CARBAMAZEPINE (Generic for TEGRETOL)

Carbamazepine 200mg, Oral tablet

Marijuana

· Severity: Moderate

· Notes for Consumers: The effects of marijuana may be decreased if combined with this medicine. Do not drive or operate machinery until you know how this combination will affect you. Contact your health care provider right away if you notice slurred speech, confusion, severe drowsiness, increased heart rate, or any other new or unusual side effects.

· Notes for Professionals: The incidence of marijuana associated adverse effects may change following coadministration with carbamazepine. Carbamazepine is an inducer of CYP2C9 and CYP3A4, two isoenzymes responsible for the metabolism of marijuana's most psychoactive compound, delta-9-tetrahydrocannabinol (Delta-9-THC). When given concurrently with carbamazepine, the amount of Delta-9-THC converted to the active metabolite 11-hydroxy-delta-9-tetrahydrocannabinol (11-OH-THC) may be increased. These changes in Delta-9-THC and 11-OH-THC plasma concentrations may result in an altered marijuana adverse event profile.

Carbamazepine 200mg, Oral tablet

Alcohol

· Severity: Moderate

· Notes for Consumers: Do not drink alcoholic beverages without talking to your healthcare provider while taking Carbamazepine. Decreased alertness, drowsiness, falls, or other side effects may occur. Do not drive or operate machinery if you are drinking alcohol-containing beverages. If you notice slurred speech, confusion, severe weakness, or difficulty breathing, contact your health care provider immediately.

· Notes for Professionals: Because of its primary CNS effect, caution should be used when carbamazepine is taken with other centrally acting drugs such as ethanol. The limited evidence from pharmacokinetic studies suggests that neither acute nor chronic ethanol use will significantly alter the pharmacokinetics of carbamazepine.

Carbamazepine 200mg, Oral tablet

Grapefruit juice

· Severity: Moderate

· Notes for Consumers: Grapefruit juice and grapefruit-containing foods may increase the effects of Carbamazepine. Do not significantly alter your intake of grapefruit juice while taking this drug.

· Notes for Professionals: Grapefruit juice has been shown to increase carbamazepine peak and trough serum concentrations and the AUC by up to 40 percent. Grapefruit juice contains a compound that inhibits CYP3A4 in enterocytes. Increased sedation or other side effects may be possible. It is recommended that patients not significantly alter their grapefruit ingestion while taking carbamazepine.

Carbamazepine 200mg, Oral tablet

Enteral Feedings

· Severity: Moderate

· Notes for Consumers: Enteral feedings may decrease the actions of Carbamazepine oral suspension. To avoid an interaction with liquid nutrition products, take Carbamazepine oral suspension at least 15 minutes before or 15 minutes after you take tube feedings or nutritional supplement beverages (examples: Ensure, Jevity, and others). Enteral feedings do not appear to interact with Carbamazepine tablets or capsules.

· Notes for Professionals: Concurrent enteral feedings appear to slow or impede the absorption of carbamazepine suspension from the GI tract. Where possible, hold continuous enteral feedings at least 15 minutes before and 15 minutes after the administration of a carbamazepine suspension dose. Flush enteral tubes with appropriate volumes of water or other compatible fluid before and after carbamazepine suspension administration.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>