Details About Generic Salt ::  Carbamaz

Main Medicine Class::    

Atreol, Carbatrol, Epitol, Tegretol, Tegretol XR, APO-Carbamazepine, Novocarbamaz, Tegretol CR
Class: Anticonvulsant


Drugs Class ::

 Action Mechanism appears to act by reducing polysynaptic responses and blocks post-tetanic potentiation.

Indications for Drugs ::

 Indications Treatment of epilepsy (partial seizures with complex symptoms, generalized tonic-clonic seizures [grand mal], mixed seizure patterns or other partial or generalized seizures), in patients refractory to or intolerant of other agents. Treatment of pain of trigeminal neuralgia. Unlabeled use(s): Management of neurogenic diabetes insipidus; treatment of certain psychiatric disorders; management of alcohol, cocaine and benzodiazepine withdrawal; relief of restless legs syndrome. Nonhereditary chorea in children.

Drug Dose ::



ADULTS: Initial dose: PO 200 mg bid (tablets) or 100 mg qid (suspension). Increase weekly by up to 200 mg/day in 3–4 divided doses to reach minimum effective dose (maximum 1200 mg/day). CHILDREN > 15 yr: PO 200 mg bid (tablets) or 100 mg qid (suspension). Increase weekly by up to 200 mg/day in 3–4 divided doses to reach minimum effective dose (maximum 1200 mg/day). CHILDREN 12–15 YR: Initial dose: PO 200 mg bid (tablets) or 100 mg qid (suspension). Increase weekly by up to 200 mg/day in 3–4 divided doses to reach minimum effective dose (maximum 1000 mg/day). ADULTS & CHILDREN > 12 YR: Maintenance: 800–1200 mg/day. CHILDREN 6–12 YR: Initial dose: PO 100 mg bid (tablets) or 50 mg qid (suspension). Increase weekly by 100 mg/day in 3–4 divided doses to reach minimum effective dose (maximum 1000 mg/day). (Alternative regimen: 20–30 mg/kg/day in divided doses tid or qid). Maintenance: 400–800 mg/day in 3–4 divided doses. Extended Release: ADULTS & CHILDREN > 12 YR: Initial dose: PO 200 mg twice daily.

Trigeminal Neuralgia

ADULTS: initial dose: PO 100 mg bid (tablets) or 50 mg qid (suspension). may increase by up to 200 mg/day in 3–4 divided doses (tablets: 100 mg increments q 12 hr; suspension: 50 mg qid) prn (maximum 1200 mg/day). maintenance: 200–1200 mg/day. use minimum effective dose or discontinue drug once every 3 mo. extended release: ADULTS: Initial dose: PO 100 mg twice daily.

Contraindication ::

 Contraindications Hypersensitivity to tricyclic antidepressants; history of bone marrow depression; active liver disease. Discontinue MAO inhibitors at least 14 days before administration of carbamazepine.

Drug Precautions ::


Pregnancy: Category D. Lactation: Excreted in breast milk. Children: Safety and efficacy in children < 6 yr not established. Elderly: May make elderly more prone to CNS side effects; may cause confusion, agitation or activation of latent psychosis. Special-risk patients: Use with caution in patients with prior adverse hematologic reactions to any drug; glaucoma; cardiac, hepatic or renal disease; and mixed seizure disorders, including absence seizures. Aplastic anemia and agranulocytosis: Has been associated with carbamazepine therapy. The risk of developing these reactions is 5 to 8 times greater than in the general population; however, the overall risk of these reactions in the untreated general population is low. Obtain complete pretreatment hematological testing as a baseline. If in the course of treatment, a patient exhibits low are decreased white blood cell or platelet counts, monitor the patient closely.


Drug Side Effects ::

 Adverse Reactions

CV: AV block; CHF; hypertension; hypotension; syncope; edema; thrombophlebitis; aggravation of coronary artery disease; arrhythmias. CNS: Dizziness; drowsiness; unsteadiness; confusion; headache; hyperacusis; fatigue; speech disturbances; abnormal involuntary movements; peripheral neuritis and paresthesias; depression with agitation; talkativeness; behavior changes (children); paralysis. DERM: Pruritic and erythematous rashes; exfoliative dermatitis; erythema multiforme and nodosum; purpura; aggravation of disseminated lupus erythematosus; toxic epidermal necrolysis; urticaria; photosensitivity; pigment changes; alopecia; diaphoresis; Stevens-Johnson syndrome. EENT: Blurred vision; visual hallucinations; diplopia; nystagmus; punctate cortical lens opacities; conjunctivitis; tinnitus; dryness and irritation of the mouth and throat. GI: Nausea; vomiting; gastric distress; abdominal pain; diarrhea; constipation; anorexia; GU: Urinary frequency or retention; oliguria with hypertension; renal failure; azotemia; impotence; albuminuria; glycosuria; elevated BUN; urinary microscopic deposits. HEMA: Aplastic anemia; leukopenia; agranulocytosis; eosinophilia; leukocytosis; thrombocytopenia; pancytopenia; bone marrow depression. HEPA: Abnormal liver function tests; jaundice; hepatitis. META: Hyponatremia; hypothyroidism. RESP: Pulmonary hypersensitivity (eg, fever, dyspnea, pneumonitis or pneumonia). OTHER: Aching joints and muscles; leg cramps; adenopathy; lymphadenopathy; fever; chills; SIADH.

Drug Mode of Action ::  

 Action Mechanism appears to act by reducing polysynaptic responses and blocks post-tetanic potentiation.

Drug Interactions ::


Anticoagulants: May decrease anticoagulant effects. Barbiturates: May result in decreased carbamazepine serum concentrations, possibly leading to decreased effectiveness. Charcoal, activated: May reduce absorption of carbamazepine. Cimetidine: May result in carbamazepine toxicity. Contraceptives, oral: Causes breakthrough bleeding and reduces effectiveness of contraceptives. Diltiazem, verapamil, danazol, propoxyphene, macrolide antibiotics (except azithromycin): May increase carbamazepine levels and may result in toxicity. Doxycycline hyclate: May decrease doxycycline hyclate levels. Felbamate: May decrease concentrations of felbamate or carbamazepine. Felodipine: May decrease effects of felodipine. Haloperidol: May decrease effects of haloperidol. Hydantoins (eg, phenytoin): May decrease carbamazepine levels; may alter hydantoin levels. Isoniazid: May result in toxicity of isoniazid, carbamazepine or both. Lithium: May cause adverse CNS effects regardless of drug levels. Macrolide antibiotics (eg, clarithromycin, erythromycin, troleandomycin): May increase toxicity. Nondepolarizing muscle relaxants: May make these agents less effective. Primidone: Decreased carbamazepine levels. Primidone’s active metabolite (phenobarbital) may be increased. Propoxyphene: Increases carbamazepine levels. SSRIs (fluoxetine, fluvoxamine): Increased carbamazepine levels with possible toxicity. Theophylline: May reduce effects of theophylline and carbamazepine. Theophylline levels may be increased or decreased. Tricyclic antidepressants: May increase carbamazepine levels; may decrease tricyclic antidepressant levels. Valproic acid: May decrease valproic acid levels; may alter carbamazepine levels. Verapamil: Concomitant therapy has resulted in symptoms of toxicity.

Drug Assesment ::


  • Obtain patient history, including drug history and any known allergies.
  • Note hypersensitivity to tricyclic antidepressants.
  • Determine if MAO inhibitors have been taken within last 2 wk.
  • Perform pretreatment baseline hematologic studies (CBC, platelets, reticulocyte, serum iron), liver function tests, eye examination, urinalysis and BUN, and continue to monitor monthly for first 2 mo and then yearly throughout treatment.
  • Monitor drug levels if noncompliance or toxicity is suspected.
  • If signs of bone marrow suppression occur (infections, sore throat, bruising, unusual bleeding), notify physician immediately.
  • If signs of liver dysfunction occur (jaundice, dark urine, light-colored stools), withhold drug and notify physician immediately.
  • If signs of renal dysfunction occur (decreased urine output, elevated BUN, elevated creatinine), notify physician immediately.

  Irregular breathing, respiratory depression, tachycardia, hypotension, hypertension, shock, coma, LOC, convulsions, muscle twitching, tremor, ataxia, drowsiness, dizziness, nystagmus, nausea, vomiting, anuria, urinary retention, abnormal EEG

Drug Storage/Management ::


  • Discontinue MAO inhibitors for minimum 2 wk before administering carbamazepine.
  • Give with food to reduce GI irritation. Tablets can be crushed and mixed with food.
  • Carbamazepine suspension may produce higher peak level than equivalent tablet dose. Adjust dose accordingly when switching from one form of drug to other.
  • Shake suspension thoroughly before administration.
  • To minimize loss via nasogastric tube due to adherence to polyvinyl chloride tubing, dilute suspension with equal volume of diluent and flush tube after administration.
  • Store in cool, dry environment.

Drug Notes ::

 Patient/Family Education

  • Instruct patient to carry/wear identification indicating use of this drug.
  • Advise patient that drowsiness, dizziness, and ataxia are common reactions during first few days of therapy.
  • Inform patient with epilepsy that abrupt withdrawal from this drug may precipitate seizures.
  • Advise patient to use nonhormonal form of contraception.
  • If drowsiness, sedation or blurred vision occurs, institute safety precautions.
  • Instruct patient to report these symptoms to physician: nosebleeds, mouth ulcers, sore throat, petechiae, unusual bleeding, fever, jaundice, dark urine or light-colored stools.
  • Caution patient to avoid exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.


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