Carbamazepine overdose after exposure to simethicone: a case report

Ozlem Guneysel , Ozge Onur , Arzu Denizbasi and Murat Saritemur

Marmara University, School of Medicine, Department of Emergency Medicine, Istanbul, Turkey

author email corresponding author email

Journal of Medical Case Reports 2008, 2:242doi:10.1186/1752-1947-2-242


Published:	24 July 2008

Abstract

Introduction

Carbamazepine is an anticonvulsant drug and is also used as a treatment for patients with manic-depressive illness, post-herpetic neuralgia or phantom limb pain. The drug itself has many drug interactions. Simethicone is an antifoaming agent and is reported to be an inert material with no known drug interaction with carbamazepine.

Case presentation

We present a case of a patient who was routinely using carbamazepine 400 mg three times per day and levetiracetam 500 mg twice daily, and experienced carbamazepine overdose after exposure to simethicone. After cessation of simethicone therapy normal drug levels of carbamazepine were obtained again with the standard dose of the drug. The mechanism of interaction is unknown but the risk of overdose should be considered when prescribing simethicone to a patient who is using carbamazepine.

Conclusion

Simethicone and carbamazepine, when taken together, may be a cause of carbamazepine toxicity. The risk of carbamazepine overdose should be considered when prescribing simethicone to a patient who is using carbamazepine.