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Possible carbamazepine toxicity with terbinafine
Navdeep S Baath1, Jennifer Hong, S Pirzada Sattar
1Creighton University Department of Psychiatry, Omaha, NE, USA.
Summary
This case report details a carbamazepine and terbinafine drug interaction. Terbinafine increased carbamazepine levels, causing toxicity symptoms like dizziness and falls.
Area of Science:
- Pharmacology
- Clinical Toxicology
Background:
- Carbamazepine is an anticonvulsant and mood-stabilizing drug.
- Terbinafine is an antifungal medication.
Observation:
- A 50-year-old male experienced toxicity symptoms including gait ataxia, dizziness, and falls.
- These symptoms emerged after initiating terbinafine treatment while on carbamazepine therapy.
Findings:
- The patient developed elevated carbamazepine levels.
- This drug-drug interaction between carbamazepine and terbinafine is reported for the first time.
- The Naranjo Scale indicated a probable interaction (score 6).
Implications:
- Terbinafine likely inhibited carbamazepine metabolism, leading to increased drug levels.
- Healthcare providers should exercise caution when co-prescribing carbamazepine and terbinafine.
- This interaction highlights the importance of monitoring drug levels during concurrent medication use.