Carbamazepine
This medicine is in class of anticonvulsants drugs. It works by reducing abnormal electrical activity in the brain. It is used to control certain types of seizures in people with epilepsy. It is also used to treat trigeminal neuralgia (a condition that causes facial nerve pain). Carbamazepine are also used to treat episodes of mania (frenzied, abnormally excited or irritated mood) or mixed episodes (symptoms of mania and depression that happen at the same time) in patients with bipolar I disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods).
How should Carbamazepine be used?
Carbamazepine comes as a tablet, a chewable tablet, an extended-release (long-acting) tablet, an extended-release capsule, and as a suspension (liquid) to take by mouth. The regular tablet, chewable tablet, and suspension are usually taken two to four times a day with meals. The extended-release tablet (Tegretol XR) is usually taken twice a day with meals. The extended-release capsule (Carbatrol, Equetro) is usually taken twice a day with or without meals. To help you remember to take carbamazepine, take it at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take carbamazepine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the extended-release tablets whole; do not split, chew, or crush them. The extended-release capsules may be opened and the beads inside sprinkled over food, such as a teaspoon of applesauce or similar food. Do not crush or chew the extended-release capsules or the beads inside them.
Shake the suspension well before each use to mix the medication evenly.
Your doctor will start you on a low dose of carbamazepine and gradually increase your dose.
Carbamazepine may help control your condition but will not cure it. It may take a few weeks or longer before you feel the full benefit of carbamazepine. Continue to take carbamazepine even if you feel well. Do not stop taking carbamazepine without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood. If you have a seizure disorder and you suddenly stop taking carbamazepine, your seizures may become worse. Your doctor will probably decrease your dose gradually.
Other uses of Carbamazepine
Carbamazepine is also sometimes used to treat mental illnesses, depression, posttraumatic stress disorder, drug and alcohol withdrawal, restless legs syndrome, diabetes insipidus, certain pain syndromes, and a disease in children called chorea. Talk to your doctor about the possible risks of using this medication for your condition.
What special precautions should I follow?
Before taking carbamazepine,
tell your doctor and pharmacist if you are allergic (rash, wheezing, hives, difficulty swallowing or breathing, swelling of your face, eyes, eyelids, lips, or tongue) to carbamazepine, amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor, Zonalon), imipramine (Tofranil), nortriptyline (Pamelor), oxcarbazepine (Trileptal), protriptyline, other medications for seizures such as phenobarbital, phenytoin (Dilantin, Phenytek), or primidone (Mysoline), any other medications, or any of the ingredients in carbamazepine preparations. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
Some medications should not be taken with carbamazepine. Make sure you have discussed any medications you are currently taking or plan to take with your doctor and pharmacist before starting carbamazepine. Before starting, stopping, or changing any medications while taking carbamazepine, get the advice of your healthcare provider.
tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Your doctor will probably tell you not to take carbamazepine. If you stop taking carbamazepine, you should wait at least 14 days before you start to take an MAO inhibitor.
tell your doctor and pharmacist what other prescription medications, vitamins, and nutritional supplements you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
The following nonprescription or herbal products may interact with carbamazepine: acetaminophen (Tylenol), cimetidine (Tagamet), ibuprofen (Advil, Motrin), loratadine (Claritin), and omeprazole (Prilosec OTC, Zegerid OTC). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking carbamazepine. Do not start any of these medications while taking carbamazepine without discussing it with your healthcare provider.
if you are taking any other liquid medications, do not take them at the same time as carbamazepine suspension.
tell your doctor if you have or have ever had glaucoma (a condition in which increased pressure in the eye can lead to gradual loss of vision); or heart, kidney, thyroid, or liver disease.
you should know that carbamazepine may decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, injections, implants, or intrauterine devices). Use another form of birth control while taking carbamazepine. Tell your doctor if you have unexpected vaginal bleeding or think you may be pregnant while you are taking carbamazepine.
tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Carbamazepine may harm the fetus. If you become pregnant while taking carbamazepine, call your doctor immediately.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking carbamazepine.
you should know that carbamazepine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
remember that alcohol can add to the drowsiness caused by this medication.
you should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while you are taking carbamazepine for the treatment of epilepsy, mental illness, or other conditions. A small number of adults and children 5 years of age and older (about 1 in 500 people) who took anticonvulsants such as carbamazepine to treat various conditions during clinical studies became suicidal during their treatment. Some of these people developed suicidal thoughts and behavior as early as one week after they started taking the medication. There is a risk that you may experience changes in your mental health if you take an anticonvulsant medication such as carbamazepine, but there may also be a risk that you will experience changes in your mental health if your condition is not treated. You and your doctor will decide whether the risks of taking an anticonvulsant medication are greater than the risks of not taking the medication. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: panic attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling or staying asleep; aggressive, angry, or violent behavior; mania (frenzied, abnormally excited mood); talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; giving away prized possessions; or any other unusual changes in behavior or mood. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.
if you have fructose intolerance (an inherited condition in which the body lacks the protein needed to break down fructose [a fruit sugar found in certain sweeteners such as sorbitol]), you should know that the oral suspension is sweetened with sorbitol. Tell your doctor if you have fructose intolerance.
What side effects can this medication cause?
Carbamazepine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
dizziness
thinking abnormal
difficulty speaking
uncontrollable shaking of a part of the body
constipation
dry mouth
Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING and SPECIAL PRECAUTION sections, call your doctor immediately:
confusion
rash
fast, slow, or pounding heartbeat
yellowing of the skin or eyes
dark urine
pain on the right side of your stomach area
loss of appetite
nausea
vomiting
vision changes
fatigue
swelling of your face, eyes, eyelids, lips, or tongue
difficulty swallowing or breathing
headache, new or increased number of seizures, difficulty concentrating, confusion, weakness, or unsteadiness
severe rash with one or more of the following: fever, muscle or joint aches, red or swollen eyes, blisters or peeling skin, mouth sores, or swelling of your face or neck
Carbamazepine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
Symptoms of overdose may include the following:
unconsciousness
restlessness
muscle twitching
abnormal movements
shaking of a part of your body that you cannot control
unsteadiness
drowsiness
dizziness
vision changes
irregular or slowed breathing
rapid or pounding heartbeat
nausea
vomiting
difficulty urinating
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