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Eslicarbazepine Disease Interactions

There are 5 disease interactions with eslicarbazepine:

Major

Anticonvulsants (applies to eslicarbazepine) depression

Major Potential Hazard, Moderate plausibility.

Antiepileptic drugs can increase depression and suicidal thoughts or behaviors in patients receiving these drugs for any indication. Patients should be monitored for the emergence or worsening of depression, suicidal thoughts and unusual changes in mood or behavior. Caregivers and family should be alert for the emergence or worsening of symptoms. Behaviors of concern should be reported immediately to the healthcare providers.

Major

Anticonvulsants (applies to eslicarbazepine) liver disease

Major Potential Hazard, Moderate plausibility.

Most anticonvulsants are primarily metabolized by the liver. Metabolic activity may be decreased in patients with liver disease, resulting in elevated drug levels and increased risk of toxicity. Therapy with anticonvulsants should be administered cautiously in patients with mild and moderate liver impairment. Therapy with these drugs is mostly not recommended in patients with severe liver impairment. Caution is also advised when treating patients with a history of liver disease, since the use of some anticonvulsants has been associated with hepatotoxicity. Baseline and periodic evaluation of liver function is recommended. Therapy should be discontinued and not readministered if evidence of liver damage is observed and felt to be drug-related.

References

  1. Ponte CD "Carbamazepine-induced thrombocytopenia, rash, and hepatic dysfunction." Drug Intell Clin Pharm 17 (1983): 642-4
  2. Horowitz S, Patwardhan R, Marcus E "Hepatotoxic reactions associated with carbamazepine therapy." Epilepsia 29 (1988): 149-54
  3. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals, East Hanover, NJ.
  4. Sumi M, Watari N, Umezawa O, Kaneniwa N "Pharmacokinetic study of carbamazepine and its epoxide metabolite in humans." J Pharmacobiodyn 10 (1987): 652-61
  5. Laspina I, Secchi P, Grampa G, Uccellini D, Porazzi D "Acute cholangitis induced by carbamazepine." Epilepsia 35 (1994): 1029-31
  6. Levy M, Goodman MW, Van Dyne BJ, Sumner HW "Granulomatous hepatitis secondary to carbamazepine." Ann Intern Med 95 (1981): 64-5
  7. Levy RH, Pitlick WH, Troupin AS, et al "Pharmacokinetics of carbamazepine in normal man." Clin Pharmacol Ther 17 (1975): 657-68
  8. Pellock JM "Carbamazepine side effects in children and adults." Epilepsia 28 (1987): s64-70
  9. Swinburn BA, Croxson MS, Miller MV, Crawford KB "Carbamazepine induced granulomatous hepatitis." N Z Med J Mar (1986): 167
  10. Eadie MJ "Formation of active metabolites of anticonvulsant drugs: a review of their pharmacokinetic and therapeutic significance." Clin Pharmacokinet 21 (1991): 27-41
  11. Tomson T, Tybring G, Bertilsson L "Single-dose kinetics and metabolism of carbamazepine-10,11-epoxide." Clin Pharmacol Ther 33 (1983): 58-65
  12. Vree TB, Janssen TJ, Hekster YA, et al "Clinical pharmacokinetics of carbamazepine and its epoxy and hydroxy metabolites in humans after an overdose." Ther Drug Monit 8 (1986): 297-304
  13. Eichelbaum M, Ekbom K, Bertilsson L, et al "Plasma kinetics of carbamazepine and its epoxide metabolite in man after single and multiple doses." Eur J Clin Pharmacol 8 (1975): 337-41
  14. Gerardin AP, Abadie FV, Campestrini JA, Theobald W "Pharmacokinetics of carbamazepine in normal humans after single and repeated oral doses." J Pharmacokinet Biopharm 4 (1976): 521-35
  15. Rawlins MD, Collste P, Bertilsson L, Palmer L "Distribution and elimination kinetics of carbamazepine in man." Eur J Clin Pharmacol 8 (1975): 91-6
  16. Westenberg HG, van der Kleihn E, Oei TT, de Zeeuw RA "Kinetics of carbamazepine and carbamazepine-epoxide, determined by use of plasma and saliva." Clin Pharmacol Ther 23 (1978): 320-8
  17. Cotter LM, Eadie MJ, Hooper WD, et al "The pharmacokinetics of carbamazepine." Eur J Clin Pharmacol 12 (1977): 451-6
  18. Larrey D, Hadengue A, Pessayre D, et al "Carbamazepine-induced acute cholangitis." Dig Dis Sci 32 (1987): 554-7
  19. Hopen G, Nesthus I, Laerum OD "Fatal carbamazepine-associated hepatitis." Acta Med Scand 210 (1981): 333-5
  20. Eichelbaum M, Kothe KW, Hoffmann F, von Unruh GE "Kinetics and metabolism of carbamazepine during combined antiepileptic drug therapy." Clin Pharmacol Ther 26 (1979): 366-71
  21. Levander HG "Granulomatous hepatitis in a patient receiving carbamazepine." Acta Med Scand 208 (1980): 333-5
  22. Soffer EE, Taylor RJ, Bertram PD, et al "Carbamazepine-induced liver injury." South Med J 76 (1983): 681-3
View all 22 references
Major

Anticonvulsants (applies to eslicarbazepine) renal dysfunction

Major Potential Hazard, Moderate plausibility.

Most anticonvulsants are primarily excreted by the kidney. The plasma clearance may be decreased and the half-life prolonged in patients with impaired renal function. Therapy with anticonvulsants should be administered cautiously in patients with significant renal dysfunction. In most cases it is recommended to adjust the dosage in patients with CrCl <50 mL/min to half the usual starting dose and then increase slowly to achieve the desired clinical response. The renal function should be monitored regularly in patients receiving therapy.

References

  1. "Product Information. Trileptal (oxcarbazepine)" Novartis Pharmaceuticals, East Hanover, NJ.
Moderate

Anticonvulsants (applies to eslicarbazepine) hyponatremia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hypothyroidism, Congestive Heart Failure, Adrenal Insufficiency, SIADH

Some anticonvulsants can cause clinically significant hyponatremia (Na < 125 mmol/L). Therapy with these drugs should be administered cautiously in patients with conditions predisposing to hyponatremia, such as SIADH, use of diuretics or drugs associated with inappropriate antidiuretic hormone secretion, adrenal insufficiency, hypothyroidism, primary polydipsia, and edema (e.g., due to liver cirrhosis, congestive heart failure, or nephrotic syndrome). Serum sodium levels should be monitored during maintenance therapy, and patients should be monitored for signs and symptoms possibly indicating hyponatremia such as nausea, malaise, headache, lethargy, confusion, obtundation, and increase in seizure frequency or severity. If hyponatremia occurs, conservative measures such as fluid restriction, a reduction in dosage, or discontinuation of therapy will usually suffice.

References

  1. Van Amelsvoort T, Bakshi R, Devaux CB, Schwabe S "Hyponatremia associated with carbamazepine and oxcarbazepine therapy: a review." Epilepsia 35 (1994): 181-8
  2. Nielsen OA, Johannessen AC, Bardrum B "Oxcarbazepine-induced hyponatremia, a cross-sectional study." Epilepsy Res 2 (1988): 269-71
  3. "Product Information. Trileptal (oxcarbazepine)" Novartis Pharmaceuticals, East Hanover, NJ.
  4. Ryan M, Adams AG, Larive LL "Hyponatremia and leukopenia associated with oxcarbazepine following carbamazepine therapy." Am J Health Syst Pharm 58 (2001): 1637-9
  5. Woster P, Carrazana EJ "Oxcarbazepine and hyponatremia." Am J Health Syst Pharm 59 (2002): 467
  6. Friis ML, Kristensen O, Boas J, Dalby M, Deth SH, Gram L, Mikkelsen M, Pedersen B, Sabers A, Worm-Petersen J, et al "Therapeutic experiences with 947 epileptic out-patients in oxcarbazepine treatment." Acta Neurol Scand 87 (1993): 224-7
  7. Steinhoff BJ, Stoll KD, Stodieck SR, Paulus W "Hyponatremic coma under oxcarbazepine therapy." Epilepsy Res 11 (1992): 67-70
View all 7 references
Moderate

Eslicarbazepine (applies to eslicarbazepine) thyroid function tests

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Thyroid Disease

Dose-dependant decreases in thyroid function tests (serum T3 and T4) have been observed in patients taking eslicarbazepine. These changes were not associated with other abnormal thyroid function tests suggesting hypothyroidism. Abnormal thyroid function should be evaluated and clinicians should be cognizant of these effects when prescribing or administering eslicarbazepine therapy to patients with thyroid disorders.

Eslicarbazepine drug interactions

There are 477 drug interactions with eslicarbazepine

Eslicarbazepine alcohol/food interactions

There is 1 alcohol/food interaction with eslicarbazepine

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.