Carbatrol Warnings and Precautions

You should review Carbatrol warnings and precautions prior to taking the medication. For example, the drug can cause low levels of sodium in the blood; serious, or even life-threatening, skin rashes; and anemia. Precautions and warnings with Carbatrol also extend to women who are pregnant or breastfeeding, as well as people with kidney disease, liver disease, or certain allergies.

Carbatrol: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Carbatrol® (carbamazepine) if you have:
 
  • Absence seizures (petit mal seizures)
  • Anemia or other blood disorders
  • An irregular heart rhythm (arrhythmia)
  • Glaucoma
  • Heart disease
  • Kidney disease, including kidney failure (renal failure)
  • Liver disease, including liver failure, cirrhosis, or hepatitis
  • Thyroid problems
  • Any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Carbatrol Warnings and Precautions

Warnings and precautions to be aware of prior to taking Carbatrol include the following:
 
  • Carbatrol can cause low levels of sodium in the blood (hyponatremia), which can be serious. Let your healthcare provider know if you have possible signs of this condition, such as:

 

    • Nausea
    • A general ill feeling
    • Headaches
    • Lethargy
    • Confusion
    • Decreased consciousness
    • Worsening of seizures.

 

  • Carbatrol can cause very serious cases of anemia or other low blood counts, which may put you at risk for bleeding or serious infections. These problems, while rare, can be fatal. Your healthcare provider should test your blood counts (using a simple blood test) before you start taking the medication and periodically thereafter.

 

  • Seizure medications, including Carbatrol, may increase the risk of suicidal thoughts or behavior. Let your healthcare provider know immediately if you feel depressed or have any suicidal thoughts (see Seizure Medications and Suicide for more information)

 

  • Rarely, Carbatrol can cause very dangerous skin reactions known as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). These problems start out as skin rashes but can progress to permanent disfigurement or even loss of life. Not every skin rash in people taking Carbatrol will be related to SJS or TEN. However, because of the seriousness of such problems, it is recommended that people stop taking Carbatrol immediately at the first sign of a rash, unless it is very clear that the rash is not related to Carbatrol. In most (but not all) cases, SJS and TEN reactions occur within the first month of starting Carbatrol.
     
  • Interestingly, SJS and TEN reactions to Carbatrol are much more common in people of Asian descent, who are more likely to have a specific gene (known as HLA-B*1502) that appears to increase the risk of such problems. If you are of Asian descent, your healthcare provider may choose to test for the gene before recommending Carbatrol for you.
      
  • Carbatrol can make agitation, confusion, or psychosis worse. Tell your healthcare provider if you experience any unusual changes in thoughts or behavior during treatment.
     
  • As with all seizure medications, Carbatrol should not be stopped suddenly (see Carbatrol Withdrawal).
     
  • The medication can increase the pressure within the eye, which can be especially dangerous for people with glaucoma.
     
  • Sometimes, Carbatrol can make seizures worse in people with absence seizures (petit mal seizures). Due to this problem (and because Carbatrol is not generally effective at treating absence seizures), the drug is usually not recommended for treating people with absence seizures.
     
  • Tell your healthcare provider if you have heart, liver, or kidney disease, as Carbatrol may not be the best choice for you. Your body may not handle the drug the way it should, or you may be at an increased risk for certain Carbatrol side effects.
     
  • Make sure you know how Carbatrol affects you before driving or operating any machinery, as the drug can cause drowsiness and dizziness. In general, you should avoid alcohol while taking it, due to the risk of increased drowsiness.
     
  • Your healthcare provider should check your liver and kidney function (using a blood test) before starting Carbatrol and periodically thereafter. Your healthcare provider should also check your eyes regularly, as the medication can cause eye problems.
     
  • Carbatrol can cause a decrease in thyroid function (hypothyroidism).
     
  • Carbatrol has been reported to interfere with some pregnancy tests.
     
  • Carbatrol can interact with other medications (see Carbatrol Drug Interactions).
     
  • Carbatrol is considered a pregnancy Category D medication. This means that it is probably not safe for women to take while pregnant. Talk to your healthcare provider about the risks and benefits of taking the drug during pregnancy (see Carbatrol and Pregnancy).
     
  • Carbatrol passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Carbatrol and Breastfeeding).

 

  • Early evidence suggests that seizure medications, including Carbatrol, may increase the risk of suicidal thoughts or behaviors (see Seizure Medications and Suicide for more information).
     
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