Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- Carbatrol (carbamazepine)
- Myorisan (isotretinoin)
Interactions between your drugs
carBAMazepine ISOtretinoin
Applies to: Carbatrol (carbamazepine), Myorisan (isotretinoin)
MONITOR: A case report has suggested that isotretinoin may decrease the AUC of carbamazepine. Pharmacologic effects may be reduced. The mechanism is unknown.
MANAGEMENT: Clinical monitoring of serum carbamazepine concentrations and patient response is recommended when isotretinoin is added to or discontinued from an existing regimen, or when the dosage is changed. Patients should be advised to notify their physician if they experience a reduction in or loss of efficacy.
References
- Marsden JR (1988) "Effect of isotretinoin on carbamazepine pharmacokinetics." Br J Dermatol, 119, p. 403-4
Drug and food interactions
carBAMazepine food
Applies to: Carbatrol (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
- (2002) "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals
- 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
- 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
ISOtretinoin food
Applies to: Myorisan (isotretinoin)
GENERALLY AVOID: The combined use of ethanol and isotretinoin may result in a disulfiram-like reaction. The mechanism has not been established.
MANAGEMENT: Alcohol consumption should be avoided during isotretinoin therapy.
References
- (2001) "Product Information. Accutane (isotretinoin)." Roche Laboratories
Therapeutic duplication warnings
No duplication 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.
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
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