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[Interaction between erythromycin and carbamazepine]
Nederlands Tijdschrift Voor Geneeskunde
|September 30, 1989
Insights
Erythromycin can cause carbamazepine intoxication in infants by competing for liver enzymes. This drug interaction significantly increases carbamazepine levels, leading to toxicity.
Area of Science:
- Pharmacology
- Drug Interactions
- Pediatric Medicine
Background:
- Carbamazepine is an anticonvulsant medication.
- Erythromycin is a common antibiotic.
- Drug metabolism often involves liver enzymes.
Observation:
- A six-month-old infant developed carbamazepine intoxication.
- The infant was concurrently receiving erythromycin and carbamazepine.
- Serum carbamazepine levels were significantly elevated at 30 mg/L.
Findings:
- Erythromycin interferes with carbamazepine metabolism.
- This interaction occurs due to competition for hepatic enzymes.
- Elevated carbamazepine levels can lead to toxicity.
Implications:
- Clinicians must be aware of this potential drug interaction.
- Dosage adjustments or alternative medications may be necessary.
- Monitoring carbamazepine levels is crucial when co-prescribed with erythromycin.
Abstract:
A six-month-old girl receiving erythromycin was given carbamazepine treatment. Two days later signs of carbamazepine intoxication developed and a serum carbamazepine concentration of 30 mg/l was found (4-9 mg/l being the desired therapeutical level). The interaction of erythromycin and carbamazepine by liver enzyme competition is clinically significant.