Adding carbamazepine to olanzapine.
- Olanzapine is principally metabolized by CYP1A2 and CYP2D6.
- Carbamazepine is principally metabolized by CYP3A4, and is a potent inducer of CYP1A2, CYP2C9, CYP3A4 and UDP-glucuronosyltransferases.
- This combination of drugs may have possible synergistic effects. However, the pharmacokinetic drug interactions will influence the plasma levels. Dose adaptation will be recommended for this combination.
- Consider alternative for carbamazepine, otherwise start carbamazepine according to the general dosing advice.
- Check clinical effect or olanzapine plasma concentration after 2 weeks and adapt dose if necessary. 
- Close clinical monitoring for evidence of altered olanzapine effect is recommended in patients receiving carbamazepine.
KNMP; Informatorium Medicamentorum 2015; Monografie "olanzapine" (Dutch)
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- Woods SW Chlorpromazine equivalent doses for the newer atypical antipsychotics; J Clin Psychiatry 2003;64:663-667
- WHO Collaborating Centre for Drug Statistics Methodology ATC=N03AF01
- Farmacotherapeutisch Kompas - carbamazepine (dutch)
- Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002.
- Bazire S, Psychotropic Drug Directory 2007, HealthComm UK Limited, Aberdeen, 2007.
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