Co-administration of mTor Inhibitors and Carbamazepine May Lead to Ineffectiveness of Therapy: A Case Report of a 24-year-old Man

Adverse Event: Drug interaction leading to low exposure of mTor inhibitors and their ineffectiveness. The Patient: A 24-year-old male patient, known to have tuberous sclerosis complex since birth, developed renal epithelioid angiomyolipomas with hepatic metastasis. Everolimus treatment failed after 8 months of administration, this lead to a switch to temsirolimus treatment without more efficiency that appeared later on was due to drug-drug interaction which was dealt with in an effective manner. Evidence that Links the Drug to the Event: The timeline was consistent with the administration of carbamazepine for epilepsy attacks. A pharmacokinetic analysis showed a decrease in sirolimus and temsirolimus blood concentrations. Management: Therapeutic drug monitoring of temsirolimus and sirolimus lead us to conclude that a threefold increase in the dose of temsirolimus was needed to ensure the effectiveness of treatment without adverse effects. Conclusion: Clinicians should be aware of the potential drug interactions with mTor inhibitors in individuals using antiepileptic drugs. Close monitoring is necessary by measuring temsirolimus and/or sirolimus and/or everolimus concentrations in the blood. Citation: Sawan A, Becker G, Lefevre P, et al. Co-administration of mTor Inhibitors and Carbamazepine May Lead to Ineffectiveness of Therapy: A Case Report of a 24-year-old Man. Clin Image Case Rep J. 2022; 4(2): 216. Clin Image Case Rep J. 2022; 4(2): 216 www.literaturepublishers.org 2