Combining-Carbamazepine-Lamotrigine
From Psychiatrienet
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Adding lamotrigine to carbamazepine.
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.
- 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.
Start lamotrigine- Carbamazepine can reduce lamotrigine serum concentration considerably. Add lamotrigine according to the general dosing advice. [6] [7] [8]
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]
- ↑ WHO Collaborating Centre for Drug Statistics Methodology ATC=N03AF01
- ↑ 2.0 2.1 Farmacotherapeutisch Kompas; Toxicologie (dutch)
- ↑ 3.0 3.1 Farmacotherapeutisch Kompas - carbamazepine (dutch)
Cite error: Invalid
<ref>tag; name "ftk" defined multiple times with different content - ↑ KNMP; Informatorium Medicamentorum 2023; Monografie "carbamazepine" (Dutch)
- ↑ Drugs.com lamotrigine
- ↑ 6.0 6.1 Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
- ↑ 7.0 7.1 Bazire S, Pshychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007.
- ↑ 8.0 8.1 Levy RH et al, Metabolic Drug Interactions, Lippincott Williams & Wilkins, Philadelphia, 2000.
- ↑ Koch HJ et al. Clinically relevant reduction of lamotrigine concentrations by carbamazepine. J Clin Psychiatry 2005;66:400-1
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