Combining-Carbamazepine-Lamotrigine

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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
  • 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.
Eenrichtingbord.png Start lamotrigine
  
Lamotrigine
  • Carbamazepine can reduce lamotrigine serum concentration considerably. Add lamotrigine according to the general dosing advice. [6] [7] [8]
Nietinrijdenbord.png Stop lamotrigine
  
Lamotrigine
Letopbord.png Cave
  • Abrupt stop of carbamazepine can cause serious lamotrigine rash as lamotrigine levels increase. [9]
  • Lamotrigine may increase levels of carbamazepine metabolites. [6] [7] [8]


  1. WHO Collaborating Centre for Drug Statistics Methodology ATC=N03AF01
  2. 2.0 2.1 Farmacotherapeutisch Kompas; Toxicologie (dutch)
  3. 3.0 3.1 Farmacotherapeutisch Kompas - carbamazepine (dutch) Cite error: Invalid <ref> tag; name "ftk" defined multiple times with different content
  4. KNMP; Informatorium Medicamentorum 2015; Monografie "carbamazepine" (Dutch)
  5. Drugs.com lamotrigine
  6. 6.0 6.1 Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
  7. 7.0 7.1 Bazire S, Pshychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007. Cite error: Invalid <ref> tag; name "”bazire”" defined multiple times with different content
  8. 8.0 8.1 Levy RH et al, Metabolic Drug Interactions, Lippincott Williams & Wilkins, Philadelphia, 2000.
  9. Koch HJ et al. Clinically relevant reduction of lamotrigine concentrations by carbamazepine. J Clin Psychiatry 2005;66:400-1
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