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 BRAND NAMES
- International: Tegretol
- Italy: Tegretol
 MECHANISM OF ACTION
Carbamazepine major anticonvulsant mechanism consist on the blockade of conductance at the neuronal voltage-dependent sodium channel.
- Anticonvulsant for the following seizure types:
- Partial seizures
- Tonic-clonic seizures (grand mal)
- Carbamazepine is a mood stabilizer indicated for the treatment of acute manic or mixed episodes associated with bipolar I disorder
- Treatment of the pain associated true trigeminal neuralgia
- Bone marrow depression
- Known hypersensitivity to Carbamazepine
- Known hypersensitivity to tricyclic antidepressants (amitriptyline, desipramine, imipramine, protriptyline, nortriptyline, etc.)
- Concomitant use with monoamine oxidase inhibitors (MAOIs) or use within 14 days of discontinuing an MAOI
- Concomitant use with delavirdine or other non-nucleoside reverse transcriptase inhibitors. Carbamazepine decreases efficacy of these drugs
- Concomitant use of nefazodone (Nefazodone is a substrate and a competitive inhibitor of CYP3A4; Carbamazepine is a potent inducer of hepatic CYP3A4. Coadministration of carbamazepine and nefazodone may result in an increased metabolism and insufficient plasma concentrations of nefazodone.)
 WARNINGS AND PRECAUTIONS
Serious Dermatologic Reactions(Skin rashes)
Decreased bone marrow function: Aplastic Anemia and Agranulocytosis (lowered white blood cell count)
- Drug Reaction with Eosinophilia and Systemic Symptoms also known as Multiorgan hypersensitivity, has occurred with Carbamazepine. Monitor for hypersensitivity (signs or symptoms include fever, rash, and/or lymphadenopathy, in association with other organ system involvement, such as hepatitis, nephritis, hematologic abnormalities, myocarditis, or myositis sometimes resembling an acute viral infection. Eosinophilia is often present)
- Suicidal Behavior and Ideation: Antiepileptic drugs, including Carbamazepine, increase the risk of suicidal thoughts or behavior. Monitor for depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.
- Embryofetal Toxicity: Advise women of child-bearing potential of possible risks to the fetus.
- Abrupt Discontinuation and Risk of Seizure: Antiepileptic drugs should not be discontinued abruptly. Taper the dose when discontinuing treatment.
- Hyponatremia: Hyponatremia has been reported in association with Carbamazepine use, either alone or in combination with some diuretics (Hydrochlorothiazide, Furosemide). Signs and symptoms of hyponatremia include headache, new or increased seizure frequency, difficulty concentrating, memory impairment, confusion, weakness, and unsteadiness, which can lead to fall.
- Hepatic Porphyria: Avoid Carbamazepine use in patients with hepatic porphyria. Carbamazepine can cause acute episodes of porphyria
 PREGNANCY AND LACTATION
- Pregnancy Category D (US). Carbamazepine can cause fetal harm (congenital malformations, including spina bifida) when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. Use in pregnancy only if the potential benefits of treatment outweigh the risks.
- Nursing Mothers: Discontinue drug or discontinue nursing, taking into consideration importance of drug to mother
 SIDE EFFECTS
The most frequently observed adverse reactions are: Drowsiness, dizziness,, nausea, vomiting, ataxia, constipation, pruritus, dry mouth, asthenia, rash, blurred vision, unsteadiness, and speech disorder.
For serious adverse reactions (See WARNINGS AND PRECAUTIONS)
 RELATED LINKS