Changes

| info = * Topiramate induces CYP3A4 and is an inhibiter of CYP2C19.* Carbamazepine is principally metabolized by CYP3A4 (also CYP2C8), but is also a potent inducer of CYP1A2, CYP3A4 and UDP-glucuronosyltransferases.* This combination of drugs may have possible synergistic effects. However, the pharmacokinetic drug interactions will influence the plasma levels. Dose adaptation will be recommended for this combination. 

* Carbamazepine can increase topiramate clearance. Add By adding topiramate to carbamazepine according to the general dosing advice and check the effects of topiramate and increase no dose if adaptation is necessary. <ref name=”bazire”> Bazire S, Pshychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007. </ref> <ref name=”medicatiebewaking”> Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002. </ref> <ref name=”bazire”"drugscomint"> Bazire S, Pshychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007. {{Drugscominteract|carbamazepine-with-topiramate-2216-0-497-0|carbamazepine|topiramate}}</ref>| cave = * This combination of drugs is subject to pharmacokinetic drug interactions. Discontinuation or dose reduction of either drug will need monitoring of the clinical effects and dose adaptation of the drug remained.