biaxin and Epitol Interactions

Interactions between biaxin(clarithromycin) and Epitol (carbamazepine)

carbamazepine and clarithromycin (Major Drug-Drug)

GENERALLY AVOID: Some macrolide antibiotics can significantly increase serum carbamazepine levels. The mechanism is probably inhibition of hepatic CYP450 3A4 isoenzymes. Severe carbamazepine toxicity has been reported.

MANAGEMENT: Alternative antimicrobial therapy, if available, is generally recommended for patients on carbamazepine. A macrolide that does not affect carbamazepine levels, such as azithromycin, may be substituted if clinically appropriate. If this combination must be used, carbamazepine levels should be monitored and the patient should be carefully observed for signs of carbamazepine toxicity. Patients should be advised to report signs of carbamazepine toxicity (nausea, visual disturbances, dizziness, or ataxia) to their physicians. The carbamazepine dosage may require reduction.