carbamazepine, Tegretol, Tegretol XR , Equetro, Carbatrol, Epitol, Teril

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is carbamazepine, and how does it work (mechanism of action)?

Carbamazepine is an anti-seizure medication. Recurrent seizures (epilepsy) are divided into two main categories according to how much of the brain is involved, either partial or generalized epilepsy (which includes petit mal, grand mal, and myoclonic epilepsy). Seizures are called "simple" if there is no loss of consciousness and "complex" if there is. Medicines that inhibit seizures are called anti-convulsants. Carbamazepine works as an anti-convulsant for partial and grand mal seizures by reducing or blocking certain responses by nerves in the brain. It also is used for treating trigeminal neuralgia. One dosage form, Equetro, has been approved for treating bipolar disorder. The FDA approved carbamazepine in March 1968.

What brand names are available for carbamazepine?

Tegretol, Tegretol XR , Equetro, Carbatrol, Epitol, Teril

Is carbamazepine available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for carbamazepine?

Yes

What are the side effects of carbamazepine?

Serious side effects include dangerously low red and white blood cell counts. Severe skin reactions can occur as well as serious liver abnormalities, such as hepatitis, resulting in jaundice. Low sodium levels and thyroid abnormalities have been described. Minor more common side effects include dizziness, unsteadiness, nausea, and vomiting.

Rarely, patients with Asian ancestry may develop severe skin reactions to carbamazepine (Stevens-Johnson syndrome and toxic epidermal necrolysis). These patients can be identified by genetic testing, and such testing is recommended for all patients who are Asian before starting therapy.

Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.

Quick GuideEpilepsy: Symptoms, Causes and Treatment

Epilepsy: Symptoms, Causes and Treatment

What is the dosage for carbamazepine?

Carbamazepine may be taken with or without food. Carbamazepine is excreted by the kidney and eliminated by the liver, and dosages may need to be lowered in patients with liver or kidney dysfunction.  Blood levels of carbamazepine are used for adjusting dosing. The dose for seizures is 800 to 1600 mg daily in divided doses. Trigeminal neuralgia is treated with 400-1200 mg daily in divided doses. The dose for treating bipolar disorder using Equetro is begun at 200 mg every 12 hours initially, and then increased by 200 mg a day up to a maximum dose of 1600 mg per day.

Which drugs or supplements interact with carbamazepine?

: Carbamazepine interacts with multiple drugs, and caution should be used in combining other medicines with it. Lower levels of carbamazepine are seen when administrated with phenobarbital, phenytoin (Dilantin), or primidone (Mysoline). Warfarin (Coumadin), phenytoin (Dilantin), theophylline, and valproic acid (Depakote, Depakote ER, Depakene, Depacon) are more rapidly eliminated with carbamazepine, while carbamazepine levels are elevated when taken with erythromycin, cimetidine (Tagamet), propoxyphene (Darvon), and calcium channel blockers. Carbamazepine also increases the elimination of the hormones in birth control pills and can reduce the effectiveness of birth control pills. Unexpected pregnancies have occurred in patients taking both carbamazepine and birth control pills.

Is carbamazepine safe to take if I'm pregnant or breastfeeding?

If possible, carbamazepine should not be used in pregnancy or while breastfeeding.

What else should I know about carbamazepine?

What preparations of carbamazepine are available?

Tablets: 200 mg. Chewable tablets; 100 mg. Extended release tablets; 100, 200 and 400 mg. Suspension; 100 mg/5 ml. Equetro is available in 100, 200 and 300 mg extended release tablets

How should I keep carbamazepine stored?

Carbamazepine should be stored in a tight, light resistant container at room temperature.

Reference: FDA Prescribing Information

Summary

Carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol, Epitol, Teril) is an antiseizure medication prescribed to treat simple and complex seizures and grand mal generalized seizures. Side effects, drug interactions, dosage, storage, and patient safety information should be reviewed prior to taking any medication.

Treatment & Diagnosis

Medications & Supplements

Prevention & Wellness

Subscribe to MedicineNet's General Health Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Reviewed on 7/31/2014
References
Reference: FDA Prescribing Information

Health Solutions From Our Sponsors