This article describes possible interactions with carbamazepine oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.
Carbamazepine comes as tablets that you swallow. It’s also available as a liquid suspension that’s swallowed, a tablet that’s chewed, and an extended-release tablet and capsule that are swallowed. (“Extended release” means the drug is slowly released into your body over a long period of time.) Interactions of carbamazepine may vary depending on the form of carbamazepine you’re prescribed.
Boxed warnings
This drug has boxed warnings about the risks of serious skin reactions and serious low blood cell levels. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
See the end of this article for more information about these warnings.
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Other drugs and carbamazepine
The drugs in the list below may interact with carbamazepine oral tablet. This article doesn’t include all medications that interact with carbamazepine.
Drug classes or drugs that may interact with carbamazepine oral tablet include:
- certain HIV medications:
- drug examples: ritonavir (Norvir), atazanavir (Reyataz)
- what might happen: can increase the risk of side effects of carbamazepine
- certain pain relievers:
- drug examples: oxycodone (Oxycontin, others), acetaminophen (Tylenol)
- what might happen: can make certain pain relievers less effective than usual or increase the risk of side effects of certain pain relievers
- certain antibiotics:
- drug examples: ciprofloxacin (Cipro), clarithromycin
- what might happen: can increase the risk of side effects of carbamazepine
- certain anti-nausea medications:
- drug examples: aprepitant (Emend, others)
- what might happen: can increase the risk of side effects of carbamazepine
- certain heart drugs:
- certain seizure medications:
- drug examples: phenytoin (Dilantin), phenobarbital
- what might happen: can make carbamazepine less effective
- certain mental health drugs:
- drug examples: fluoxetine (Prozac), fluvoxamine
- what might happen: can increase the risk of side effects of carbamazepine
- certain cancer drugs:
- drug examples: cisplatin, doxorubicin
- what might happen: can make carbamazepine less effective
- blood thinners:
- omeprazole (Prilosec)
- what might happen: can increase the risk of side effects of carbamazepine
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Get free cardWhen to avoid carbamazepine
Certain health conditions or other factors could increase some risks with carbamazepine oral tablet. Because of this, doctors may not prescribe carbamazepine in these cases. These health conditions or other factors are called contraindications.
Here’s a list of carbamazepine contraindications:
- History of bone marrow depression. If you have a history of bone marrow depression, taking carbamazepine oral tablet may worsen your symptoms of bone marrow depression.
- Sensitivity to tricyclic medications. If you’ve had a reaction to a tricyclic medication, such as amitriptyline or nortriptyline (Pamelor), taking carbamazepine oral tablet may cause another reaction.
- Use of monoamine oxidase inhibitors (MAOIs). If you’ve taken an MAOI drug in the last 14 days, taking carbamazepine oral tablet may increase the risk of serious side effects, including serotonin syndrome.
- Use of nefazodone. If you take nefazodone, taking carbamazepine oral tablet may make nefazodone less effective.
- Past allergic reaction to carbamazepine. If you’ve ever had an allergic reaction to carbamazepine oral tablet, taking it again may cause another allergic reaction.
Before you start taking carbamazepine, tell your doctor if anything listed above relates to you. They can recommend whether you should take carbamazepine.
Alcohol and carbamazepine
Carbamazepine oral tablet is known to interact with alcohol.
Taking carbamazepine oral tablet and drinking alcohol may increase your risk of drowsiness and dizziness.
Talk with your doctor if you have additional questions about carbamazepine interactions with alcohol.
Other interactions and carbamazepine
Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether carbamazepine oral tablet has these interactions.
The information below doesn’t include all other possible interactions with carbamazepine.
Carbamazepine and supplements
Before taking carbamazepine oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
Carbamazepine oral tablet may interact with melatonin supplements. Melatonin is a dietary supplement that’s often used to help with sleep problems. In some cases, combining carbamazepine and melatonin can lead to more drowsiness and dizziness. It may also decrease the effectiveness of melatonin.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Carbamazepine interactions with herbs
Carbamazepine oral tablet may interact with St. John’s Wort. This herb is often used for depression symptoms. But taking carbamazepine and St. John’s Wort may reduce the effectiveness of carbamazepine. This can lead to unmanaged seizures or nerve pain.
Because of this, ask your doctor or pharmacist before taking any of these products while taking carbamazepine oral tablet.
Carbamazepine interactions with vitamins
Carbamazepine oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before taking any of these products while taking carbamazepine oral tablet.
Carbamazepine and food
Carbamazepine oral tablet may interact with caffeine. Caffeine is found in some foods and drinks, including coffee, certain teas, sodas, and chocolate. Combining caffeine and carbamazepine may lower the effects of caffeine.
Carbamazepine oral tablet may also interact with grapefruit and grapefruit juice. Consuming grapefruit or grapefruit juice with carbamazepine can raise the risk of side effects of carbamazepine.
Because of this, talk with your doctor or pharmacist about what foods you should avoid while taking carbamazepine oral tablet.
Carbamazepine and vaccines
Carbamazepine oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking carbamazepine oral tablet.
Carbamazepine and lab tests
Carbamazepine oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before having any tests while taking carbamazepine oral tablet.
Carbamazepine and cannabis or CBD
Studies of cannabis (commonly called marijuana) and cannabis products have been shown to interact with carbamazepine. Cannabidiol (CBD) is an example of a cannabis product.
Taking carbamazepine and cannabis may lead to decreased or altered effects of cannabis.
Before you take carbamazepine, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Health factors and carbamazepine
Certain medical conditions or other health factors may increase the risk of interactions with carbamazepine oral tablet. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking Carbamazepine, tell your doctor about your health history. They’ll determine whether carbamazepine is right for you.
These health conditions or other factors might interact with carbamazepine oral tablet:
- history of bone marrow depression*
- use of nefazodone*
- past sensitivity or allergic reaction to tricyclic antidepressants*
- Asian ancestry
- history of suicidal thoughts or behaviors
- history of depression
- history of hepatic porphyria (a rare inherited blood disorder caused by liver problems)
- history of increased intraocular pressure
- liver problems
- heart disease
- age 65 years or older
- pregnancy or breastfeeding
- past allergic reaction to carbamazepine*
* For more details about this health condition or factor, see the “When to avoid carbamazepine” section.
Suicide prevention
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
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- Text HOME to the Crisis Text Line at 741741.
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- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Questions about carbamazepine and interactions
Here you’ll find answers to some common questions about carbamazepine and possible interactions.
Does Tegretol, carbamazepine’s brand-name version, interact with any supplements?
Yes, carbamazepine oral tablet and Tegretol may interact with melatonin supplements and St. John’s Wort. Combining Tegretol and melatonin can lead to more drowsiness, dizziness, or decreased effectiveness of melatonin. Taking Tegretol and St. John’s Wort may reduce the effectiveness of Tegretol.
Tegretol is a brand-name drug. Its generic version is carbamazepine. A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs.
If you have more questions about Tegretol interactions with supplements, talk with your doctor or pharmacist.
What painkillers can I take with carbamazepine?
It depends. Certain pain relievers may interact with carbamazepine oral tablet. These may include oxycodone (Oxycontin, others), ibuprofen (Advil, others), and acetaminophen (Tylenol). But in some cases, it may still be safe to combine carbamazepine oral tablet with these pain relievers if the appropriate dosage adjustment is made.
Talk with your doctor to determine which pain relievers are safe for you to take with carbamazepine. They can discuss treatment options and determine whether you’ll need to adjust the doses of your medications.
Preventing carbamazepine interactions
You may be able to help avoid certain interactions with carbamazepine oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you’re prescribed a new drug while taking carbamazepine oral tablet.
Taking carbamazepine exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about carbamazepine and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Do I need to take carbamazepine at a different time than my other medications?
- Is it still safe to take carbamazepine if I drink coffee?
- Do other drugs used for my condition have similar interactions?
Boxed warnings for carbamazepine
This drug has boxed warnings about the risks of serious skin reactions and serious low blood cell levels. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
Serious skin reactions. Carbamazepine can cause serious and life threatening skin reactions. Examples include toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). These skin reactions can cause severe damage to your skin and organs. Symptoms can include skin rash, hives, sores in your mouth, or blistering and peeling of your skin. The risk may be higher if you have Asian ancestry and certain genetic risk factors.
Due to this risk, if you’re of Asian descent, doctors may order a genetic blood test before prescribing carbamazepine oral tablet. If you experience any of the above symptoms, contact your doctor right away.
Serious low blood cell levels. Carbamazepine oral tablet can significantly lower your platelet or white blood cell levels. This can put you at higher risk of serious infections, unusual bleeding, and severe fatigue. You may experience symptoms such as:
- fever
- sore throat
- easy bruising
- red or purple spots on your body
- bleeding gums
- nosebleeds
- severe fatigue or weakness
If you notice any of these symptoms, call your doctor right away.
To learn more, talk with your doctor.
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.