Carbamazepine

💊 What is Carbamazepine used for?

• •Partial seizures with complex symptoms (also called psychomotor or temporal lobe seizures)
• •Generalized tonic-clonic seizures (also called grand mal seizures)
• •Mixed seizure patterns that include these types or other partial or generalized seizures
• •Pain from true trigeminal neuralgia
• •Glossopharyngeal neuralgia (the label says beneficial results have also been reported)

How it works

How it is usually taken

• •The label says the medicine should be taken with meals.
• •The dose is adjusted to each person's needs. The label says a low starting dose with a gradual increase is advised.
• •Once seizures are controlled, the label says the dose may be lowered very gradually to the lowest effective level.
• •The label says blood level monitoring can help with effectiveness and safety.
• •The label says this medicine is not a simple pain reliever and should not be used for minor aches or pains.
• •Follow the instructions from your prescriber or pharmacist for your own dose and schedule.

Comes as

• •200 mg tablets (white, capsule-shaped, scored)

⚠️ Carbamazepine side effects

🛑 Who should not take Carbamazepine, and who should be careful

The label says not to take it if

• 🚨You have a history of bone marrow depression.
• 🚨You are allergic to carbamazepine or any of its ingredients.
• 🚨You take nefazodone. The label says this combination is contraindicated.
• 🚨You are allergic to tricyclic antidepressants (TCAs). Ask your provider or pharmacist for a list of these medicines if you are not sure.
• 🚨You have taken a monoamine oxidase inhibitor (MAOI) in the last 14 days. The label says MAOIs should be stopped for at least 14 days before carbamazepine, or longer if the situation permits.
• 🚨You test positive for HLA-B*1502. The label says carbamazepine should not be used unless the benefits clearly outweigh the risks.

Tell your doctor before taking it if

• •Tell your provider if you have or have had suicidal thoughts or actions, depression, or mood problems.
• •Tell your provider if you have or have had heart, blood, liver, or kidney problems, or increased pressure in your eye.
• •Tell your provider about any allergic reactions to medicines.
• •Tell your provider if you drink or eat grapefruit or grapefruit juice.
• •Tell your provider if you use birth control. The label says carbamazepine may make birth control less effective, and menstrual bleeding changes should be reported.
• •Tell your provider if you are pregnant or plan to become pregnant, or if you are breastfeeding or plan to breastfeed.
• •The label says blood testing is needed before treatment as a baseline.
• •If you are of Asian descent, the label says you may need a genetic blood test (HLA-B*1502) before taking carbamazepine.

🔀 Carbamazepine with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Nefazodone: the label says carbamazepine should not be taken with nefazodone.
• •Monoamine oxidase inhibitors (MAOIs): the label says they are not recommended, and they should be stopped at least 14 days before carbamazepine.
• •Liquid medicines: the label reports that mixing carbamazepine suspension with chlorpromazine (Thorazine) or liquid Mellaril formed an orange rubbery precipitate. The label says carbamazepine suspension should not be given at the same time as other liquid medicines or diluents.
• •Other anticonvulsants: the label says carbamazepine may be used alone or with other anticonvulsants, and phenytoin may need to be increased when added.
• •Grapefruit: the label asks patients to tell their provider if they drink or eat grapefruit.
• •Birth control: the label says carbamazepine may make birth control less effective.
• •The label says there are other clinically meaningful interactions, but the full list is not included in the text provided.

Alcohol and food

The label does not say.

🤰 Carbamazepine in pregnancy and breastfeeding

Pregnancy

The label says carbamazepine may harm an unborn baby. You and your healthcare provider should decide whether to take it during pregnancy. Tell your provider right away if you become pregnant while taking it. The label mentions the North American Antiepileptic Drug (NAAED) Pregnancy Registry, which collects safety information. You can enroll by calling 1-888-233-2334.

Breastfeeding

The label says carbamazepine passes into breast milk. It also says there is potential for serious side effects in nursing infants. A decision should be made about whether to stop nursing or stop the drug, taking into account how important the drug is to the mother.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20° to 25°C (68° to 77°F). Protect from light and moisture. Keep in a tight, light-resistant, child-resistant container.

If a dose is missed

The label does not say.

If too much is taken

The label reports that deaths have occurred after carbamazepine overdoses. Early signs and symptoms can appear within 1 to 3 hours, and nervous system (neuromuscular) disturbances are the most prominent. Breathing problems and heart problems can also occur. If an overdose is suspected, get emergency medical help right away.

🗒️ Questions to ask about Carbamazepine

• Am I at risk for serious skin reactions, and do I need the HLA-B*1502 genetic test before starting?
• How often will I need blood tests while taking this medicine?
• What should I do if I develop a rash or a fever during treatment?
• Can I still use my birth control while taking carbamazepine?
• Are there other medicines or foods, such as grapefruit, that I should avoid with this medicine?
• What warning signs of mood changes or suicidal thoughts should I watch for, and who should I call?

❓ Carbamazepine: frequently asked questions