Anticonvulsant
“Alert: Black Box Warning
Blood dyscrasias:
The risk of developing anemia or agranulocytosis is increased during treatment. Complete pretreatment hematological testing should be obtained prior to use; monitor patient closely if white blood cells or platelet counts decrease during therapy; discontinue if significant bone marrow suppression occurs.
Dermatologic toxicity:
Severe and sometimes fatal dermatologic reactions, including toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), may occur during therapy. The risk is increased in patients with the variant HLA-B*1502 allele, found most often in patients of Asian ancestry. Patients with an increased likelihood of carrying this allele should be screened prior to initiating therapy. Avoid use in patients testing positive for the allele; discontinue therapy in patients who have a serious dermatologic reaction. “
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Carbamazepine, Tegretol is a sodium channel block which prevents repetitive and sustained action potentials in the neuronal membrane leading to a reduction in synaptic neuronal transmission in the central nervous system. Carbamazepine, Tegretol has also been shown to exhibit in addition to anticonvulsant properties, anticholinergic, antineuralgic, antidiuretic, muscle relaxant, antimanic, antidepressive, and antiarrhythmic properties.
Indications For Use
Bipolar disorder, focal (partial) onset seizures and generalized onset seizures, neuropathic pain.
Precautions
Before starting Carbamazepine, Tegretol makes sure your physician is aware of any allergies or medications you currently take and is prepared to monitor you thoroughly while on Carbamazepine, Tegretol. You can experience drowsiness, agitation, and suicidal ideation. There are serious side effects associated with taking Carbamazepine, Tegretol such as blood dyscrasias, dermatologic toxicity, hepatic and renal toxicity, and multi-organ hypersensitivity reactions.
Usual Dosing
Oral: 100mg to 1800mg daily in divided doses depending on achieving the optimal response to therapy.
Pharmacist Tips On Using
How to Take:
Chewable or Immediate Release Tablets: Take with food.
ER Capsule: Consists of three different types of beads: immediate release, extended release, and enteric release. The bead types are combined in a ratio to allow twice daily dosing. May be opened and contents sprinkled over food such as a teaspoon of applesauce; may be administered with or without food; do not crush or chew capsule or beads inside the capsule.
ER Tablet: Should be inspected for damage. Damaged ER tablets (without release portal) should not be administered. Should be administered with meals; swallow whole, do not crush or chew.
Suspension: Shake well before administration. Must be given on a 3 to 4 times/day schedule versus tablets, which can be given 2 to 4 times/day. Because a given dose of suspension will produce higher peak and lower trough levels than the same dose given as the tablet form, patients given the suspension should be started on lower doses given more frequently (same total daily dose) and increased slowly to avoid unwanted side effects. When carbamazepine suspension has been combined with chlorpromazine or thioridazine solutions, a precipitate forms, which may result in loss of effect. Therefore, it is recommended that the carbamazepine suspension dosage form not be administered at the same time with other liquid medicinal agents or diluents. Should be administered with meals.
Side Effects
Dizziness, drowsiness, ataxia, nausea, vomiting
Note this is not a complete list of side effects for Carbamazepine, Tegretol only common ones
Frequently Asked Questions
Why do I feel so down/depressed since starting this medication? /Why am I having mood swings since starting this medication?
Rarely antiepileptic medications such as this can cause mood or behavior changes and in severe cases result in suicidal ideation. If you are feeling any of these things or family members are reporting mood or behavioral changes, see your physician immediately to discuss your options as it could be a result of this medication. Many scenarios where this medication is used can also result in these mood or behavioral changes so it is important to be open and honest with your physician about your feelings to make sure they have all of the information to treat you.
Why would my physician prescribe a medication with such serious side effects?
Your physician takes the most recent clinical guidelines to make evidence-based decisions on what medication is appropriate in which situations. Your current medications, your allergies, age, cost of medication, comorbid conditions, and many other factors will further complicate or limit which medications are appropriate. This medication is used for many serious conditions and your physician has determined the benefits outweigh the risks. Furthermore, they will be monitoring your bloodwork and symptoms closely to see if any serious complications are starting to arise and be able to adjust therapy to prevent progression.