Carbamazepine may lower the plasma concentration primobolan enanthate (reduce or even reverse the effects) and require adjustment of doses of the following drugs: klobazama, clonazepam, digoxin, ethosuximide, primidone, valproic acid, alprazolam, corticosteroids (prednisone, dexamethasone), cyclosporine teteratsiklinov (doxycycline) haloperidol, methadone, oral drugs containing estrogen and / or progesterone (requires selection of alternative contraceptive methods), theophylline, oral anticoagulants (warfarin, fenprokumona, dicumarol), lamotrigine, topiramate, tricyclic antidepressants (imipramine, amitriptyline, nortriptyline, clomipramine), clozapine , felbamate, tiagabine, oxcarbazepine, protease inhibitors used in the treatment infection (indinavir, ritonavir, saquinovir), calcium channel blockers (group digidropiridonov, eg, felodipine), itraconazole, levothyroxine, midazolam, olazapina, praziquantel, risperidone, tramadol, ziprasidone.
It is possible to increase or decrease phenytoin plasma carbamazepine on the background and raising mefenitoina (in rare cases).
In an application finlepsin and drugs lithium may increase neurotoxic effect of both active substances.
Tetracyclines may reduce the therapeutic effect finlepsin.
Carbamazepine or combined with paracetamol increases the risk of toxic effects on the liver and reduces the therapeutic efficacy (acceleration of metabolism of paracetamol).
Co-administration of carbamazepine with phenothiazines, pimozide, thioxanthenes, molindone, haloperidol, maprotiline, clozapine and tricyclic antidepressants leads to increased inhibitory action on the central nervous system and weaken the anticonvulsant effect of carbamazepine.
Monoamine oxidase inhibitors – increase the risk of giperpiretichekih crises, hypertensive crises, convulsions, death (before prescribing carbamazepine monoamine primobolan enanthate oxidase inhibitors should be discontinued at least 2 weeks, or if the clinical situation allows, even for a longer period).
Co-administration with a diuretic (hydrochlorothiazide, furosemide) may lead to hyponatremia, accompanied by clinical symptoms.
It reduces the effects of non-depolarizing muscle relaxants (pancuronium). In the case of such a combination – you may need to increase the dose of muscle relaxants, and the need to carry out careful monitoring of patients as fast as possible termination of their actions).
Reduces portability of ethanol.
It accelerates the metabolism of indirect anticoagulants, hormonal contraceptive drugs, folic acid; praziquantel, may enhance the elimination of thyroid hormones.
It accelerates the metabolism of anesthetic agents (enflurane, halothane, halothane) with increased risk of hepatotoxic effects; enhances the formation of nephrotoxic metabolites methoxyflurane.
It enhances the hepatotoxic effects of isoniazid.
Monotherapy of epilepsy begin with low primobolan enanthate doses destination individually raising them to achieve the desired therapeutic effect.
It is advisable to determine the concentration in plasma in order to select the optimal dose, in particular in combination therapy. In some cases, the dose needed for treatment can significantly deviate from the recommended initial and maintenance doses, for example, due to rapid metabolism due to the induction of hepatic microsomal enzymes, or due to interactions of drugs in combination therapy.
Finlepsin should not be combined with a sedative-hypnotic. If necessary finlepsin can be combined with other agents used to treat alcohol withdrawal. During treatment should regularly monitor the content finlepsin plasma. In connection with the development of side effects of the central and autonomic nervous system of patients is set close observation in the hospital.
When transferring a patient on carbamazepine should gradually reduce the dose previously designated antiepileptic until its complete abolition.
Sudden discontinuation of carbamazepine may trigger epileptic seizures. If you want to dramatically interrupt treatment, the patient should be transferred to other antiepileptic drugs under the cover shown in such cases the drug (eg, diazepam, intravenously or rectally, or phenytoin intravenously).
It described several cases of vomiting, diarrhea and / or low power, seizures and / or respiratory depression in newborns whose mothers took carbamazepine concomitantly with other anticonvulsants (probably these reactions are manifestations of neonatal withdrawal syndrome). Before the appointment of carbamazepine in the treatment process to be a study of liver function, especially in patients with a history of which there is evidence of liver disease and in elderly patients. In the case of strengthening the already existing liver dysfunction or when active liver disease drug should be discontinued immediately. Also, before you start treatment it is necessary to conduct a study of the blood picture (including platelet count, reticulocyte count), the primobolan enanthate iron level in the blood serum of urinalysis, urea levels in the blood, determining the concentration of electrolytes in the blood serum (and periodically during treatment, because . may develop hyponatremia). Subsequently, these indicators should be monitored during the first month of treatment each week, and then – on a monthly basis.