Interactions

Drug-Drug

• May ↑ metabolism of and therefore ↓ levels/ effectiveness of corticosteroids , doxycycline , felbamate , quinidine , warfarin , estrogen-containing contraceptives , barbiturates , cyclosporine , benzodiazepines , theophylline , lamotrigine , phenytoin , topiramate , valproic acid , bupropion , and haloperidol

• Danazol ↑ blood levels (avoid concurrent use if possible)

• Concurrent use (within 2 wk) of MAO inhibitors may result in hyperpyrexia, hypertension, seizures, and death

• Verapamil , diltiazem , propoxyphene , itraconazole , ketoconazole , erythromycin , clarithromycin , SSRIs , antidepressants , or cimetidine may inhibit the hepatic metabolism or carbamazepine and ↑ levels; may cause toxicity

• Enzyme inducers such as rifampin , phenobarbital , phenytoin , primidone , and methosuximide may ↓ serum concentration of carbamazepine

• May ↑ risk of hepatotoxicity from isoniazid

• Felbamate ↓ carbamazepine levels but ↑ levels of active metabolite

• May ↓ effectiveness and ↑ risk of toxicity from acetaminophen

• May ↑ risk of CNS toxicity from lithium

• May ↓ duration of action of nondepolarizing neuromuscular blocking agents

Drug-Food
Grapefruit juice↑ serum levels and oral bioavailability by 40% and therefore may ↑ effects

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