Carbamazepine-10,11-epoxide
CBZ-E
What it isActive 10,11-epoxide metabolite of carbamazepine, formed by CYP3A4; a sodium-channel blocker equipotent with the parent in animal seizure models.
Why it mattersIt carries part of carbamazepine’s antiseizure effect and part of its dose-related toxicity.
What it changes⚑ Cleared by epoxide hydrolase, not CYP: valproate, loxapine, quetiapine and brivaracetam inhibit it and raise the epoxide (Tegretol label).
FDA-approved for
- seizures (active metabolite of carbamazepine)
NO BOXED WARNINGS
Principal riskAccumulates when epoxide hydrolase is inhibited (valproate, loxapine, quetiapine, brivaracetam), so toxicity can appear while the carbamazepine level looks unchanged
Classes and tags
Clinical profile
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