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Drug Interactions between Epitol and mebendazole

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

carBAMazepine mebendazole

Applies to: Epitol (carbamazepine) and mebendazole

MONITOR: Coadministration with anticonvulsant drugs such as carbamazepine, phenytoin, phenobarbital, and primidone may decrease mebendazole levels. The mechanism is unknown, but induction of hepatic metabolism by these anticonvulsant drugs has been proposed. A study of 17 patients on high dose, long-term (over 18 months) oral mebendazole therapy for hydatid disease describes a reduction in serum mebendazole concentrations that was attributed to concomitant carbamazepine or phenytoin therapy. However, since plasma mebendazole levels varied greatly among patients in the study, and each patient had only a single measurement of plasma mebendazole, the clinical significance of the purported pharmacokinetic interaction cannot be fully determined. Clinical impact is expected to be minimal in the treatment of intestinal infections, but may be increased when mebendazole is used for helminthic diseases in tissues beyond the GI tract.

MANAGEMENT: Caution and monitoring for altered clinical efficacy are recommended if mebendazole is used concomitantly with anticonvulsant drugs such as carbamazepine, phenytoin, phenobarbital, or primidone in patients being treated for systemic helminthic infections. Dose adjustments or alternative treatments may be required if an interaction is suspected.

References

  1. Bekhti A, Pirotte J, Woestenborghs R (1986) "A correlation between serum mebendazole concentrations and the aminopyrine breath test: implications in the treatment of hyatid disease." Br J Clin Pharmacol, 21, p. 223-6
  2. Luder PJ, Siffert B, Witassek F, Meister F, Bircher J (1986) "Treatment of hydatid disease with high oral doses of membendazole." Eur J Clin Pharmacol, 31, p. 443-8
  3. Romo ML, Carpio A, Kelvin EA (2014) "Routine drug and food interactions during antihelminthic treatment of neurocysticercosis: a reason for the variable efficacy of albendazole and praziquantel?" J Clin Pharmacol, 54, p. 361-7
  4. Pawluk SA, Roels CA, Wilby KJ, Ensom MHH (2015) "A review of pharmacokinetic drug–drug interactions with the anthelmintic medications albendazole and mebendazole." Clin Pharmacokinet, 54, p. 371-83
View all 4 references

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Drug and food interactions

Moderate

carBAMazepine food

Applies to: Epitol (carbamazepine)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of carbamazepine. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

In a small, randomized, crossover study, the administration of carbamazepine with grapefruit juice (compared to water) increased plasma drug concentrations by approximately 40%. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits.

MANAGEMENT: Patients receiving carbamazepine should be advised to avoid or limit consumption of alcohol. Given the drug's narrow therapeutic index, patients receiving carbamazepine therapy should preferably avoid the regular consumption of grapefruits and grapefruit juice to prevent any undue fluctuations in plasma drug levels. Patients should be advised to report signs of carbamazepine toxicity (nausea, visual disturbances, dizziness, or ataxia) to their physicians.

References

  1. (2002) "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals
  2. Garg SK, Kumar N, Bhargava VK, Prabhakar SK (1998) "Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy." Clin Pharmacol Ther, 64, p. 286-8
  3. Bailey DG, Dresser GR, Kreeft JH, Munoz C, Freeman DJ, Bend JR (2000) "Grapefruit-felodipine interaction: Effect of unprocessed fruit and probable active ingredients." Clin Pharmacol Ther, 68, p. 468-77

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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