Drugs A - Z

Carbamazepine Chewable tablet

It is used to control seizures caused by certain types of epilepsy

Generic Name: carbamazepine

Brand Names: Tegretol XR, Tegretol, Equetro, Epitol, Carbatrol

There is an FDA Alert for this drug. Click here to view it.

    Serious Dermatologic Reactions and HLA-B*1502 Allele
  • Serious and sometimes fatal dermatologic reactions, including toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), reported in patients receiving carbamazepine therapy.
  • Such reactions are estimated to occur in 1–6 per 10,000 new users of carbamazepine in countries with mainly Caucasian populations; however, risk in some Asian countries estimated to be approximately 10 times higher.
  • Retrospective, case-control studies in patients of Asian ancestry have demonstrated a strong association between risk of developing SJS and TEN and presence of human leukocyte antigen (HLA)-B*1502, an inherited allelic variant of the HLA-B gene. The HLA-B*1502 allele is found almost exclusively in patients with ancestry across broad areas of Asia.
  • Screen patients with ancestry in genetically at-risk populations for presence of HLA-B*1502 prior to initiating carbamazepine therapy. Patients testing positive for the allele should not receive carbamazepine therapy unless benefit clearly outweighs risk. (See Serious Dermatologic Reactions and HLA-B*1502 Allele under Cautions.)

    Hematologic Effects
  • Aplastic anemia and agranulocytosis reported.
  • Risk of aplastic anemia or agranulocytosis in patients receiving carbamazepine appears to be 5–8 times greater than that in general population, but overall risk of these reactions in untreated general population is low (about 6 or 2 cases per million population year for agranulocytosis or aplastic anemia, respectively).
  • Transient or persistent minor hematologic changes (e.g., decreased leukocyte or platelet counts) are not uncommon, but, in most cases, have not progressed to more serious conditions (e.g., aplastic anemia, agranulocytosis).
  • Determine baseline hematologic function before initiation of therapy; closely monitor patients exhibiting abnormalities during therapy. Most hematologic changes observed during periodic monitoring are unlikely to signal occurrence of aplastic anemia or agranulocytosis.
  • Consider discontinuance if evidence of substantial bone marrow depression develops.

REMS:

FDA approved a REMS for carbamazepine to ensure that the benefits of a drug outweigh the risks. The REMS may apply to one or more preparations of carbamazepine and consists of the following: medication guide. See the FDA REMS page ([Web]) or the ASHP REMS Resource Center ([Web]).

What is this medicine?

CARBAMAZEPINE (kar ba MAZ e peen) is used to control seizures caused by certain types of epilepsy. This medicine is also used to treat nerve related pain. It is not for common aches and pains.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
  • Asian ancestry
  • bone marrow disease
  • glaucoma
  • heart disease or irregular heartbeat
  • kidney disease
  • liver disease
  • porphyria
  • psychotic disorders
  • suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
  • an unusual or allergic reaction to carbamazepine, tricyclic antidepressants, phenytoin, phenobarbital or other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

Take this medicine by mouth. Chew it or swallow whole. Follow the directions on the prescription label. Take this medicine with food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking this medicine except on the advice of your doctor or health care professional.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children 6 years of age and younger for selected conditions, precautions do apply.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
  • delavirdine
  • MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
  • nefazodone
  • oxcarbazepine

This medicine may also interact with the following medications:

  • acetaminophen
  • acetazolamide
  • barbiturate medicines for inducing sleep or treating seizures, like phenobarbital
  • certain antibiotics like clarithromycin, erythromycin or troleandomycin
  • cimetidine
  • cyclosporine
  • danazol
  • dicumarol
  • doxycycline
  • female hormones, including estrogens and birth control pills
  • grapefruit juice
  • isoniazid, INH
  • levothyroxine and other thyroid hormones
  • lithium and other medicines to treat mood problems or psychotic disturbances
  • loratadine
  • medicines for angina or high blood pressure
  • medicines for cancer
  • medicines for depression or anxiety
  • medicines for sleep
  • medicines to treat fungal infections, like fluconazole, itraconazole or ketoconazole
  • medicines used to treat HIV infection or AIDS
  • methadone
  • niacinamide
  • praziquantel
  • propoxyphene
  • rifampin or rifabutin
  • seizure or epilepsy medicine
  • steroid medicines such as prednisone or cortisone
  • theophylline
  • tramadol
  • warfarin


Last Updated: July 15, 2011
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