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