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Carbamazepine
- Bipolar disorder -- The medication is approved to treat manic or mixed episodes (which include characteristics of both mania and depression) associated with bipolar disorder, also known as manic depression.
- Epilepsy -- Carbamazepine is approved to treat various types of seizures, though it is usually not effective at treating absence seizures (petit mal seizures).
- Trigeminal neuralgia -- The medication also is approved to treat pain associated with trigeminal neuralgia (also known as tic douloureux), a nerve condition that causes episodes of facial pain (typically cheek or jaw pain).
Not all forms are approved for each of these uses. Equetro is approved to treat bipolar disorder only, while Carbatrol, Epitol, Tegretol, and generic carbamazepine are approved to treat epilepsy and trigeminal neuralgia, but not bipolar disorder.
Tegretol is made by Novartis Pharmaceuticals, while Carbatrol and Equetro are made by Shire US, Inc. Equetro is marketed and distributed by Validus Pharmaceuticals, Inc. Epitol is made by Teva Pharmaceuticals. Several different manufacturers make generic carbamazepine.
How Does Carbamazepine Work?
Epilepsy is a brain disorder that causes recurring, brief changes in how the brain's electrical system works. These changes in brain activity can lead to a seizure (see Epilepsy Symptoms). It is not known exactly how carbamazepine works to prevent partial seizures in people with epilepsy. It may work by blocking sodium channels in the brain. By blocking sodium channels, the medication may decrease the activity of nerve cells, preventing them from firing abnormally. Carbamazepine may also prevent the abnormal brain signals from spreading to other parts of the brain.
It is thought that carbamazepine works to treat trigeminal neuralgia by blocking the nerve signals that cause pain and other unpleasant sensations.
Some general considerations for when and how to take carbamazepine include the following:
- Carbamazepine comes in several different forms, including tablets, chewable tablets, extended-release tablets, extended-release capsules, and suspension (liquid). It is taken by mouth, usually two to four times daily, depending on the particular product.
- The medication can be taken with or without food. If carbamazepine upsets your stomach, try taking it with food.
- Make sure to shake the suspension form thoroughly just before each dose. Do not mix it with food or other liquids, including other medications.
- Do not crush, chew, or break the long-acting form of carbamazepine. Inspect each tablet to make sure it is not chipped or damaged. Make sure each tablet has a tiny hole (this is how the medication is released from the tablet). You may notice the shell in your stool; this is normal and should not cause any problems.
- Do not crush or chew the extended-release capsules, as this could cause too much medication to be released too quickly. If necessary, the capsules can be opened and the contents sprinkled over a spoonful of applesauce or other soft food. The food and medication should immediately be swallowed whole, without chewing.
- Carbamazepine should be taken at the same times each day to maintain an even level in your blood.
- For the medication to work properly, it must be taken as prescribed. Carbamazepine will not work if you stop taking it.
- Do not stop taking this medication without first discussing it with your healthcare provider (see Carbamazepine Withdrawal).
The dose of carbamazepine your healthcare provider recommends will vary, depending on a number of factors, including:
- The particular product
- Your age and weight
- The medical condition being treated
- Other medications you may be taking
- Other medical conditions you may have.
As always, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
Side Effects of Carbamazepine
As with any medicine, side effects are possible with carbamazepine. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
Common side effects include but are not limited to:
- Dizziness
- Drowsiness
- Unsteadiness
- Nausea
- Vomiting.
(Click Carbamazepine Side Effects to learn more, including potentially serious side effects you should report immediately to your healthcare provider.)
You can read about specific side effects in the following eMedTV articles:
What Should I Tell My Healthcare Provider Before Taking Carbamazepine?
You should talk with your healthcare provider prior to taking this drug if you have:
- Anemia or other blood disorders
- Absence seizures (petit mal seizures)
- Acute intermittent porphyria
- Glaucoma
- Heart disease
- An irregular heart rhythm (arrhythmia)
- Thyroid problems
- Liver disease, including liver failure, cirrhosis, or hepatitis
- Kidney disease, including kidney failure (renal failure)
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
Make sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
What If I Take an Overdose?
People who take too much carbamazepine may have overdose symptoms that could include:
- Irregular breathing or difficulty breathing
- A rapid heart rate (tachycardia)
- Low blood pressure (hypotension) or high blood pressure (hypertension)
- Shock
- Loss of consciousness
- Coma
- Seizures
- Restlessness
- Twitching or shakiness
- Unusual body movements or postures
- Coordination problems
- Drowsiness
- Dizziness
- Nausea or vomiting.
How Should Carbamazepine Be Stored?
Carbamazepine should be stored at room temperature, away from moisture and heat, in an airtight container. Keep this and all other medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you do not take your carbamazepine as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose. Make sure to let your healthcare provider know if you miss any doses, especially if your carbamazepine blood levels are being monitored.
Carbamazepine is available in the following forms:
- Carbatrol extended-release capsules
- Epitol tablets
- Equetro extended-release capsules
- Tegretol chewable tablets
- Tegretol immediate-release tablets
- Tegretol XR extended-release tablets
- Tegretol® Suspension.
Is There a Generic Version of Carbamazepine?
Currently, some (but not all) forms of carbamazepine are available in generic form.
Visit the following articles for more information:
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
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