Major
Carbamazepine × Dabigatran
Antiepileptics. Carboxamide derivatives×Direct thrombin inhibitor
Mechanism
Carbamazepine induces P-glycoprotein, the main dabigatran clearance route. Dabigatran plasma levels fall and anticoagulant effect weakens – stroke risk in atrial fibrillation rises.
Symptoms
The patient feels nothing. Stroke, deep vein thrombosis, and pulmonary embolism risks rise.
Management
Avoid the combination. Alternative anticoagulants: warfarin with INR monitoring or low molecular weight heparin for short courses. Alternative anticonvulsants without induction: levetiracetam, lamotrigine.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.