Drug Interaction Report

Nevirapine and Carbamazepine: Interaction Details

A pharmacist-reviewed analysis of the Nevirapine and Carbamazepine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Nevirapine

Viramune Viramune® Viramune® XR
+

Carbamazepine

Carbatrol Epitol Equetro Tegretol
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 163 documented Nevirapine interactions, 132 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Reduced nevirapine exposure and reduced carBAMazepine exposure

Interaction Deep Dive

Use caution with concomitant administration of carBAMazepine (a CYP3A substrate and CYP2B6 inducer) with nevirapine (a CYP3A inducer and CYP2B6 substrate), as it may reduce carBAMazepine and nevirapine exposure12. If coadministering, closely monitor carBAMazepine and nevirapine levels and adjust the dosage as needed 34. Monitor virologic response of carBAMazepine 12.

Why it happens (mechanism)

Induction of CYP2B6-mediated metabolism of nevirapine; induction of CYP3A-mediated metabolism of carBAMazepine

Common questions

Can I take Nevirapine and Carbamazepine together?

Reduced nevirapine exposure and reduced carBAMazepine exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Nevirapine and Carbamazepine interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

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 Nevirapine 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 a safer alternative to one of these medications for me?

References (4)

  1. Product Information: VIRAMUNE(R) oral suspension, nevirapine oral suspension. Boehringer Ingelheim Pharmaceuticals Inc (per FDA), Ridgefield, CT, 2024. DailyMed
  2. Product Information: VIRAMUNE XR(R) oral extended-release tablets, nevirapine oral extended-release tablets. Boehringer Ingelheim Pharmaceuticals Inc (per FDA), Ridgefield, CT, 2024. DailyMed
  3. Product Information: Tegretol(R)-XR oral extended-release tablets, carbamazepine oral extended-release tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
  4. 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
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Nevirapine

Keep reading about Nevirapine

All Nevirapine interactions (163) Nevirapine drug information
Also serious with: Atazanavir Cobicistat Dasabuvir Ensitrelvir
Carbamazepine

Keep reading about Carbamazepine

All Carbamazepine interactions (256)
Also serious with: Lurasidone Linezolid Injection Doravirine Lenacapavir Oral
Beyond drug–drug

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:

Nevirapine + Activated Charcoal Beer Grapefruit Siberian Cocklebur St. John's Wort Wine Acacia Rigidula Adrafinil + 172 more
Carbamazepine + 1,4-butanediol Activated Charcoal Asarabacca Beer Gamma-hydroxybutyrate (ghb) Grapefruit Kava L-tryptophan + 276 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.