title: Possible interaction between phenobarbital, carbamazepine and itraconazole.
abstract: 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However, carbamazepine, a well known enzyme inducer, had been initiated 15 days before. 20 days after carbamazepine was withdrawn, the itraconazole concentration 4 hours after administration was near the lower end of the therapeutic range.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.
authors.affiliation: Service de Pneumologie, CHU Bretonneau, Tours, France.
authors.forename: M
authors.initials: M
authors.lastname: Bonay
authors.forename: A P
authors.initials: AP
authors.lastname: Jonville-Bera
authors.forename: P
authors.initials: P
authors.lastname: Diot
authors.forename: E
authors.initials: E
authors.lastname: Lemarie
authors.forename: M
authors.initials: M
authors.lastname: Lavandier
authors.forename: E
authors.initials: E
authors.lastname: Autret
mesh_terms: D000328:Adult; D001228:Aspergillosis / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D001927:Brain Diseases / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D002220:Carbamazepine / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D004790:Enzyme Induction / Q000187:drug effects; D006801:Humans; D017964:Itraconazole / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D008297:Male; D010634:Phenobarbital / Q000009:adverse effects* / Q000627:therapeutic use; D012640:Seizures / Q000188:drug therapy / Q000209:etiology
chemical_list: D017964:Itraconazole; D002220:Carbamazepine; D010634:Phenobarbital