Lansoprazole Carbamazepine

Deravirdine (Rescnptor) [Antiretroviral/NNRTI] Uses HIV Infxn Action Nonnucleoside RT inhibitor Dose 400 mg PO tid Caution [C, ] CDC recommends HIV-infected mothers not to breast-feed (transmission risk) w/ renal/hepatic impair Contra Use w/ drugs dependent on CYP3A for clearance (Table VI-8) Disp Tabs SE Fat redistribution, immune reconstitution synd, HA, fatigue, rash, T transaminases, N/V/D Interactions T Effects W/ fluoxetine T effects OF benzodiazepines, cisapride, clarithromycin, dapsone, ergotamine, indinavir, lovastatin, midazolam, nifedipine, quinidine, ritonavir, simvastatin, terfena-dine, triazolam, warfarin effects W/ antacids, barbiturates, carbamazepine, cimetidine, famotidine, lansoprazole, nizatidine, phenobarbital, phenytoin, ranitidine, rifabutin, rifampin effects OF didanosine EMS Use of benzodiazepines and CCBs should be avoided may cause a widespread rash located on upper body and arms OD May cause an extension of nl SEs symptomatic and supportive Deferasirox (Exjade) [Iron Chelator] Uses Chronic iron overload d/t transfusion in pts >2 y Action Oral iron chelator Dose Initial 20 mg/kg... 

Transporter efflux transporter effects predominant Examples Amiodarone Atorvastatin Azithromycin Carbamazepine Carvediioi Chlorpromazine Ciprofloxacin Cisapride Cyciosporine Danazoi Dapsone Diclofenac Diflunisal Digoxin Erythromycin Flurbiprofen Glipizide Glyburide Griseofulvin Ibuprofen Indinavir Indomethacin Itraconazole Ketoconazole Lansoprazole Lovastatin Mebendazole Naproxen Nelfinavir Ofloxacin Oxaprozin Phenazopyridine Phenytoin Piroxicam Raloxifene Ritonavir Saquinavir Saquinavir Sirolimus Sirolimus Spironolactone Spironolactone Tacrolimus Tacrolimus ... 

Acetaminophen, aldrin, alfentanil, amiodarone, aminopyrine, amitriptyline, amprenavir, androstenedione,antipyrine, astemizole, benzphetamine, budesonide, carbamazepine, celecoxib, chlorpromazine, chlorzoxazone, cisapride, clarithromycin, clozapine, cocaine, codeine, cortisol, cyclophosphamide,cyclosporin, dapsone, delavirdine, dextromethorphan, digitoxin, diltiazem, diazepam, erythromycin, 17j3-estradiol, ethinylestradiol, etoposide, felbamate, fentanyl, flutamide, hydroxyarginine, ifosphamide, imipramine, indinavir, ketoconazole, lansoprazole, loratidine, losartan, lovastatin, (iS)"mephen3d in, methadone, mianserin, miconazole, mifepristone, nelfinavir, nevirapine, nicardipine, nifedipine, odansetron, omeprazole, orphenadrine, proguanil, propafenone, quinidine, quinine, rapamycin, retinoic acid, ritonavir, saquinavir, selegiline, serindole, sufentanil, sulfinpyrazone, tacrolimus, tamoxifen, tamsulosin, taxol, teniposide, terfenadine, tetrahydrocannabinol, theophylline, toremifene, triazolam, trimethadone, trimethoprim, troleandomycin, verapamil, warfarin, zatosetron, Zolpidem, zonisamide... 

Omeprazole markedly raised the levels of a single dose of carbamazepine, but had no significant effect on carbamazepine taken long-term. Some anecdotal reports surest that carbamazepine serum levels may possibly be reduced by lansoprazole. Pantoprazole did not affect the pharmacokinetics of carbamazepine in one study. 

In 2001 the manufacturers of lansoprazole had on record 5 undetailed case reports of apparent interactions between lansoprazole and carbamazepine. One of them describes the development of carbamazepine toxicity when lansoprazole was added, but there is some doubt about this case because it is thought that the patient may have started to take higher doses of carbamazepine. 

The ofter4 cases are consistent, in that carbamazepine levels fell shortly after lansoprazole was added, and/or the control of seizures suddenly worsened. One patient had a fall in carbamazepine serum levels from 11.5 to 7.7 mg/L. The carbamazepine levels of another patient returned to normal when the lansoprazole was stopped. ... 

It seems that in practice no clinically relevant interaction is likely to occur between omeprazole and carbamazepine. For lansoprazole, information seems to be limited to this handful of reports from which no broad general conclusions can be drawn, but they do suggest that this interaction should be considered if lansoprazole is added to established treatment with carbamazepine. Pantoprazole appears not to afifeet the pharmacokinetics of carbamazepine. 

Class 2 (High PermeabiUty, Low Solrrbility) Azathioprine, Azithromycin, Alprazolam, Warfarin, Haloperidol, Glipizide, Griseofulvinum, Danazol, Dapsone, Diclofenac, Indometacin, Itraconzol, Carbamazepine, Carvedilol, Ketoconazole, Lansoprazol, Mebendazole, Mefloqrrine, Nalidixic acid. Nevirapine, Piroxicam, Praziquantel, Ritonavir, Rifampicinirm, Spironolactone, Tamoxifen, Terfenadine, Trimethoprim, Ibnprofen, lopanoic add, Lovastatin, Naproxen, Oxaprozin, Flubiprofen, Cisapride. ... 

Information on possible drug interactions with lansoprazole is incomplete [59]. Some pertinent drugs have been studied only at standard dosage (prednisone [60]), not at all (carbamazepine), or data were published only in descriptive terms (warfarin [61]). However, compounds representative of most CYP isoforms have been studied with negative results [20, 60], with the notable exception of 2D6 (not investigated). 

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