Carbamazepine with Aripiprazole Lauroxil Interaction Details
Brand Names Associated with Carbamazepine
- Carbamazepine
- Carbatrol®
- Epitol®
- Equetro®
- Tegretol®
- Tegretol®-XR
- Teril®
Brand Names Associated with Aripiprazole Lauroxil
- Abilify Mycite®
- Abilify®
- Aripiprazole
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 25, 2023
Interaction Effect
Decreased aripiprazole exposure
Interaction Summary
Aripiprazole lauroxil is a prodrug of aripiprazole and aripiprazole is a CYP3A4 substrate. Coadministration of aripiprazole lauroxil and a CYP3A4 inducer may result in decreased aripiprazole exposure and decreased efficacy. If coadministration with Aristada(R) for more than 2 weeks is required, increase the Aristada(R) dosage for patients receiving 441 mg IM monthly to 662 mg monthly. No adjustment of Aristada(R) is required for other dosages. Avoid the concomitant use of Aristada Initio(TM) and strong CYP3A4 inducers because the dosage of Aristada Initio(TM) cannot be modified .
Severity
Moderate
Onset
Unspecified
Evidence
Probable
How To Manage Interaction
Coadministration of aripiprazole lauroxil and a CYP3A4 inducer for longer than 2 weeks may result in decreased aripiprazole exposure and reduced efficacy. If coadministration with Aristada(R) for more than 2 weeks is required, increase the Aristada(R) dosage for patients receiving 441 mg IM monthly to 662 mg monthly. No adjustment of Aristada(R) is required for other dosages. Avoid the concomitant use of Aristada Initio(TM) and strong CYP3A4 inducers because the dosage of Aristada Initio(TM) cannot be modified .
Mechanism Of Interaction
Induction of CYP3A4-mediated metabolism of aripiprazole
Literature Reports
A) During drug interaction studies, coadministration of aripiprazole 30 mg/day and carbamazepine 200 mg twice daily resulted in a 70% decrease in the AUC and Cmax of both aripiprazole and its active metabolite .
B) The addition of carbamazepine 200 mg twice daily to steady-state aripiprazole (12 or 24 mg orally for 3 to 5 weeks) decreased plasma concentrations of aripiprazole and its active metabolite, dehydro-aripiprazole by 64% and 68% in a pharmacokinetic study (N=18, in patients with schizophrenia. The mean carbamazepine plasma concentration achieved was 9.3 mcg/mL The concentration ratio of aripiprazole to dehydro-aripiprazole did not change during the study .
Carbamazepine Overview
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Carbamazepine is used alone or in combination with other medications to control certain types of seizures in people with epilepsy. It is also used to treat trigeminal neuralgia (a condition that causes facial nerve pain). Carbamazepine extended-release capsules (Equetro brand only) are also used to treat episodes of mania (frenzied, abnormally excited or irritated mood) or mixed episodes (symptoms of mania and depression that happen at the same time) in patients with bipolar I disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Carbamazepine is in a class of medications called anticonvulsants. It works by reducing abnormal electrical activity in the brain.
Aripiprazole Lauroxil Overview
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Aripiprazole is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) in adults and teenagers 13 years of age and older. It is also used alone or with other medications to treat episodes of mania or mixed episodes (symptoms of mania and depression that happen together) in adults, teenagers, and children 10 years of age and older with bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Aripiprazole is also used with an antidepressant to treat depression when symptoms cannot be controlled by the antidepressant alone. Aripiprazole is also used to treat children 6 to 17 years of age who have autistic disorder (a developmental problem that causes difficulty communicating and interacting with others). Aripiprazole may help control irritable behavior such as aggression, temper tantrums, and frequent mood changes in these children. Aripiprazole is also used to treat children 6 to 18 years of age who have Tourette's disorder (a condition characterized by the need to perform repeated motions or to repeat sounds or words). Aripiprazole is in a class of medications called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.