Carbamazepine and Felbamate interaction

Carbamazepine and Felbamate: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Felbamate (Felbatol) label · effective 2025-08-15

Major

IT IS NOT KNOWN WHETHER CONCOMITANT USE OF OTHER ANTIEPILEPTIC DRUGS AND/OR OTHER DRUGS AFFECT THE INCIDENCE OF HEPATIC FAILURE.

Boxed warningby drug classView label on DailyMed
Moderate

Carbamazepine Felbatol ® causes a decrease in the steady-state carbamazepine plasma concentrations and an increase in the steady-state carbamazepine epoxide plasma concentration.

Drug interactionsnames CarbamazepineView label on DailyMed
Moderate

The carbamazepine steady-state C min decreased 31% to 5±1 micrograms/mL when felbamate (3000 mg/day, divided into three doses) was coadministered.

Drug interactionsnames CarbamazepineView label on DailyMed
Moderate

Carbamazepine epoxide steady-state C min concentrations increased 57% from 1.0±0.3 to 1.6±0.4 micrograms/mL with the addition of felbamate.

Drug interactionsnames CarbamazepineView label on DailyMed
Moderate

Carbamazepine Carbamazepine causes an approximate 50% increase in the clearance of Felbatol ® at steady-state and, therefore, the addition of carbamazepine results in an approximate 40% decrease in the steady-state trough concentrations of Felbatol ® as compared to the same dose of Felbatol ® given as monotherapy.

Drug interactionsnames CarbamazepineView label on DailyMed

From the Carbamazepine (EQUETRO) label · effective 2025-08-19

Moderate

Limited evidence suggests that HLA-B*1502 may be a risk factor for the development of SJS/TEN in patients of Chinese ancestry taking other anti-epileptic drugs associated with SJS/TEN, including phenytoin.

Warnings and precautionsby drug classView label on DailyMed
Minor

Such drugs include the following: Aminophylline, c isplatin, doxorubicin, felbamate, phosphenytoin, methsuximide , phenobarbital, phenytoin, primidone, rifampin and theophylline.

Drug interactionsnames FelbamateView label on DailyMed
Minor

…clonazepam, clozapine, cyclosporin, delavirdine, desipramine, diazepam, dicumarol, dihydropyridine calcium channel blockers (e.g., felodipine), doxycycline, ethosuximide, everolimus, felbamate, glucocorticoids, haloperidol, imatinib, itraconazole, lamotrigine, levothyroxine, lorazepam, methadone, methsuxamide, mianserin, midazolam, mirtazapine, nefazodone, olanzapine,…

Drug interactionsnames FelbamateView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.