Document made available to the pharmacist to communicate a drug interaction to the doctor.DOWNLOAD
Carbamazepine may induce CYP 3A4 and P-gp and decrease the plasma concentration of Glecaprevir / Pibrentasvir.
P-gp and BCRP; OATP1B1/3 (glecaprevir)
P-gp, BCRP, OATP1B1/3; 3A4, 1A2 and UGT 1A1 (weak probably without clinical consequences)
Possible decrease of clinical efficacy.
3A4 (main), 2C8, 1A2; Active metabolite: epoxide hydrolase (CBZ-10,11- epoxide)
3A4 (potent), 2C9, 2C19, P-gp, UGT and possibly 1A2
Gabapentin, pregabalin, levetiracetam, brivaracetam, or valproic acid
|- 66%/- 51%|
|- 67%/- 50%|
Ref #3373 : No significant changes in carbamazepine concentrations.
Ref #3524 : Case report of five patients who received standard doses for the treatment of chronic hepatitis C infection while being maintained on first generation anticonvulsants (carbamazepine, phenobarbital, phenytoin). Four patients were treated with glecaprevir/pibrentasvir for 8 weeks and one patient with ledipasvir/sofosbuvir for 12 weeks. All five patients achieved a sustained virologic response (SVR) despite this drug interaction. The authors conclude that all efforts to prevent concomitant use with strong inducers should be made.