Carbamazepine, either alone or when given with
phenobarbital or
phenytoin, has been shown to decrease
itraconazole levels resulting in treatment failure. Carbama- zepine is predicted to decrease
posaconazole and
voriconazole levels.
Concurrent use should be avoided unless the benefits are expected to outweigh the risks, although note that the use of
voriconazole is specifically contraindicated. If concurrent use is necessary it seems likely that the antifungal dose will need to be increased. It would seem prudent to use other alternatives wherever possible or monitor
efficacy very closely.