less or not at all, muscle twitches, restlessness, tremors, slurred speech, staggering walk, and feeling light-headed or fainting. If your doctor does prescribe these medications together, you may need a dose adjustment or special test 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 ritonavir may significantly increase the plasma concentrations and pharmacologic effects of carbamazepine. The proposed mechanism is ritonavir inhibition of CYP450 3A4, the isoenzyme responsible for the metabolic clearance of carbamazepine. There have been case reports of patients stabilized on carbamazepine therapy who developed ataxia, disorientation, vertigo, vomiting, and transient liver dysfunction following the addition of ritonavir, subsequently requiring discontinuation of ritonavir or substantial reductions of carbamazepine dosage. The effect of carbamazepine on ritonavir clearance has not been reported. Theoretically, ritonavir plasma levels may decrease due to carbamazepine induction of CYP450 3A4, which also metabolizes ritonavir.

MANAGEMENT: Given its narrow therapeutic index, caution is advised if carbamazepine must be used concomitantly with ritonavir. Carbamazepine levels and pharmacologic effects should be closely monitored and the dosage adjusted accordingly, particularly following initiation or discontinuation of ritonavir in patients who are stabilized on their anticonvulsant regimen. Patients should be advised to contact their physician if they develop signs of carbamazepine toxicity such as ataxia, dizziness, nausea, vomiting, and visual disturbances. In addition, it may be appropriate to monitor patients for potentially reduced antiretroviral response due to decreased plasma levels of ritonavir and other antiretroviral agents induced by carbamazepine.

References

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Durant J, Clevenbergh P, Garraffo R, Halfon P, Icard S, DelGiudice P, Montagne N, Schapiro JM, Dellamonica P "Importance of protease inhibitor plasma levels in HIV-infected patients treated with genotypic-guided therapy: pharmacological data from the Viradapt Study." Aids 14 (2000): 1333-9
Brooks J, Daily J, Schwamm L "Protease inhibitors and anticonvulsants." AIDS Clin Care 9 (1997): 87,90
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"Product Information. Norvir (ritonavir)." Abbott Pharmaceutical, Abbott Park, IL.
Garcia AB, Ibarra AL, Etessam JP, et al. "Protease inhibitor-induced carbamazepine toxicity." Clin Neuropharmacol 23 (2000): 216-8
Liedtke MD, Lockhart SM, Rathbun RC "Anticonvulsant and antiretroviral interactions." Ann Pharmacother 38 (2004): 482-9
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Kato Y, Fujii T, Mizoguchi N, et al. "Potential interaction between ritonavir and carbamazepine." Pharmacotherapy 20 (2000): 851-4
Mateu-de Antonio J, Grau S, Gimeno-Bayon JL, Carmona A "Ritonavir-induced carbamazepine toxicity." Ann Pharmacother 35 (2001): 125-6
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Equetro

Generic Name: carbamazepine

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

Synonyms: n.a.

What is Equetro?

Norvir

Generic Name: ritonavir

Brand name: Norvir, Norvir Soft Gelatin

Synonyms: n.a.

What is Norvir?

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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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