Lessons of the month 2: A case of inappropriate drug-drug interaction in kidney transplant

Clin Med (Lond). 2022 Mar;22(2):169-171. doi: 10.7861/clinmed.2021-0789.

Abstract

Carbamazepine remains a first-line antiepileptic medication for the treatment of partial seizures. Despite its widespread use, carbamazepine has significant neurotoxicity and hypersensitivity reactions. We report a case of a patient post-kidney transplant who was on regular carbamazepine for childhood epilepsy and developed nystagmus, diplopia and a broad-base gait after receiving diltiazem. Understanding of the interaction between diltiazem and carbamazepine is necessary to prevent the neurotoxic effects.

Keywords: carbamazepine; diltiazem; drug interaction; kidney transplant; neurotoxicity.

Publication types

  • Case Reports

MeSH terms

  • Anticonvulsants* / adverse effects
  • Carbamazepine* / adverse effects
  • Child
  • Diltiazem* / adverse effects
  • Diplopia / chemically induced
  • Drug Interactions
  • Gait
  • Gait Disorders, Neurologic / chemically induced
  • Humans
  • Kidney Transplantation*
  • Nystagmus, Pathologic / chemically induced

Substances

  • Anticonvulsants
  • Carbamazepine
  • Diltiazem