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Alagesic LQ oral

Selected Antipsychotics/Strong CYP3A4 Inducers

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Barbiturates, carbamazepine, enzalutamide, mitotane, phenytoin/fosphenytoin, rifabutin, rifampin and St. John's Wort may speed up how quickly your liver processes your antipsychotic medication.

What might happen:

The amount of medicine in your blood may decrease and it may not work as well.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together and if you notice any change in your condition. Your doctor may want to change the dose of your medicine while you are taking barbiturates, carbamazepine, phenytoin, rifampin, or St. John's wort.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Abilify (aripiprazole) US prescribing information. Otsuka America Pharmaceutical, Inc. February, 2012.
2.Haldol (haloperidol) US prescribing information. Ortho-McNeil-Janssen Pharmaceuticals, Inc. August, 2011.
3.Seroquel (quetiapine fumarate) US prescribing information. AstraZeneca Pharmaceuticals LP July, 2011.
4.Risperdal Consta (risperidone long acting injection) US prescribing information. Janssen Pharmaceutical Ltd. September, 2011.
5.Abilify Maintena (aripiprazole ext-rel inj.) prescribing information. Otsuka Pharmaceuticals February, 2013.
6.Mula M, Monaco F. Carbamazepine-risperidone interactions in patients with epilepsy. Clin Neuropharmacol 2002 Mar-Apr;25(2):97-100.
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13.Spina E, Avenoso A, Facciola G, Salemi M, Scordo MG, Giacobello T, Madia AG, Perucca E. Plasma concentrations of risperidone and 9-hydroxyrisperidone: effect of comedication with carbamazepine or valproate. Ther Drug Monit 2000 Aug;22(4):481-5.
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15.Mahatthanatrakul W, Nontaput T, Ridtitid W, Wongnawa M, Sunbhanich M. Rifampin, a cytochrome P450 3A inducer, decreases plasma concentrations of antipsychotic risperidone in healthy volunteers. J Clin Pharm Ther 2007 Apr;32(2):161-7.
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21.Klein E, Bental E, Lerer B, Belmaker RH. Carbamazepine and haloperidol v placebo and haloperidol in excited psychoses. A controlled study. Arch Gen Psychiatry 1984 Feb;41(2):165-70.
22.Hirokane G, Someya T, Takahashi S, Morita S, Shimoda K. Interindividual variation of plasma haloperidol concentrations and the impact of concomitant medications: the analysis of therapeutic drug monitoring data. Ther Drug Monit 1999 Feb;21(1):82-6.
23.Raitasuo V, Lehtovaara R, Huttunen MO. Effect of switching carbamazepine to oxcarbazepine on the plasma levels of neuroleptics. A case report. Psychopharmacology (Berl) 1994 Sep;116(1):115-6.
24.Kahn EM, Schulz SC, Perel JM, Alexander JE. Change in haloperidol level due to carbamazepine--a complicating factor in combined medication for schizophrenia. J Clin Psychopharmacol 1990 Feb;10(1):54-7.
25.Fast DK, Jones BD, Kusalic M, Erickson M. Effect of carbamazepine on neuroleptic plasma levels and efficacy. Am J Psychiatry 1986 Jan; 143(1):117-8.
26.Jann MW, Ereshefsky L, Saklad SR, Seidel DR, Davis CM, Burch NR, Bowden CL. Effects of carbamazepine on plasma haloperidol levels. J Clin Psychopharmacol 1985 Apr;5(2):106-9.
27.Cohen D, Diemont WL. Deterioration of schizoaffective disorder due to an interaction between haloperidol and carbamazepine. Ned Tijdschr Geneeskd 2002 Oct 12;146(41):1942-4.
28.Kanter GL, Yerevanian BI, Ciccone JR. Case report of a possible interaction between neuroleptics and carbamazepine. Am J Psychiatry 1984 Sep;141(9):1101-2.
29.Brayley J, Yellowlees P. An interaction between haloperidol and carbamazepine in a patient with cerebral palsy. Aust N Z J Psychiatry 1987 Dec;21(4):605-7.
30.Kim YH, Cha IJ, Shim JC, Shin JG, Yoon YR, Kim YK, Kim JI, Park GH, Jang IJ, Woo JI, Shin SG. Effect of rifampin on the plasma concentration and the clinical effect of haloperidol concomitantly administered to schizophrenic patients. J Clin Psychopharmacol 1996 Jun;16(3):247-52.
31.Takeda M, Nishinuma K, Yamashita S, Matsubayashi T, Tanino S, Nishimura T. Serum haloperidol levels of schizophrenics receiving treatment for tuberculosis. Clin Neuropharmacol 1986;9(4):386-97.
32.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/ DrugInteractionsLabeling/ucm093664.htm. Updated 08/05/2011.
33.This information is based on or an extract from the UW Metabolism and Transport Drug Interaction Database (DIDB) Platform, Copyright University of Washington 1999-2014..

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