Changes

| info = &nbsp;* Carbamazepine is principally metabolized by CYP3A4 (also CYP2C8), but is also a potent inducer of CYP1A2, CYP3A4 and UDP-glucuronosyltransferases.* Lamotrigine is principally metabolised by UDP-glucuronosyltransferases.* This combination of drugs may have possible synergistic effects. However, the pharmacokinetic drug interactions will influence the plasma levels.| metabolites_ref = <ref name="informatorium">{{KNMP|carbamazepine}} </ref>

* Carbamazepine can reduce lamotrigine serum concentration considerably. Add lamotrigine according to the general dosing advice. Dose adjustment of carbamazepine is not necessary when lamotrigine is added. <ref name=”freeman”"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=”bazire”> Bazire S, Pshychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007.</ref> <ref name=”levyrh”> Levy RH et al, Metabolic Drug Interactions, Lippincott Williams & Wilkins, Philadelphia, 2000. </ref"drugscomint">* Lamotrigine may increase levels of carbamazepine metabolites. <ref name=”freeman”> {{PubmedDrugscominteract|lamotrigine-with-carbamazepine-1430-0-497-0|9433333lamotrigine|Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21carbamazepine}}</ref> <ref name=”bazire”> Bazire S, Pshychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007.</ref> <ref name=”levyrh”> Levy RH et al, Metabolic Drug Interactions, Lippincott Williams & Wilkins, Philadelphia, 2000. </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;66:400-1CombiCaLa}}</ref>