This reaction has resulted in severe cardiotoxicity. Diltiazem Nicatinamide Erythromycin Propoxyphene Fluoxetine Terfenadine Fluvoxamine Valproic Acid Isoniazid Verapamil Itraconazole Table 2. Drugs that Decrease Carbamazepine Concentrations Charcoal Phenytoin Cisplatin Primidone Doxorubicin Rifampin Felbamate Theophylline Phenobarbital Tricyclic Antidepress. The most common adverse effects associated with carbamazepine use are gastrointestinal and neurologic effects, consisting of nausea, vomiting, drowsiness, dizziness, ataxia, and vertigo. These reactions typically occur upon initiation of therapy or with dosage increases.
Most patients respond to a reduction in dose.
Gradual changes in dosage often avoids these effects. In some patients, these reactions can be prevented by giving smaller doses on a more frequent interval, avoiding high peak serum carbamazepine concentrations. Carbamazepine-associated blood dyscrasias range from mild to severe. Severe carbamazepine-induced agranulocytosis and aplastic anemia have an estimated incidence of 1 in 600,000 patients. Other adverse reactions include elevated liver function tests, jaundice and hepatitis, pancreatitis, and renal dysfunction.