Cisplatin Injection and Carbamazepine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Carbamazepine
Cisplatin Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced carBAMazepine exposure
Interaction Deep Dive
Concomitant administration of carBAMazepine (a CYP3A substrate) with CISplatin (a CYP3A inducer) may reduce carBAMazepine exposure. If coadministering, closely monitor carBAMazepine levels and adjust the carBAMazepine dosage as needed234. A 36-year old epileptic female undergoing antineoplastic therapy with DOXOrubicin and CISplatin experienced subtherapeutic carBAMazepine and valproic acid concentrations which resulted in tonic-clonic seizures. Although the exact mechanism is unknown, possible causes include decreased absorption or accelerated elimination of carBAMazepine 1.
Why it happens (mechanism)
Induction of CYP3A-mediated metabolism of carBAMazepine
Literature reports
1 report — tap to read
a) A 36-year old female epileptic patient requiring CISplatin and DOXOrubicin therapy for papillary adenocarcinoma experienced tonic-clonic seizures after two days of antineoplastic treatment. Plasma concentrations of carBAMazepine, valproic acid, and phenytoin were all determined to be subtherapeutic (0.5 mg/L, 24.3 mg/L, and 0.3 mg/L, respectively). One month later, she was controlled on phenytoin 450 mg daily, carBAMazepine 1200 mg daily, and valproic acid 1200 mg daily. During her second course of CISplatin and DOXOrubicin, she again suffered a tonic-clonic seizure. Plasma concentrations of her anticonvulsants were phenytoin 0.2 mg/L, carBAMazepine 3.5 mg/L, and valproic acid 34.1 mg/L. Three days following her chemotherapy, plasma concentrations of the anticonvulsants had returned to their previous values. During her sixth and final chemotherapy course, carBAMazepine levels remained low (1.4 mg/L) but stable during all 15 days of the course 1.
Common questions
Can I take Cisplatin Injection and Carbamazepine together?
Reduced carBAMazepine exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Cisplatin Injection and Carbamazepine interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Cisplatin Injection or Carbamazepine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (4)
- Neef C & de Voogd-van der Straaten I: An interaction between cytostatic and anticonvulsant drugs. Clin Pharmacol Ther 1988; 43:372-375. PubMed
- Product Information: Tegretol(R)-XR oral extended-release tablets, carbamazepine oral extended-release tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
- Product Information: Tegretol(R) oral chewable tablets, oral tablets, oral suspension, carbamazepine oral chewable tablets, oral tablets, oral suspension. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
- Product Information: CARBATROL(R) oral extended-release capsules, carbamazepine oral extended-release capsules. Takeda Pharmaceuticals America Inc (per FDA), Lexington, MA, 2023. DailyMed
Keep reading about Carbamazepine
Keep reading about Cisplatin Injection
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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