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Possible Interaction between Phenobarbital, Carbamazepine and Itraconazole

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Summary

We report a case of a possible interaction between itraconazole, phenobarbital and carbamazepine. The first plasma itraconazole concentration, measured when the patient had been taking phenobarbital for 2 months, was very low. The second measurement, 2 months after withdrawing phenobarbital, was higher but below the therapeutic range. However, carbamazepine, a well known enzyme inducer, had been initiated 15 days before. 20 days after carbamazepine was withdrawn, the itraconazole concentration 4 hours after administration was near the lower end of the therapeutic range. The mechanism of this possible interaction is probably the same for phenobarbital and carbamazepine, involving hepatic microsomal enzyme system induction.

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Authors and Affiliations

  1. Service de Pneumologie and Centre de Pharmacovigilance, CHU Bretonneau, Tours, France

    Marcel Bonay,  Annie Pierre Jonville-Bera, Patrice Diot, Etienne Lemarie, Michel Lavandier & Elisabeth Autret

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  1. Marcel Bonay
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  2. Annie Pierre Jonville-Bera
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  3. Patrice Diot
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  4. Etienne Lemarie
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  5. Michel Lavandier
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  6. Elisabeth Autret
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Bonay, M., Jonville-Bera, A.P., Diot, P. et al. Possible Interaction between Phenobarbital, Carbamazepine and Itraconazole. Drug-Safety 9, 309–311 (1993). https://doi.org/10.2165/00002018-199309040-00008

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  • DOI: https://doi.org/10.2165/00002018-199309040-00008

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