Equetro and Verapamil oral/injection

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 carBAMazepine together with verapamil. Combining these medications can alter the blood levels and effects of both medications. Specifically, verapamil levels may decrease, which may make the medication less effective in treating your condition. At the same time, carBAMazepine levels may increase, and you may experience more frequent and/or severe side effects. Contact your doctor if you develop headache, nausea, vomiting, dizziness, confusion, slurred speech, visual disturbances, tremors and/or incoordination, as these may be signs and symptoms of excessive carBAMazepine levels. 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.

ADJUST DOSE: Coadministration with diltiazem or verapamil may significantly increase the plasma concentrations of carbamazepine. The proposed mechanism is inhibition of carbamazepine metabolism via CYP450 3A4. There have been case reports of carbamazepine toxicity associated with the use of both calcium channel blockers (CCBs), which is consistent with their status as moderate CYP450 3A4 inhibitors. The onset is usually within 2 to 4 days after initiation of the CCB, and a reduction in carbamazepine dosage by 50% to 60% or discontinuation of the CCB is often required. A retrospective study found that 10 of 15 patients receiving carbamazepine with diltiazem or verapamil experienced signs and symptoms of toxicity, but not those receiving carbamazepine with nifedipine. Reduced carbamazepine levels and epileptic episodes have also been observed following withdrawal of CCB therapy. Conversely, carbamazepine may induce the first-pass metabolism and decrease the plasma concentrations of diltiazem and verapamil, although the magnitude of this interaction has not been studied.

MANAGEMENT: Caution is advised during concomitant use of carbamazepine with diltiazem or verapamil. Serum carbamazepine levels and pharmacologic response should be monitored more closely following the initiation or discontinuation of CCB therapy, and the carbamazepine dosage adjusted as necessary. Some clinicians recommend empirically reducing the carbamazepine dosage by 50% upon initiation of the CCB. Patients should be advised to contact their physician if they experience potential signs and symptoms of carbamazepine toxicity such as headache, nausea, vomiting, dizziness, confusion, slurred speech, nystagmus, visual disturbances, tremors, and ataxia. If carbamazepine is added to existing diltiazem or verapamil therapy, patients should be monitored for potentially reduced blood pressure and cardiac effects.

Equetro

Generic Name: carbamazepine

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

Synonyms: n.a.

What is Equetro?

Verapamil oral/injection

Generic Name: verapamil

Brand name: Calan, Isoptin SR, Verelan, Isoptin, Calan SR, Isoptin IV, Covera-HS, Verelan PM

Synonyms: Verapamil

What is Verapamil oral/injection?