Does Tegretol Interact With Fycompa?

Posted on Fri, 4 Nov 2016

Question: I've epilepsy and I've couple questions to ask you
What's the interaction between tegretol and fycompa ?
And, what do you of this new medication called briviact instead of fycompa ? Which one do you think better for refractory ?
P.S. I take tegretol, lyrica and lyrical. I've focal sz.
Just to add one more thing, I have sz everyday more than two.
Is there anything new or good for refractory Sz, such as cannabis med in USA ?

Answered by Dr. Ishu Bishnoi (3 hours later)

Brief Answer:
Tegretol and Fycompa interaction, new anti epileptics

Detailed Answer:
Hi XXXX, thanks for asking from HCM.

I can understand your concern. I will answer your question one by one.

1) Tegretol and Fycompa interaction - Tegretol reduces fycompa efficiency and vice versa. So taking both drugs together can decrease each other efficiency.

2) There is no comparative analysis which has studied Briviact and Fycompa. A study by comparative analysis has shown that satisfactory score of fycompa is 3.8/5, while it is not available for Briviact.

There is no interaction between two drugs.

So you can take both drugs together.

You can consult your doctor about other options like

: Epilepsy surgery
: Vagal nerve stimulation
: Combination of three or more drugs to treat seizures.
Do not go for cannabis. Hope it will help you.
Thanks. Take care

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Ishu Bishnoi (9 hours later)

I take 600mg of tegretol and I'm ok during morning. However, when I take my evening med, which is 700mg, I start to get sz. What does that mean? And,I take lyrica 150mg twice.

When I take 4mg, I start to have more sz than usual, in the morning and at night. What does that mean?

What do you of topmax?

Answered by Dr. Ishu Bishnoi (6 hours later)

Brief Answer:
Cause of your condition

Detailed Answer:
Hi XXXX, welcome back.

Thanks for asking. Tegretol is an anti epileptic drug. It will always try to control seizures. If you are developing seizures in evening even after taking Tegretol, it could be due to

: Inability of Tegretol to control seizures - It could be due to combined use of fycompa.
: Lyrica side effect - Lyrica or Pregabaline can cause seizures sometimes. It is a known side effect.

Why are you taking Lyrica? Do you have any complaint of nerve pain or disc pain?

You said you are taking 4mg tablet. Most probably it is "Fycompa". You haven't mentioned which drug. As I mentioned in the previous answer, use of fycompa with Tegretol is not recommended due to their drug interaction. You must ask your treating doctor to change the combination.

The combination should be such that
: The drugs do not interact with each other metabolism.
: The drugs enhance each others mechanism of action.

Now coming to Topmax, It is a newer anti epileptic drug with less side effects. It treats
: Tonic clonic seizures
: Complex or simple partial seizures
: Even prevent Migraine attacks

Side effects
: Bad taste in mouth, diarrhoea
: Dizziness
: Kidney stones
: Depression
: Irregular heart beats
All these effects are rare.

It does not react with other anti epileptics except benzodiazepine.

Hope it will help you. If still in doubt, do let me know.
Thanks. Take care

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ishu Bishnoi (2 hours later)

No. Lyrica is one of many meds I've tried, but it seems to reduce my sz.
Briviact, I know it's really new med, but what do you think of it ? Is it good, especially for those with refectory sz ? Have you giving it to any of patient ?

Answered by Dr. Ishu Bishnoi (4 hours later)

Brief Answer:
Briviact use

Detailed Answer:
Hi XXXX, welcome back.

I got your point. Lyrica is not usually prescribed for seizures. Gabapentine can be used to reduce seizures.

Coming to Briviact, I have not used it yet. I have read about it in recent articles. It is not the first line of drug. It is used as add on therapy in case of refractory seizures, especially in partial seizures. As I have not tried it yet, so I can not really tell you my experience.

Hope it will help you. Thanks. Take care. If still in doubt, do let me know.
Dr Ishu Bishnoi

Above answer was peer-reviewed by : Dr. Nagamani Ng