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Dizzy and Depressed

Fatal Forty DDI: nefazodone, carbamazepine, CYP3A4

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A Case Approach to Perioperative Drug-Drug Interactions

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Abstract

This case discusses the pharmacokinetic interaction between carbamazepine and nefazodone leading to supratherapeutic carbamazepine levels. Carbamazepine is a cytochrome P450 3A4 substrate and nefazodone is a 3A4 inhibitor.

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References

  1. Kerr BM, Thummel KE, Wurden CJ, et al. Human liver carbamazepine metabolism: role of CYP3A4 and CYP2C8 in 10,11-epoxide formation. Biochem Pharmacol. 1994;47:1969–79.

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  2. Ashton AK, Wolin RE. Nefazodone-induced carbamazepine toxicity. Am J Psychiatry. 1996;153:733.

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  3. Laroudie C, Salazar DE, Cosson JP, et al. Carbamazepine-nefazodone interaction in healthy subjects. J Clin Psychopharmacol. 2000;20:46–53.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    William A. Shakespeare MD & Juraj Sprung MD, PhD

Authors
  1. William A. Shakespeare MD
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  2. Juraj Sprung MD, PhD
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Corresponding author

Correspondence to William A. Shakespeare MD .

Editor information

Editors and Affiliations

  1. Anesthesia Services Department, Philadelphia Veterans Affairs Med Center, Philadelphia, PA, USA

    Catherine Marcucci MD

  2. Department of Anesthesiology, Oregon Health and Science University, Portland, OR, USA

    Michael P. Hutchens MD

  3. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    Erica D. Wittwer MD, PhD , Toby N. Weingarten MD , Juraj Sprung MD, PhD  & Wayne T. Nicholson MD, PharmD, MSc , ,  & 

  4. Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Kirk Lalwani MD

  5. Department of Anesthesiology, University of Pittsburgh School of Med Liliane S. Kaufmann Building, Pittsburgh, PA, USA

    David G. Metro MD

  6. Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA

    Randal O. Dull MD, PhD

  7. Department of Anesthesiology, Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Christopher E. Swide MD

  8. Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA

    F. Jacob Seagull PhD

  9. Department of Anesthesiology and Perioperative Medicine, Portland, OR, USA

    Jeffrey R. Kirsch MD (Professor and Chair) (Professor and Chair)

  10. Department of Psychiatry, University of Maryland Medical System VA Maryland Health Care System, Baltimore, MD, USA

    Neil B. Sandson MD

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Shakespeare, W.A., Sprung, J. (2015). Dizzy and Depressed. In: Marcucci, C., et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7495-1_169

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  • DOI: https://doi.org/10.1007/978-1-4614-7495-1_169

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7494-4

  • Online ISBN: 978-1-4614-7495-1

  • eBook Packages: MedicineMedicine (R0)

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