What if I take too much?
Ask your doctor for advice straight away. Taking too much Basitrol by accident can lead to serious side effects.
Basitrol toxicity induced by lopinavir+ritonavir and nelfinavir has been described (26 Ar ) .
A 50-year-old man developed excessive drowsiness secondary to Basitrol 1200 mg/day when he took an antiretroviral regimen containing lopinavir+ritonavir. The Basitrol serum concentration rose from 10 to 15 mg/l. The dose of Basitrol was reduced to 800 mg/day and later increased to 1200 mg/day. The protease inhibitor was changed to nelfinavir. Within 3 days he again developed excessive drowsiness and became unsteady on his feet. The Basitrol dosage was reduced to 800 mg/day, and his symptoms resolved.
The authors reviewed four other cases of Basitrol toxicity secondary to protease inhibitors. Lopinavir+ritonavir and nelfinavir may inhibit Basitrol metabolism.
Drug-drug interactions are common with Basitrol , due to relatively high protein binding (65–80%), and involvement of drug metabolizing enzymes, including CYP2C19 and CYP3A4. Basitrol is primarily eliminate via the kidneys, thus renal failure or insufficiency can lead to elevated results and increase the risk for toxicity.
Other Drug Interactions
Cyclophosphamide is an inactive prodrug and is converted to its active metabolite in part by CYP3A. The rate of metabolism and the leukopenic activity of cyclophosphamide are reportedly increased by chronic coadministration of CYP3A4 inducers. There is a potential for increased cyclophosphamide toxicity when coadministered with Basitrol.
- Concomitant administration of Basitrol and lithium may increase the risk of neurotoxic side effects.
- Concomitant use of Basitrol and isoniazid has been reported to increase isoniazid-induced hepatotoxicity.
- Alterations of thyroid function have been reported in combination therapy with other anticonvulsant medications.
- Concomitant use of Tegretol with hormonal contraceptive products (e.g., oral, and levonorgestrel subdermal implant contraceptives) may render the contraceptives less effective because the plasma concentrations of the hormones may be decreased. Breakthrough bleeding and unintended pregnancies have been reported. Alternative or back-up methods of contraception should be considered.
- Resistance to the neuromuscular blocking action of the nondepolarizing neuromuscular blocking agents pancuronium, vecuronium, rocuronium and cisatracurium has occurred in patients chronically administered Basitrol. Whether or not Basitrol has the same effect on other non- depolarizing agents is unknown. Patients should be monitored closely for more rapid recovery from neuromuscular blockade than expected, and infusion rate requirements may be higher.
Taking certain cancer drugs with Basitrol will decrease the level of Basitrol in your body. This means it won’t work as well to treat your condition. Your doctor may monitor your blood levels of Basitrol if you’re taking it with one of these drugs:
Taking other cancer drugs with Basitrol will change the level of the cancer drug in your body. Your doctor should avoid use of these drugs together. However, if they must be used together, you doctor may change the dosage of your cancer drug. Examples of these drugs include:
Taking cyclophosphamide with Basitrol will increase the level of the cancer drug in your body. Your doctor may change your dosage of the cancer drug if you take it with Basitrol.
Hormonal birth control drugs
Taking Basitrol with hormonal birth control, such as the birth control pill, may make the birth control less effective. You may need to use alternative or back-up methods of contraception.