ramelteon by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.rapacuroniumcarbamazepine decreases effects of rapacuronium by pharmacodynamic antagonism. Minor/Significance Unknown.riluzolecarbamazepine will decrease the level or effect of riluzole by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.rocuroniumcarbamazepine decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.sagesage decreases effects of carbamazepine by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction; some species of sage may cause convulsions.serdexmethylphenidate/dexmethylphenidateserdexmethylphenidate/dexmethylphenidate increases effects of carbamazepine by decreasing metabolism. Minor/Significance Unknown.sertralinesertraline increases levels of carbamazepine by decreasing metabolism. Minor/Significance Unknown.succinylcholinecarbamazepine decreases effects of succinylcholine by pharmacodynamic antagonism. Minor/Significance Unknown.sulfamethoxazolecarbamazepine will decrease the level or effect of sulfamethoxazole by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.thyroid desiccatedcarbamazepine decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.tiagabinecarbamazepine decreases levels of tiagabine by increasing metabolism. Minor/Significance Unknown.tibolonecarbamazepine decreases levels of tibolone by increasing metabolism. Minor/Significance Unknown. Theoretical interaction.tolbutamidecarbamazepine will decrease the level or effect of tolbutamide by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.trazodonecarbamazepine decreases levels of trazodone by increasing metabolism. Minor/Significance Unknown.trimipraminecarbamazepine decreases levels of trimipramine by increasing metabolism. Minor/Significance Unknown.vasopressincarbamazepine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.vecuroniumcarbamazepine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.abametapirSerious - Use Alternative (1)abametapir will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.abemaciclibSerious - Use Alternative (1)carbamazepine will decrease the level or effect of abemaciclib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of abemaciclib with strong CYP3A4 inducers reduces plasma concentration of abemaciclib and its metabolites.abirateroneMonitor Closely (1)carbamazepine decreases levels of abiraterone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Avoid coadministration of abiraterone with strong CYP3A4 inducers; if a strong CYP3A4 inducer must be used, increase abiraterone dosage frequency from once daily to twice daily.abrocitinibSerious - Use Alternative (1)carbamazepine will decrease the level or effect of abrocitinib by increasing metabolism. Avoid or Use Alternate Drug. Abrocitinib is a CYP2C9 and CYP2C19 substrate. Drugs that are strong inducers of CYP2C19 or CYP2C9 decreases the combined exposure of abrocitinib and its active metabolites, resulting in loss of or reduced clinical response.acalabrutinibSerious - Use Alternative (1)carbamazepine will decrease the level or effect of acalabrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of acalabrutinib with strong CYP3A inducers. If a strong CYP3A inducer must be used, increase acalabrutinib dose to 200 mg twice daily.acetaminophenMinor (1)carbamazepine decreases levels of acetaminophen by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.acetaminophen IVMinor (1)carbamazepine decreases levels of acetaminophen IV by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.acetaminophen rectalMinor (1)carbamazepine decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.acetazolamideMinor (1)acetazolamide will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.adagrasibSerious - Use Alternative (2)carbamazepine will decrease the level or effect of adagrasib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. adagrasib will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of adagrasib, a CYP3A4 inhibitor, with sensitive CYP3A substrates unless otherwise recommended in the prescribing information for these substrates.afatinibSerious - Use Alternative (1)carbamazepine decreases levels of afatinib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Increase afatinib daily dose by 10 mg as tolerated if chronic therapy with P-gp inducer required; resume previous afatinib dose 2-3 days after P-gp inducer discontinued.alfentanilMonitor Closely (1)carbamazepine will decrease the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.alfuzosinMonitor Closely (1)carbamazepine will decrease the level or effect of alfuzosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.almotriptanSerious - Use Alternative (1)carbamazepine will decrease the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.alosetronMonitor Closely (1)carbamazepine will decrease the level or effect of alosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)carbamazepine will decrease the level or effect of alosetron by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.Minor (1)carbamazepine will decrease the level or effect of alosetron by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.alpelisibSerious - Use Alternative (1)carbamazepine will decrease the level or effect of alpelisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of alpelisib (CYP3A4 substrate) with strong CYP3A4 inducers.alprazolamSerious - Use Alternative (1)carbamazepine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.ambrisentanMinor (1)carbamazepine will decrease the level or effect of ambrisentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.amiodaroneSerious - Use Alternative (1)carbamazepine will decrease the level or effect of amiodarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.amitriptylineMonitor Closely (1)carbamazepine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)carbamazepine decreases levels of amitriptyline by increasing metabolism. Minor/Significance Unknown.amlodipineMonitor Closely (1)carbamazepine will decrease the level or effect of amlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.amobarbitalMonitor Closely (1)amobarbital will decrease the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.amoxapineMinor (1)carbamazepine decreases levels of amoxapine by increasing metabolism. Minor/Significance Unknown.anastrozoleMinor (1)anastrozole will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.antipyrineMinor (1)carbamazepine will decrease the level or effect of antipyrine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.antithrombin alfaMonitor Closely (1)carbamazepine decreases levels of antithrombin alfa by increasing metabolism. Use Caution/Monitor.antithrombin IIIMonitor Closely (1)carbamazepine decreases levels of antithrombin III by increasing metabolism. Use Caution/Monitor.apalutamideMonitor Closely (1)carbamazepine will decrease the level or effect of apalutamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No initial dose adjustmentSerious - Use Alternative (1)apalutamide will decrease the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.apixabanContraindicated (1)carbamazepine will decrease the level or effect of apixaban by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Reduces anticoagulant effect by decreasing apixaban systemic exposure apremilastSerious - Use Alternative (1)carbamazepine will decrease the level or effect of apremilast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration with strong CYP inducers results in a significant decrease of systemic exposure of apremilast, which may result in loss of efficacyaprepitantMonitor Closely (1)aprepitant will increase the level or effect of carbamazepine by decreasing metabolism. Modify Therapy/Monitor Closely. Monitor plasma levels when used concomitantlySerious - Use Alternative (1)carbamazepine will decrease the level or effect of aprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.argatrobanMonitor Closely (1)carbamazepine decreases levels of argatroban by increasing metabolism. Use Caution/Monitor.aripiprazoleSerious - Use Alternative (1)carbamazepine will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If carbamazepine is started in a patient already taking aripiprazole, the aripiprazole dose should be doubled; reduce aripiprazole dose if carbamazepine is discontinuedarmodafinilMonitor Closely (2)armodafinil will decrease the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. carbamazepine will decrease the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.artemether/lumefantrineContraindicated (1)carbamazepine will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacyMonitor Closely (1)artemether/lumefantrine will decrease the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.artesunateMonitor Closely (1)carbamazepine will decrease the level or effect of artesunate by increasing metabolism. Use Caution/Monitor. Coadministration may decrease AUC and peak plasma concentration of active artesunate metabolite (DHA) by inducing UGT. Monitor for decreased efficacy.asenapineMinor (1)carbamazepine will decrease the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.atazanavirContraindicated (1)carbamazepine will decrease the level or effect of atazanavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.Monitor Closely (1)atazanavir will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor plasma levels when used concomitantlyatogepantMonitor Closely (1)carbamazepine will decrease the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Recommended atogepant dosage with concomitant use of strong or moderate CYP3A4 inducers is 30 mg or 60 mg qDay.atorvastatinMonitor Closely (1)carbamazepine increases toxicity of atorvastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.Serious - Use Alternative (1)carbamazepine will decrease the level or effect of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.atracuriumMinor (1)carbamazepine decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.avanafilMonitor Closely (1)carbamazepine will decrease the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. For patients with ED, monitor response carefully because of potential for decreased effectivenessavapritinibSerious - Use Alternative (1)carbamazepine will decrease the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.avatrombopagMonitor Closely (1)carbamazepine will decrease the level or effect of avatrombopag by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. When treating ITP, coadministration of avatrombopag with a moderate or strong dual CYP2C9/3A4 inducer requires an increased avatrombopag starting dose. Refer to drug monograph for specific recommendations.axitinibSerious - Use Alternative (1)carbamazepine decreases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Selection of concomitant medication with no or minimal CYP3A4 induction potential is recommended.bazedoxifene/conjugated estrogensMonitor Closely (1)carbamazepine decreases levels of bazedoxifene/conjugated estrogens by increasing metabolism. Use Caution/Monitor. A reduction in bazedoxifene exposure may be associated with an increase risk of endometrial hyperplasia.Serious - Use Alternative (1)carbamazepine will decrease the level or effect of bazedoxifene/conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.bedaquilineSerious - Use Alternative (1)carbamazepine will decrease the level or effect of bedaquiline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of bedaquiline with strong CYP3A4 inducers due to potential for decreased therapeutic effectbelumosudilMonitor Closely (1)carbamazepine will decrease the level or effect of belumosudil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase belumosudil dosage to 200 mg PO BID when coadministered with strong CYP3A inducers.belzutifanMonitor Closely (1)belzutifan will decrease the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. bemiparinMonitor Closely (1)carbamazepine decreases levels of bemiparin by increasing metabolism. Use Caution/Monitor.bendamustineMonitor Closely (1)carbamazepine decreases levels of bendamustine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Concentrations of active metabolites may be increased.benzhydrocodone/acetaminophenMonitor Closely (1)carbamazepine will decrease the level or effect of benzhydrocodone/acetaminophen by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Caution when discontinuing CYP3A4 inducers that are coadministered with benzhydrocodone (prodrug of hydrocodone); plasma concentrations of hydrocodone may increase and can result in potentially fatal respiratory depression.benzphetamineMonitor Closely (1)carbamazepine will decrease the level or effect of benzphetamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.berotralstatMonitor Closely (1)berotralstat will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor or titrate substrate dose when berotralstat is coadministered with narrow therapeutic index drugs that are CYP3A substrates.Serious - Use Alternative (1)carbamazepine decreases levels of berotralstat by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.bexagliflozinMonitor Closely (1)carbamazepine will decrease the level or effect of bexagliflozin by Other (see comment). Modify Therapy/Monitor Closely. Bexagliflozin is a major substrate of UGT1A9. If coadministered with a UGT1A9 inducer, consider adding another antihyperglycemic agent in patients requiring additional glycemic control. bexaroteneMonitor Closely (1)carbamazepine will decrease the level or effect of bexarotene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.bictegravirSerious - Use Alternative (1)carbamazepine will decrease the level or effect of bictegravir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of strong CYP3A and UGT1A1 inducers can substantially decrease bictegravir plasma concentrations. This may result in the loss of therapeutic effect and development of resistance to bictegravir. Coadministration with another anticonvulsant should be considered.biotinMinor (1)carbamazepine decreases levels of biotin by unspecified interaction