Raltegravir

Carbamazepine

Not recommended association.

No pharmaceutical opinion available for this interaction.

Mechanism

Carbamazepine may induce the metabolism (UGT) and decrease the plasma concentration of Raltegravir.

Raltegravir

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Clinical significance unknown.

Recommendations

Association not recommended and more particularly with raltegravir HD 1200 mg QD.

Choose another antiretroviral therapy.

If this combination is used, increase the dose of raltegravir to 800 mg BID.

Monitor for signs and symptoms of therapeutic failure.

See comments.

Alternative solution(s)

Carbamazepine

Pharmacodynamic effects

Recommendations

If possible, consider an alternative.

Alternative solution(s)

Gabapentin, pregabalin, valproic acid, clobazam, leviracetam, topiramate, lacosamide, clonazepam or lamotrigine.

Monitor

Tests

Raltegravir plasma level

CD4+

Viral load HIV

Pharmacokinetic parameters

Comment

Ref #2152 : Coadministration has not been studied. The product monograph does not suggest dose adjustment with raltegravir and anticonvulsants. However, it suggests with rifampin (potent UGT inducer) an increase in the dose of raltegravir to 800 mg BID.
See raltegravir + rifampin.

Reference
  • 2152
    Raltegravir (Isentress, Isentress HD), Merck, Quebec, Canada, 19 septembre 2018.