Taking carbamazepine with other medicines and herbal supplements

Cautions with other medicines

There are some medicines that may affect the way carbamazepine works.

Tell your doctor if you're taking any of these medicines:

• medicines to help prevent blood clots such as warfarin, apixaban or rivaroxaban
• antibiotics or antifungals such as clarithromycin, erythromycin or fluconazole
• medicines used for depression or anxiety such as amitriptyline, citalopram or mirtazapine
• ciclosporin, tacrolimus or sirolimus – immunosuppressants used after transplant operations, but also sometimes to treat arthritis or psoriasis
• medicines used to treat HIV or AIDS such as dasubavir or ritonavir
• medicines called monoamine oxidase inhibitors (MAOIs), used to treat depression – these can affect carbamazepine for a few weeks even after you've stopped taking them

Taking carbamazepine with painkillers

Paracetamol and ibuprofen are safe to take with carbamazepine for a short time. Talk to your doctor if you need to take either for more than a few days.

Carbamazepine can make strong painkillers such as tramadol, oxycodone and buprenorphine less effective. Your doctor may recommend increasing your dose if you need to take these medicines.

Mixing carbamazepine with herbal remedies and supplements

Do not take St John's wort, the herbal remedy for depression, while you are being treated with carbamazepine. This is because St John's wort may make carbamazepine less effective.

There's not enough information to say that other herbal remedies or supplements are safe to take with carbamazepine. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.