Combining-Carbamazepine-Lamotrigine
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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.
Start lamotrigine- Add lamotrigine according to the general dosing advice. Dose adjustment of carbamazepine is not necessary when lamotrigine is added.[6] [7]
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]
- ↑ 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 6.2 6.3 Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
- ↑ Interactions between lamotrigine and carbamazepine on drugs.com
- ↑ Koch HJ et al. Clinically relevant reduction of lamotrigine concentrations by carbamazepine. J Clin Psychiatry 2005;66:400-1
- ↑ 9.0 9.1 9.2 Levy RH et al, Metabolic Drug Interactions, Lippincott Williams & Wilkins, Philadelphia, 2000.
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