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Drug Interactions between Carbatrol and tretinoin

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

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Interactions between your drugs

Major

carBAMazepine tretinoin

Applies to: Carbatrol (carbamazepine) and tretinoin

GENERALLY AVOID: Concomitant use of strong CYP450 3A4 inducers with tretinoin (systemic) may decrease the plasma concentration of tretinoin, which is a CYP450 3A4 substrate. Reduced efficacy of tretinoin may occur. Studies document the interaction between endogenous retinoids and CYP450 3A4 inducers (e.g., carbamazepine, phenytoin, phenobarbital) showing decreased concentration of the retinoids and reduced efficacy. While clinical data specific to tretinoin are not available, similar effects may occur.

MANAGEMENT: The manufacturer recommends avoiding concomitant use of tretinoin with strong CYP450 3A4 inducers due to a potentially significant reduction in its efficacy.

References (8)
  1. (2023) "Product Information. Jamp Tretinoin (tretinoin)." Jamp Pharma Corporation
  2. (2023) "Product Information. Vesanoid (tretinoin)." Neon Healthcare Ltd
  3. fex g, larsson k, andersson a, Berggren-Soderlund M (1995) "Low serum concentration of all-trans and 13-cis retinoic acids in patients treated with phenytoin, carbamazepine and valproate. Possible relation to teratogenicity" Arch Toxicol, 69, p. 572-74
  4. nau h, tzimas g, mondry m, plum c, spohr hl (1995) "Antiepileptic drugs alter endogenous retinoid concentrations: a possible mechanism of teratogenesis of anticonvulsant therapy" Life Sci, 57, p. 53-60
  5. (2024) "Product Information. Vesanoid (tretinoin)." H2-Pharma LLC
  6. (2024) "Product Information. Vesanoid (tretinoin)." Pharmaco Australia Ltd
  7. (2022) "Product Information. Vesanoid (tretinoin)." Xediton Pharmaceuticals Inc
  8. (2023) "Product Information. VESANOID (tretinoína)." CHEPLAPHARM ARZNEIMITTEL GMBH

Drug and food interactions

Moderate

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 (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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