USED FOR:
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Simple partial and complex partial (psychomotor, temporal lobe) seizures. |
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Tonic-clonic (grand mal) seizures. |
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Not effective in controlling absence, myoclonic, or atonic seizures. |
PRECAUTIONS:
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Tell your doctor about your medical conditions, especially if you have any liver, heart or kidney disease, blood disorders, bone marrow depression or allergies to phenytoin, phenobarbital, primidone or lamotrigine. |
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Make sure your doctor knows if you are someone with a mixed seizure disorder that includes atypical absence seizures. |
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If you experience symptoms such as fever, sore throat, rash, ulcers in the mouth, easy bruising, or reddish purple spots on the surface of the skin should report them immediately to your doctor. |
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Do not drive or operate dangerous machinery until you are sure that carbamazepine does not affect your alertness. |
POSSIBLE SIDE EFFECTS:
Depending on the individual, side effects may occur at varying degrees or not at all, including:
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double vision |
Chronic - leukopenia (decreased white blood cell count) |
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headaches |
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sodium deficiency in the blood (SIADH) |
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dizziness |
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cognitive impairment |
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fatigue |
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behavioural changes such as agitation or confusion |
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drowsiness |
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movement disorders (rare) |
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loss of coordination, unsteadiness |
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heart disorders |
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nausea/ vomiting |
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tremor |
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worsening of certain seizures (especially myoclonic) |
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Allergic Reactions/Idiosyncratic - skin rash (if you notice a rash seek immediate medical help) - liver/blood toxicity, pancreatitis, and lupus rare.
DRUG INTERACTIONS:
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Alcohol tolerance may be reduced by carbamazepine. |
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Oral contraceptives and cyclosporine may be less effective when used with carbamazepine. |
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Oral anticoagulants (warfarin), tricyclic antidepressants, clozapine, haloperidol (Haldol®), theophylline, doxycycline, ethosuximide, lamotrigine and other antiepileptic drugs are affected by carbamazepine. |
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Erythromycin (and other macrolide antibiotics), cimetidine (Tagamet®), lithium, propoxyphene (Darvon®), terfenadine, isoniazid, fluoxetine or calcium channel blockers may increase the effect and possible toxicity of carbamazepine. |
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Phenobarbital, phenytoin or primidone may reduce the levels of carbamazepine. |
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Monoamine oxidase (MAO) inhibitors should not be used with carbamazepine. |
Inform your doctor of any other medicines (prescription and nonprescription) or substances you are taking.
DAILY DOSAGE:
Adults- 600-1200 mg/day
Children- 10-30 mg/kg/day
Regimen - Generally taken in three divided doses, or two for controlled release formulation.
Initial daily dose is started low, with a gradual increase. This helps to decrease the risk for side effects. Your doctor may want to measure the amount of carbamazepine in your blood to help individualize your dosage. Dose may have to be adjusted after several weeks or a few months to maintain seizure control.
FORMS:
Tablets - 200 mg
Chewtabs - 100 and 200 mg
Controlled-Release Tablets - 200 and 400 mg
Suspension - 20 mg/ml
TIPS FOR USING CARBAMAZEPINE (Tegretol®):
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Side effects like drowsiness may lessen over time. |
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Take carbamazepine with food to avoid stomach upset. |
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Avoid alcohol. |
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Watch for signs of blood, skin, heart or liver reaction (see Precautions). |
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After several weeks or months, the doctor may need to adjust dose to maintain your seizure control. |
MISSED DOSE:
Try to take each dose at the scheduled time. If you miss a dose, take it as soon as possible. However, if the time is close to the next dose, do not take the missed dose and return to your regular dosing schedule. Do not "double-up" the dose to catch up. If you skip a whole day, inform your doctor.
STORAGE:
Store at room temperature (15 to 30oC), protect from light, heat, and moisture and keep out of reach of children.
IN PREGNANCY:
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Women who are considering pregnancy should first consult their doctor |
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Anti-epileptic drugs may slightly increase the risk of fetal abnormalities |
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Taking folic acid before and during pregnancy and Vitamin K1 during last weeks of pregnancy is suggested. |
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Women should discuss breastfeeding with their doctors. |
WARNING:
Abrupt withdrawal of any anti-epileptic medication may trigger status epilepticus, a potentially fatal condition of continued seizures without recovery. When there is a need for reduction, discontinuation or substitution of the medication, this should be done gradually and under the physician's care.
Never discontinue anti-epileptic medications or make changes in activities unless specifically advised to do so by an attending physician.
MORE INFORMATION YOU NEED TO KNOW ABOUT YOUR MEDICATION
CREDIT:
This drug fact sheet has been reviewed by the pharmacists of the Ontario Pharmacists' Association Drug Information and Research Centre (DIRC).
DISCLAIMER:
The material offered on the website of Epilepsy Toronto is to provide general information about epilepsy to the public. It is not intended to be taken as personal medical advice. Epilepsy Toronto, its employees, Board members, Medical Advisors, volunteers, agents and sponsors do not assume responsibility for inaccuracies or omissions or for consequences from the use of information obtained over this site or any links accessed through this site, and is not liable for any outcome or damages resulting from information in its content in either an indirect or direct form. We recognize that each individual's experience of epilepsy is different. Consult your physician, neurologist and/or your pharmacist with any questions you have.
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