Difference between revisions of "Combining-Carbamazepine-Lamotrigine"

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| base = carbamazepine
 
| base = carbamazepine
 
| add = lamotrigine
 
| add = lamotrigine
| info =  
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| info =  
*
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| metabolites_ref = <ref name="informatorium">{{KNMP|carbamazepine}} </ref>
 
| start =  
 
| start =  
* Carbamazepine can reduce lamotrigine serum concentration considerably. Add lamotrigine according to the general dosing advice. <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="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>
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* Add lamotrigine according to the general dosing advice. Dose adjustment 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> <ref name="drugscomint">
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{{Drugscominteract|lamotrigine-with-carbamazepine-1430-0-497-0|lamotrigine|carbamazepine}}</ref>
 
| cave =  
 
| cave =  
* 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>
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{{CombiCaLa}}
* Lamotrigine may increase levels of carbamazepine metabolites. <ref name="freeman" /><ref name="bazire" /><ref name="levyrh" />
 
 
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Latest revision as of 15:05, 22 June 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 is principally metabolized by CYP3A4, and is a potent inducer of CYP1A2, CYP2C9, CYP3A4 and UDP-glucuronosyltransferases.
  • Lamotrigine is principally metabolised by UDP-glucuronosyltransferases.

 

Eenrichtingbord.png Start lamotrigine
  • Add lamotrigine according to the general dosing advice. Dose adjustment of carbamazepine is not necessary when lamotrigine is added.[6] [7]
Letopbord.png Cave
  • Abrupt stop of carbamazepine can cause serious lamotrigine rash as lamotrigine levels increase.[8]
  • Carbamazepine likely speeds the metabolism of lamotrigine, but the clinical significance is unclear.[6][9]
  • Lamotrigine may increase blood levels of carbamazepine metabolites, which can result in neurotoxicity (data about this are contradictory).[6][9]
  • These two agents have less significant pharmacologic interactions than do lamotrigine and valproate.[6][9]


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