Moderate
Established
Deskripsi
Carbamazepine, a potent enzyme inducer, significantly reduces sertraline plasma concentrations, potentially impairing antidepressant efficacy.
Mekanisme
Carbamazepine induces CYP3A4 and CYP2C19, accelerating sertraline metabolism and lowering its AUC by up to 65%, reducing antidepressant effect.
Signifikansi Klinis
Sertraline plasma levels may be reduced below therapeutic thresholds; loss of antidepressant efficacy and worsening depression risk.
Penatalaksanaan
Monitor antidepressant response closely; sertraline dose increases may be required, or an alternative not metabolized by CYP3A4 should be considered.