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Carbamazepine  (Systemic)

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Brand Names

In the U.S.—

  • Atretol
  • Carbatrol
  • Epitol
  • Tegretol
  • Tegretol-XR

In Canada—

  • Apo-Carbamazepine
  • Novo-Carbamaz
  • Nu-Carbamazepine
  • Taro-Carbamazepine
  • Taro-Carbamazepine CR
  • Tegretol
  • Tegretol Chewtabs
  • Tegretol CR

Category


Description

Carbamazepine (kar-ba-MAZ-e-peen) is used to control some types of seizures in the treatment of epilepsy. It is also used to relieve pain due to trigeminal neuralgia (tic douloureux). It should not be used for other more common aches or pains.

Carbamazepine may also be used for other conditions as determined by your doctor.

This medicine is available only with your doctor's prescription, in the following dosage forms:



Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For carbamazepine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to carbamazepine or to any of the tricyclic antidepressants, such as amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, protriptyline, or trimipramine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Carbamazepine has not been studied in pregnant women. However, there have been reports of babies having low birth weight, small head size, skull and facial defects, underdeveloped fingernails, and delays in growth when their mothers had taken carbamazepine in high doses during pregnancy. In addition, birth defects have been reported in some babies when the mothers took other medicines for epilepsy during pregnancy. Also, studies in animals have shown that carbamazepine causes birth defects when given in large doses. Therefore, the use of carbamazepine during pregnancy should be discussed with your doctor.

Breast-feeding—Carbamazepine passes into the breast milk, and in some cases the baby may receive enough of it to cause unwanted effects. In animal studies, carbamazepine has affected the growth and appearance of the nursing babies.

Children—Behavior changes are more likely to occur in children.

Older adults—Confusion; restlessness and nervousness; irregular, pounding, or unusually slow heartbeat; and chest pain may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of carbamazepine.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking carbamazepine, it is especially important that your health care professional know if you are taking any of the following:

Other medical problems—The presence of other medical problems may affect the use of carbamazepine. Make sure you tell your doctor if you have any other medical problems, especially:


Proper Use of This Medicine

Carbamazepine suspension and tablets should be taken with meals to lessen the chance of stomach upset (nausea and vomiting). Carbamazepine extended-release capsules do not need to be taken with meals unless they upset your stomach. The contents of these extended-release capsules may be sprinkled over a teaspoonful of applesauce or other similar food; the capsule or its contents should not be crushed or chewed.

It is very important that you take this medicine exactly as directed by your doctor to obtain the best results and lessen the chance of serious side effects. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

If you are taking this medicine for pain relief:

If you are taking this medicine for epilepsy:

Dosing—

The dose of carbamazepine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of carbamazepine. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets or teaspoonfuls of suspension that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking carbamazepine.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. However, if you miss more than one dose a day, check with your doctor.

Storage—

To store this medicine:


Precautions While Using This Medicine

It is very important that your doctor check your progress at regular visits. Your doctor may want to have certain tests done to see if you are receiving the right amount of medicine or if certain side effects may be occurring without your knowing it. Also, the amount of medicine you are taking may have to be changed often.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that cause drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

This medicine may cause some people to become drowsy, dizzy, lightheaded, or less alert than they are normally, especially when they are starting treatment or increasing the dose. It may also cause blurred or double vision, weakness, or loss of muscle control in some people. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert and well-coordinated or able to see well.

Some people who take carbamazepine may become more sensitive to sunlight than they are normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:

If you have a severe reaction from the sun, check with your doctor.

Oral contraceptives (birth control pills) containing estrogen may not work properly if you take them while you are taking carbamazepine. Unplanned pregnancies may occur. You should use a different or additional means of birth control while you are taking carbamazepine. If you have any questions about this, check with your health care professional.

For diabetic patients:

For patients taking the oral suspension form of Tegretol :

Before having any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some pregnancy tests and the metyrapone test may be affected by this medicine.

Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine. Taking carbamazepine together with medicines that are used during surgery or dental or emergency treatments may increase the CNS depressant effects and cause other unwanted effects.

Your doctor may want you to carry a medical identification card or bracelet stating that you are taking this medicine.


Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

In addition, check with your doctor as soon as possible if any of the following side effects occur:

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.


Additional Information

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, carbamazepine is used in certain patients with the following medical conditions:

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.


Revised: 12/07/1998

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