No pharmaceutical opinion available for this interaction.
Carbamazepine may induce the metabolism (UGT) and decrease the plasma concentration of Raltegravir.
Possible decrease of clinical efficacy.
Clinical significance unknown.
Association not recommended and more particularly with raltegravir HD 1200 mg QD.
If this combination is used, increase the dose of raltegravir to 800 mg BID.
Monitor for signs and symptoms of therapeutic failure.
3A4 (main), 2C8, 1A2; Active metabolite: epoxide hydrolase (CBZ-10,11- epoxide)
3A4 (potent), 2C9, 2C19, P-gp, UGT and possibly 1A2
If possible, consider an alternative.
As clinically indicated : valproic acid, brivaracetam, clobazam, clonazepam, ethosuximide, gabapentin, lacosamide, lamotrigine, levetiracetam, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, vigabatrin, zonisamide.
Raltegravir plasma level
Viral load HIV
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.