CARBAMAZEPINE

Brand & Generic Names

Apo-Carbamazepine
Epitol
Mazepine
Novocarbamaz
PMS Carbamazepine
Tegretol
Tegretol Chewtabs
Tegretol CR

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Analgesic, anticonvulsant

Uses

• Decreased frequency, severity and duration of attacks of tic douloureaux*.
• Prevents seizures.
• Used for pain relief, alcohol withdrawal, bipolar disorder, diabetes insipidus.

Dosage & Usage Information

How to take:
Regular or chewable tablet--Swallow with liquid or food to lessen stomach irritation.

When to take:
At the same times each day.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Reduces transmission of pain messages at certain nerve terminals.
Reduces excitability of nerve fibers in brain, thus inhibiting repetitive spread of nerve impulses.

Time lapse before drug works:
Tic douloureaux--24 to 72 hours.
Seizures--1 to 2 weeks.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Involuntary movements, irregular bleeding, decreased urination, decreased blood pressure, dilated pupils, flushed skin, stupor, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• If patient is unconscious and not breathing, give mouth-to- mouth breathing. If there is no heartbeat, use cardiac massage and mouth-to-mouth breathing (CPR). Don't try to make patient vomit. If you can't get help quickly, take patient to nearest emergency facility.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

• Blurred vision. convenient.
• Back-and-forth eye movements.

Infrequent:

• Confusion, slurred speech, fainting, depression, headache, hallucinations, hives, rash, mouth sores, sore throat, fever, unusual bleeding or bruising, unusual fatigue, jaundice.
• Diarrhea, nausea, vomiting, constipation, dry mouth, impotence.

Rare:

• Breathing difficulty; irregular, pounding or slow heartbeat; chest pain; uncontrollable body jerks; numbness, weakness or tingling in hands and feet; tender, bluish legs or feet; less urine; swollen lymph glands.
• Frequent urination, muscle pains, joint aches.

Warnings & Precautions

Don't take if:

• You are allergic to carbamazepine.
• You have had liver or bone-marrow disease.
• You have taken MAO inhibitors in the past 2 weeks.

Before you start, consult your doctor:

• If you have high blood pressure, thrombophlebitis or heart disease.
• If you have glaucoma.
• If you have emotional or mental problems.
• If you have liver or kidney disease.
• If you drink more than 2 alcoholic drinks per day.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Studies inconclusive on harm to unborn child. Animal studies show fetal abnormalities. Decide with your doctor whether drug benefits justify risk to unborn child.

Breast-feeding:
Drug passes into milk. Avoid drug or discon- tinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Not recommended.

Prolonged use:

• Jaundice and liver damage.
• Hair loss.
• Ringing in ears.
• Lower sex drive.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check complete blood counts (white blood cell count, platelet count, red blood cell count, hemoglobin, hematocrit), serum iron.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes.

Discontinuing:
Don't discontinue without doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.

Others:

• Use only if less-hazardous drugs are not effective. Stay under medical supervision.
• Periodic blood tests are needed.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticoagulants*,	Decreased anti-
oral	coagulant effect.
Anticonvulsants,	Decreased effect of
hydantoin*	both drugs.
Antidepressants,	Confusion. Possible
tricyclic (TCA)*	psychosis.
Barbiturates	Possible increased barbiturate
	metabolism.
Cimetidine	Increased carbamazepine effect.
Cisapride	Decreased carbamazepine effect.
Clozapine	Toxic effect on bone marrow and
	central nervous system.
Contraceptives*,	Reduced contraceptive
oral	protection. Use another birth-
	control method.
Cortisone*	Decreased cortisone effect.
Desmopressin	May increase desmopressin effect.
Digitalis	Excess slowing of
preparations*	heart.
Doxycycline	Decreased doxycycline effect.
Erythromycins*	Increased carbamazepine effect.
Estrogens	Decreased estrogen effect.
Ethinamate	Dangerous increased effects of
	ethinamate. Avoid combining.
Fluoxetine	Increased depressant effects of
	both drugs.
Guanfacine	May increase depressant effects of
	either drug.
Isoniazid	Increased risk of liver damage.
Leucovorin	High alcohol content of leucovorin
	may cause adverse effects.
MAO Inhibitors*	Dangerous over stimulation. Avoid.
Mebendazole	Decreased effect of mebendazole.
Methyprylon	Increased sedative effect, perhaps
	to dangerous level. Avoid.
Nabilone	Greater depression of central
	nervous system.
Nicardipine	May increase carbamazepine effect
	and toxicity.
Nimodipine	May increase carbamazepine effect
	and toxicity.
Nizatidine	Increased carbamazepine effect and
	toxicity.
Phenytoin	Decreased carbamazepine effect.
Phenobarbital	Decreased carbamazepine effect.
Primidone	Decreased carbamazepine effect.
Propoxyphene (Darvon)	Increased toxicity of both. Avoid.
Sertraline	Increased depressive effects of both
	drugs.
Tiopronin	Increased risk of toxicity to bone
	marrow.
Tranquilizers*	Increased
(benzodiazepine)	carbamazepine effect.
Verapamil	Possible increased carbamazepine
	effect.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Increased sedative effect of
	alcohol. Avoid.
Beverages:	None expected.
Cocaine:	Increased adverse effects of
	carbamazepine. Avoid.
Foods:	None expected.
Marijuana:	Increased adverse effects of
	carbamazepine. Avoid.
Tobacco:	None expected.