Combining-Lamotrigine-Carbamazepine
From Psychiatrienet
{{Drugcombi | base = lamotrigine | add = carbamazepine | info =
- This combination of drugs may have possible synergistic effects. However, the pharmacokinetic drug interactions will influence the plasma levels. Dose adaptation is recommended for this combination. [1]
| start =
- Start carbamazepine with a daily dose of 200 mg and increase dose based serum concentration if necessary. Check lamotrigines effect after 2 weeks of therapy and adapt dose if necessary. [2]
| cave =
- Abrupt stop of carbamazepine can cause serious lamotrigine rash as lamotrigine levels increase.[3]
- Carbamazepine likely speeds the metabolism of lamotrigine, but the clinical significance is unclear.[4][5]
- Lamotrigine may increase blood levels of carbamazepine metabolites, which can result in neurotoxicity (data about this are contradictory).[4][5]
- These two agents have less significant pharmacologic interactions than do lamotrigine and valproate.[4][5]
- ↑ Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
- ↑ Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002.
- ↑ Koch HJ et al. Clinically relevant reduction of lamotrigine concentrations by carbamazepine. J Clin Psychiatry 2005;66:400-1
- ↑ 4.0 4.1 4.2 Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
- ↑ 5.0 5.1 5.2 Levy RH et al, Metabolic Drug Interactions, Lippincott Williams & Wilkins, Philadelphia, 2000.
