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Drug Interactions between carbamazepine and remdesivir

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

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Interactions between your drugs

Moderate

carBAMazepine remdesivir

Applies to: carbamazepine and remdesivir

MONITOR: Theoretically, coadministration of remdesivir with potent inducers of CYP450 3A4 may decrease the plasma concentration of remdesivir, which has been shown in vitro to be a substrate of the isoenzyme. However, the potential for this interaction appears low as remdesivir's metabolism is predominantly mediated by hydrolysis via esterases in vivo, which are not significantly affected by CYP450 3A4. When a single dose of remdesivir (100 mg) was administered to healthy volunteers on carbamazepine (300 mg twice daily), remdesivir's peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 13% and 8%, respectively. One of remdesivir's metabolites (GS-704277) had no change in its Cmax or AUC, while its other metabolite (GS-441524) had a reduction in AUC of 17%.

MANAGEMENT: Caution and clinical monitoring may be advisable if remdesivir is administered concurrently with potent inducers of CYP450 3A4 as they may reduce its concentrations and effects. While clinically significant interactions are not expected, some authorities recommend avoiding concomitant use of remdesivir with potent CYP450 3A4 inducers.

References (4)
  1. (2023) "Product Information. Veklury (remdesivir)." Gilead Sciences Canada Inc
  2. (2024) "Product Information. Veklury (remdesivir)." Gilead Sciences Pty Ltd, 6
  3. (2024) "Product Information. Veklury (remdesivir)." Gilead Sciences Ltd
  4. (2024) "Product Information. Veklury (remdesivir)." Gilead Sciences

Drug and food interactions

Moderate

carBAMazepine food

Applies to: 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 (3)
  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

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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