Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDI1FZSYCE)
  Drug Name Carbamazepine Drug Info Empagliflozin Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anticonvulsants/Antimanic Agents Antidiabetic Agents
  Structure

 Mechanism of Carbamazepine-Empagliflozin Interaction (Severity Level: Moderate)
     UGT induction Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Carbamazepine Empagliflozin
      Mechanism UGT2B7 inducer UGT2B7 substrate
      Key Mechanism Factor 1
Factor Name UDP-glucuronosyltransferase 2B7
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Structure Sequence
MSVKWTSVILLIQLSFCFSSGNCGKVLVWAAEYSHWMNIKTILDELIQRGHEVTVLASSASILFDPNNSSALKIEIYPTSLTKTELENFIMQQIKRWSDLPKDTFWLYFSQVQEIMSIFGDITRKFCKDVVSNKKFMKKVQESRFDVIFADAIFPCSELLAELFNIPFVYSLSFSPGYTFEKHSGGFIFPPSYVPVVMSELTDQMTFMERVKNMIYVLYFDFWFEIFDMKKWDQFYSEVLGRPTTLSETMGKADVWLIRNSWNFQFPYPLLPNVDFVGGLHCKPAKPLPKEMEDFVQSSGENGVVVFSLGSMVSNMTEERANVIASALAQIPQKVLWRFDGNKPDTLGLNTRLYKWIPQNDLLGHPKTRAFITHGGANGIYEAIYHGIPMVGIPLFADQPDNIAHMKARGAAVRVDFNTMSSTDLLNALKRVINDPSYKENVMKLSRIQHDQPVKPLDRAVFWIEFVMRHKGAKHLRVAAHDLTWFQYHSLDVIGFLLVCVATVIFIVTKCCLFCFWKFARKAKKGKND
Gene Name UGT2B7
Uniprot ID UD2B7_HUMAN
KEGG Pathway hsa:7364
Protein Family UDP-glycosyltransferase family
Protein Function
UDP-glucuronosyltransferase (UGT) that catalyzes phase II biotransformation reactions in which lipophilic substrates are conjugated with glucuronic acid to increase the metabolite's water solubility, thereby facilitating excretion into either the urine or bile (PubMed:10702251, PubMed:15472229, PubMed:15470161, PubMed:18674515, PubMed:18719240, PubMed:19022937, PubMed:23288867, PubMed:23756265, PubMed:26220143, PubMed:17442341). Essential for the elimination and detoxification of drugs, xenobiotics and endogenous compounds (PubMed:15470161, PubMed:18674515, PubMed:23756265). Catalyzes the glucuronidation of endogenous steroid hormones such as androgens (epitestosterone, androsterone) and estrogens (estradiol, epiestradiol, estriol, catechol estrogens) (PubMed:2159463, PubMed:15472229, PubMed:18719240, PubMed:19022937, PubMed:23288867, PubMed:26220143, PubMed:17442341). Also regulates the levels of retinoic acid, a major metabolite of vitamin A involved in apoptosis, cellular growth and differentiation, and embryonic development (PubMed:10702251). Contributes to bile acid (BA) detoxification by catalyzing the glucuronidation of BA substrates, which are natural detergents for dietary lipids absorption (PubMed:23756265). Involved in the glucuronidation of the AGTR1 angiotensin receptor antagonist losartan, caderastan and zolarsatan, drugs which can inhibit the effect of angiotensin II (PubMed:18674515). Also metabolizes mycophenolate, an immunosuppressive agent (PubMed:15470161).
    Click to Show/Hide
      Mechanism Description
  • Increased metabolism of Empagliflozin caused by Carbamazepine mediated induction of UGT

Recommended Action
      Management Coadministration of empagliflozin with UGT inducers should be avoided if possible. If concomitant use is required, dosage adjustments as well as increased clinical and laboratory monitoring should be considered whenever a UGT inducer is added to or withdrawn from empagliflozin therapy.

References
1 Cerner Multum, Inc. "Australian Product Information.".
2 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3 Product Information. Glyxambi (empagliflozin-linagliptin). Boehringer Ingelheim, Ridgefield, CT.
4 Product Information. Jardiance (empagliflozin). Boehringer Ingelheim, Ridgefield, CT.