Difference between revisions of "Combining-Carbamazepine-Lamotrigine"

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* Add lamotrigine according to the general dosing advice.  
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* Add lamotrigine according to the general dosing advice. Dose addjustment of carbamazepine is not necessary when lamotrigine is added..<ref name="freeman">{{Pubmed|9433333|Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21}}</ref>
 
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* Abrupt stop of carbamazepine can cause serious lamotrigine rash as lamotrigine levels increase. <ref name="Koch"> {{Pubmed|12648898|Koch HJ et al. Clinically relevant reduction of lamotrigine concentrations by carbamazepine. J Clin Psychiatry 2005;66:400-1}}</ref>
 
* Abrupt stop of carbamazepine can cause serious lamotrigine rash as lamotrigine levels increase. <ref name="Koch"> {{Pubmed|12648898|Koch HJ et al. Clinically relevant reduction of lamotrigine concentrations by carbamazepine. J Clin Psychiatry 2005;66:400-1}}</ref>
* Carbamazepine can reduce lamotrigine serum concentration considerably.<ref name="freeman">{{Pubmed|9433333|Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21}}</ref><ref name="levyrh"> Levy RH et al, Metabolic Drug Interactions, Lippincott Williams & Wilkins, Philadelphia, 2000.</ref>
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* Carbamazepine likely speeds the metabolism of lamotrigine, but the clinical significance is unclear.<ref name="freeman"><ref name="levyrh"> Levy RH et al, Metabolic Drug Interactions, Lippincott Williams & Wilkins, Philadelphia, 2000.</ref>
* Lamotrigine may increase levels of carbamazepine metabolites. <ref name="freeman" /><ref name="levyrh" />
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* Lamotrigine may increase blood levels of carbamazepine metabolites, which can result in neurotoxicity (data about this are contradictory). <ref name="freeman" /><ref name="levyrh" />
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* These two agents have less significant pharmacologic interactions than do lamotrigine and valproate <ref name="freeman"/>
 
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Revision as of 14:42, 22 April 2010

Carbamazepine
Type moodstabilizer
Group anticonvulsant
links
ATC-code N03AF01
Medscape Carbamazepine
PubChem 2554
PubMed Carbamazepine
Drugs.com carbamazepine
Kompas (Dutch) Carbamazepine
Wikipedia Carbamazepine
Lamotrigine
Type moodstabilizer
Group anticonvulsant
links
ATC-code N03AX09
PubChem 3878
PubMed Lamotrigine
Drugs.com lamotrigine
Kompas (Dutch) Lamotrigine
Wikipedia Lamotrigine

Adding lamotrigine to carbamazepine.

Infobord.png General information
  
Carbamazepine
  • Carbamazepine is principally metabolized by CYP3A4, and is a potent inducer of CYP1A2, CYP2C9, CYP3A4 and UDP-glucuronosyltransferases.
  
Lamotrigine
  • Lamotrigine is principally metabolised by UDP-glucuronosyltransferases.
  
Carbamazepine
  
Lamotrigine
Eenrichtingbord.png Start lamotrigine
  
Lamotrigine
  • Add lamotrigine according to the general dosing advice. Dose addjustment of carbamazepine is not necessary when lamotrigine is added..[6]
Nietinrijdenbord.png Stop lamotrigine
  
Lamotrigine
Letopbord.png Cave
  • Abrupt stop of carbamazepine can cause serious lamotrigine rash as lamotrigine levels increase. [7]
  • Carbamazepine likely speeds the metabolism of lamotrigine, but the clinical significance is unclear.Cite error: Closing </ref> missing for <ref> tag
  • Lamotrigine may increase blood levels of carbamazepine metabolites, which can result in neurotoxicity (data about this are contradictory). [6][8]
  • These two agents have less significant pharmacologic interactions than do lamotrigine and valproate [6]


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