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J Clin Pharm Ther. 2015 Aug;40(4):480-2. doi: 10.1111/jcpt.12286. Epub 2015 May 26.

Multiple inductive effects of carbamazepine on combined therapy with paliperidone and amlodipine.

Author information

1
Department of Pharmacy, Akita University Hospital, Akita, Japan.
2
Department of Hospital Pharmacy, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
3
Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan.
4
Department of Pharmacy, Zikeikai-Aoimori Hospital, Aomori, Japan.

Abstract

WHAT IS KNOWN AND OBJECTIVE:

Carbamazepine is a potent inducer of cytochrome P450 3A and P-glycoprotein. However, there are no reports of the effects of carbamazepine on more than one co-administered drug.

CASE SUMMARY:

A 53-year-old female patient with schizophrenia and hypertension was on paliperidone 12 mg/day and amlodipine 5 mg/day. When carbamazepine was added to this prescription, the plasma concentrations of both drugs decreased dramatically in a dose-dependent manner. Although the patient's psychotic symptoms did not change, as a result, her mean blood pressure increased to 160·1/103·6 mmHg from 138·4/91·4 mmHg at a carbamazepine dose of 600 mg/day.

WHAT IS NEW AND CONCLUSION:

Theses cases show the effect of carbamazepine induction on two drugs simultaneously. Care is required when carbamazepine is added to drug regimens including paliperidone or amlodipine alone or together.

KEYWORDS:

CYP3A; P-glycoprotein; carbamazepine; pharmacodynamics; pharmacokinetics

PMID:
26009790
DOI:
10.1111/jcpt.12286
[Indexed for MEDLINE]

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