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