Moderate
Probable
Description
Carbamazepine reduces omeprazole plasma concentrations through CYP3A4 induction, potentially reducing the efficacy of acid suppression therapy.
Mécanisme
Carbamazepine induces CYP3A4 and CYP2C19, the primary enzymes metabolizing omeprazole, significantly increasing its clearance.
Signification clinique
Omeprazole AUC may be reduced substantially; patients with acid reflux or peptic ulcer disease may experience symptom breakthrough.
Prise en charge
Monitor GI symptom control; omeprazole dose doubling may be needed; consider pantoprazole as an alternative with less CYP2C19 dependence.