Tegretol Warnings and Precautions

It's important to review Tegretol warnings and precautions prior to taking it. For example, the medication can cause serious cases of anemia or skin reactions and can make agitation, confusion, or psychosis worse. It can also interact with certain drugs and may not be safe to use when pregnant or breastfeeding. To avoid these complications, ask your healthcare provider about any Tegretol warnings and precautions that may apply to you.

Tegretol: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Tegretol® (carbamazepine) 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:
  • 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 Tegretol Warnings and Precautions

Some of the warnings and precautions to be aware of prior to taking Tegretol include the following:
  • Seizure medications, including Tegretol, 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).


  • Tegretol 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 blood test) before you start taking the drug and periodically thereafter.
  • Rarely, Tegretol 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 Tegretol will be related to SJS or TEN. However, because of the seriousness of such problems, it is recommended that people stop taking Tegretol immediately at the first sign of a rash, unless it is very clear that the rash is not related to Tegretol. In most (but not all) cases, SJS and TEN reactions occur within the first month of starting Tegretol.
  • Interestingly, SJS and TEN reactions to Tegretol 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 Tegretol for you.
  • The medication 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, Tegretol should not be stopped suddenly (see Tegretol Withdrawal).
  • Tegretol can increase the pressure within the eye, which can be especially dangerous for people with glaucoma.


  • Be sure to tell your healthcare provider if you have acute intermittent porphyria, since Tegretol can make this condition worse.


  • Sometimes, Tegretol can make seizures worse in people with absence seizures (petit mal seizures). Due to this potential risk (and because Tegretol is not generally effective at treating absence seizures), it is usually not recommended for treating people with absence seizures.
  • Tell your healthcare provider if you have heart, liver, or kidney disease, as Tegretol 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 Tegretol side effects.
  • Make sure you know how Tegretol affects you before driving or operating any machinery, as it can cause drowsiness and dizziness. In general, you should avoid alcohol while taking Tegretol, due to the risk of increased drowsiness.
  • Tegretol can cause low levels of sodium in the blood (hyponatremia), which can be serious. Let your healthcare provider know if you have any possible signs of hyponatremia, such as:


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


  • Your healthcare provider should check your liver and kidney function (using a simple blood test) before starting Tegretol and periodically thereafter. Your healthcare provider should also check your eyes regularly, as the medication can cause eye problems.
  • Tegretol can cause a decrease in thyroid function (hypothyroidism).
  • Tegretol has been reported to interfere with some pregnancy tests.
  • Tegretol can interact with other medications (see Tegretol Drug Interactions).
  • Tegretol is considered a pregnancy Category D medication. This means that it is probably not safe for many pregnant women. Talk to your healthcare provider about the risks and benefits of taking the drug while pregnant (see Tegretol and Pregnancy).
  • Tegretol 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 Tegretol and Breastfeeding).


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


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