Drug ID: 3d00000026
Drug Name: Carbamazepine
Generic Names: Carbacontin | Carbacontin | Carbacontin | Carbatol | Carmaz | Carbatol | Tegrital | Acetol | Zen Retard | Tegrital | Mazetol | Mazetol Sr | Zen Retard | Carzep | Versitol | Zen Retard | Carbatol | Tegrital | Mazetol | Zeptol | Versitol | Versitol | Zeptol | Tegrital | Versitol | Acetol | Tegrital | Zeptol | Carmaz | Zen | Carbatrol | Epitol | Equetro | Tegretol | More
Legal Status: Non Opioid Prescription only drug
Indication for Mother: Category D :
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Recommended Dose: Adult: Epilepsy Initial: 100-200 mg 1-2 times/day, may increase slowly. Maintenance: 0.8-1.2 g/day in divided doses. Max: 2 g/day.
Prophylaxis of bipolar disorder Initial: 400 mg/day in divided doses may increase slowly. Maintenance: 400-600 mg/day. Max: 1.6 g/day.
Trigeminal neuralgia Initial: 100 mg 1-2 times/day, may increase slowly. Maintenance: 400-800 mg/day in 2-4 divided doses. Max: 1.2 g/day.
Rectal Epilepsy -250 mg 6 hourly.
Children 6-12 years of age – Initial- Either 100 mg b.i.d. for tablets or XR tablets, or ˝ teaspoon q.i.d. for suspension (200 mg/day).
Children 6 years of age – Initial- 10-20 mg/kg/day b.i.d. or t.i.d. as tablets, or q.i.d. as suspension.
Recommended In: This medication is an anticonvulsant drug, prescribed for epilepsy and bipolar disorder, as well as trigeminal neuralgia. It works by reducing or blocking certain responses in the brain.
Directions For Use: It comes as a capsule to take by mouth, with food.
Storage: Store it at room temperature.
Dosage Forms: Capsule
Side Effects: Most frequent - Dizziness, drowsiness, unsteadiness, nausea and vomiting.
Blood - Anemia, decrease in blood cell counts and bruising.
Skin - Skin disorder, itching, redness, rash, hives, photosensitivity reactions, pigmentation, inflammation, hair loss, increased sweating and Onychomadesis.
Heart - Congestive heart failure, swelling, high/low blood pressure, fainting, collapse, vein inflammation, blood clots in vein and swollen glands.
Liver- Abnormalities in liver function tests, jaundice and liver inflammation.
Respiratory - Fever, diffculty in breathing or pneumonia due to allergic reactions.
Genitourinary - Urinary frequency, urinary retention, elevation of blood urea nitrogen (BUN), kidney failure and impotence.
Gastrointestinal - Abdominal pain, diarrhea, constipation, loss of appetite, dryness of the mouth and pharynx and mouth ulcer.
In Case of Overdose: The first signs and symptoms appear after 1-3 hours. Neuromuscular disturbances are the most prominent. Cardiovascular disorders are generally milder, and severe cardiac complications occur only when very high doses ( > 60 g) have been ingested. Irregular breathing, respiratory depression. Tachycardia, hypotension or hypertension, shock, conduction disorders. Impairment of consciousness ranging in severity to deep coma. Convulsions, especially in small children. Motor restlessness, muscular twitching, tremor, athetoid movements, opisthotonos, ataxia, drowsiness, dizziness, mydriasis, nystagmus, adiadochokinesia, ballism, psychomotor disturbances, dysmetria. Initial hyperreflexia, followed by hyporeflexia. Nausea, vomiting. Anuria or oliguria, urinary retention. Isolated instances of overdosage have included leukocytosis, reduced leukocyte count, glycosuria, and acetonuria. ECG may show dysrhythmias. When alcohol, tricyclic antidepressants, barbiturates, or hydantoins are taken at the same time, the signs and symptoms of acute poisoning with carbamazepine may be aggravated or modified.
Successful management of large or intentional carbamazepine exposures requires implementation of supportive care, frequent monitoring of serum drug concentrations, as well as aggressive but appropriate gastric decontamination. The primary method for gastric decontamination of carbamazepine overdose is use of activated charcoal. For substantial recent ingestions, gastric lavage may also be considered. Dialysis, particularly high flux or high efficiency hemodialysis, may be considered in patients with severe carbamazepine poisoning associated with renal failure or in cases of status epilepticus, or where there are rising serum drug levels and worsening clinical status despite appropriate supportive care and gastric decontamination.
Keep the airways free; resort, if necessary, to endotracheal intubation, artificial respiration, and administration of oxygen. Keep the patient's legs raised and administer a plasma expander. If blood pressure fails to rise despite measures taken to increase plasma volume, use of vasoactive substances should be considered.
Avoid If: Contraindicated in patients with bone marrow depression, co administration with nefazodone, MAOIs or within last 14 days and hypersensitivity.
Caution should be exercised in patients with history of increased eye pressure, psychosis, heart, kidney, thyroid or liver diseases, mood or mental problems, suicidal thoughts, seizures, any allergy, who are taking other medications, elderly, children, during pregnancy and breast feeding.
It may cause drowsiness, dizziness or blurred vision, do not drive a car or operate machinery while taking this medication.
Avoid alcohol consumption.
Patients may develop with increased risk of suicidal thoughts, watch them carefully.
Avoid changing the medication form (tablet to suspension) without healthcare provider’s advice.
It may decrease the effect of hormonal birth control pills; use other methods to prevent pregnancy.
Avoid contact with people with any infection.
It may reduce platelet counts, avoid injury or bruising.
Avoid exposure to sunlight; otherwise it may lead to sunburn.
Drug Interaction: Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.
Other medications can affect the removal of carbamazepine from your body, which may affect how carbamazepine works. Examples include azole antifungals (such as itraconazole), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), St. John's wort, among others.
Carbamazepine can speed up the removal of other drugs from your body, which may affect how they work. Examples of affected drugs include artemether/lumefantrine, boceprevir, certain calcium channel blockers (such as nifedipine, nimodipine), nefazodone, HIV NNRTIs (such as delavirdine, efavirenz, etravirine, rilpivirine), praziquantel, ranolazine, voriconazole, warfarin, among others.
This medication may decrease the effectiveness of hormonal birth control such as pills, patch, or ring. This could cause pregnancy. Discuss with your doctor or pharmacist if you should use additional reliable birth control methods while using this medication. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well.
Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).
Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
This medication may interfere with certain laboratory tests (including thyroid function, some pregnancy tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.