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Can you take Carbamazepine with Clobazam?

1 drug interaction and 27 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

carBAMazepine cloBAZam

Applies to: carbamazepine and clobazam

Using carBAMazepine together with cloBAZam may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

carBAMazepine Food/Lifestyle

Applies to: carbamazepine

You should preferably avoid the regular consumption of grapefruits and grapefruit juice while taking carBAMazepine. This can cause carBAMazepine levels to increase. You should report signs of carBAMazepine side effects such as nausea, visual disturbances, dizziness, or muscle weakness to your doctor. You should avoid or limit the use of alcohol while being treated with carBAMazepine. Alcohol can increase the nervous system side effects of carBAMazepine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate:

cloBAZam Food/Lifestyle

Applies to: clobazam

Alcohol can increase the nervous system side effects of cloBAZam such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with cloBAZam. Do not use more than the recommended dose of cloBAZam, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Disease interactions

25 potential interactions Applies to: 20 conditions, including Depression, Underactive Thyroid, Heart Failure, Seizures, and Arrhythmia.

Acute Alcohol Intoxication

Major:

clobazam

cloBAZam has a major potential interaction with Acute Alcohol Intoxication.

The use of benzodiazepines with alcohol is not recommended. Patients with acute alcohol intoxication exhibit depressed vital signs. The central nervous system depressant effects of benzodiazepines may be additive with those of alcohol, and severe respiratory depression and death may occur. Therapy with benzodiazepines should be administered cautiously in patients who might be prone to acute alcohol intake.

Adrenal Insufficiency

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Adrenal Insufficiency.

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.

Arrhythmia

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Arrhythmia.

Aromatic antiepileptic drugs such as phenytoin, carbamazepine, and oxcarbazepine, inhibit voltage- gated sodium channels and reduce membrane excitability in neurons and muscle and can be associated with cardiovascular effects. Individual agents have demonstrated AV heart block, including second and third-degree block following treatment. This occurred generally, but not solely in patients with underlying EKG abnormalities or risk factors for conduction abnormalities. Therapy with these agents should be considered and administered cautiously in patients with a history of cardiovascular disease and conduction abnormalities.

Bone Marrow Depression/Low Blood Counts

Major:

carbamazepine

carBAMazepine has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of carbamazepine has been associated with hematologic toxicities such as leukopenia, neutropenia, thrombocytopenia and, rarely, aplastic anemia and agranulocytosis. Carbamazepine should not be used in patients with history of bone marrow depression. Complete blood counts, including platelets and possibly reticulocytes and serum iron, should be performed prior to initiating therapy and regularly during therapy. Patients who exhibit decreases in blood counts at any time during treatment should be monitored more closely. Marked depression of blood counts may be indication for permanent withdrawal of carbamazepine therapy.

Cardiovascular Conditions and Disorders

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Aromatic antiepileptic drugs such as phenytoin, carbamazepine, and oxcarbazepine, inhibit voltage- gated sodium channels and reduce membrane excitability in neurons and muscle and can be associated with cardiovascular effects. Individual agents have demonstrated AV heart block, including second and third-degree block following treatment. This occurred generally, but not solely in patients with underlying EKG abnormalities or risk factors for conduction abnormalities. Therapy with these agents should be considered and administered cautiously in patients with a history of cardiovascular disease and conduction abnormalities.

Depression

Major:

carbamazepine

carBAMazepine has a major potential interaction with Depression.

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.

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Depression.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

Moderate:

clobazam

cloBAZam has a moderate potential interaction with Depression.

Benzodiazepines depress the central nervous system and may cause or exacerbate mental depression and cause suicidal behavior and ideation. Episodes of mania and hypomania have also been reported in depressed patients treated with some of these agents. Therapy with benzodiazepines should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Drug Dependence

Major:

clobazam

cloBAZam has a major potential interaction with Drug Dependence.

Benzodiazepines have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use and/or excessive dosages. However, abrupt cessation following continual use of as few as 6 weeks at therapeutic levels has occasionally precipitated withdrawal symptoms. Addiction- prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance when treated with benzodiazepines. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of benzodiazepine therapy should be undertaken gradually using a dosage- tapering schedule. If withdrawal symptoms occur, temporary reinstitution of benzodiazepines may be necessary.

Fructose Intolerance

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Fructose Intolerance.

Carbamazepine in chewable tablets and suspension contains sorbitol and should not be administered to patients with rare hereditary problems of fructose intolerance.

Glaucoma/Intraocular Hypertension

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Carbamazepine is structurally related to the tricyclic antidepressants and has shown mild anticholinergic activity. Therapy with carbamazepine should be administered cautiously in patients with conditions that may be exacerbated by anticholinergic activity, such as urinary retention or obstruction and elevated intraocular pressure, especially angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma.

Heart Failure

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Heart Failure.

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.

Hyponatremia

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Hyponatremia.

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.

Liver Disease

Major:

carbamazepine

carBAMazepine has a major potential interaction with Liver Disease.

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.

Porphyria

Major:

carbamazepine

carBAMazepine has a major potential interaction with Porphyria.

The use of carbamazepine should be avoided in patients with a history of hepatic porphyria (e.g., acute intermittent porphyria, variegate porphyria, porphyria cutanea tarda). Acute attacks have been reported in such patients receiving carbamazepine therapy.

Psychosis

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Psychosis.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Psychosis.

Carbamazepine is structurally related to the tricyclic antidepressants (TCAs). The possibility of activation of a latent psychosis or exacerbation of psychotic symptoms, especially in elderly patients, should be borne in mind.

Moderate:

clobazam

cloBAZam has a moderate potential interaction with Psychosis.

Benzodiazepines depress the central nervous system and may cause or exacerbate mental depression and cause suicidal behavior and ideation. Episodes of mania and hypomania have also been reported in depressed patients treated with some of these agents. Therapy with benzodiazepines should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Renal Dysfunction

Major:

carbamazepine

carBAMazepine has a major potential interaction with Renal Dysfunction.

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.

Moderate:

clobazam

cloBAZam has a moderate potential interaction with Renal Dysfunction.

Benzodiazepines are excreted by the kidneys and should be used with caution in patients with impaired renal function and end-stage kidney disease.

Seizures

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Seizures.

Carbamazepine should be used with caution in patients with mixed seizure disorder that includes atypical absence seizures, as in these patients it has been associated with increased frequency of generalized convulsions.

SIADH

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with 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.

Thyroid Disease

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Thyroid Disease.

Decreased values for thyroid function tests have been observed with carbamazepine administration. One study reported decreased serum levels of T4, FT4, and T3. In that study, TSH concentrations were not significantly altered. Clinicians should be cognizant of these effects when prescribing or administering carbamazepine therapy to patients with thyroid disorders.

Underactive Thyroid

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Underactive Thyroid.

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.

Urinary Retention

Moderate:

carbamazepine

carBAMazepine has a moderate potential interaction with Urinary Retention.

Carbamazepine is structurally related to the tricyclic antidepressants and has shown mild anticholinergic activity. Therapy with carbamazepine should be administered cautiously in patients with conditions that may be exacerbated by anticholinergic activity, such as urinary retention or obstruction and elevated intraocular pressure, especially angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma.

More resources

carbamazepine

A total of 851 drugs are known to interact with carbamazepine.

clobazam

A total of 537 drugs are known to interact with clobazam.

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.