Warnings & Recalls for Carbamazepine
Black box warning
The FDA alerts patients using this drug that fatal skin reactions including Stevens Johnson syndrome and toxic epidermal necrolysis can be caused by Carbamazepine, especially in those with a particular antigen called HLA-B*1502 typically found in those with Asian ancestry. These skin reactions can be determined by red/purple skin rash followed by blistering and peeling.
Other warnings
Patients
should not take Carbamazepine if: there is a history of bone marrow problems, if there is an allergy to any antidepressant, if the patient has any hereditary problems of fructose intolerance, if the patient is allergic to any of the ingredients (citric acid, colloidal silicon dioxide, lactose monohydrate, microcrystalline cellulose, polyethylene glycol, povidone, sodium lauryl sulfate, talc, triethyl citrate), or allergic to these medications (carbamazepine, amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, or other medications for seizures, or if the patient is currently on the medication nefazodone.Patients
should not suddenly stop taking Carbamazepine because it may cause increased seizures and withdrawal symptoms.Before taking Carbamazepine, the patient's
doctor should be aware of any heart disease, high blood pressure, high cholesterol, liver/kidney disease, glaucoma, thyroid problems, lupus, porphyria and mental illness or a history of mental illness. The doctor should also be aware of any blood clots, heart failure and decreased bone marrow.The following tests should be up to date and
checked regularly while the patient is on Carbamazepine: liver function tests, mood/behavior changes, depression and anxiety, blood tests including bone marrow, skin checks, thyroid tests, urinalysis, eye examinations and heart tests.Carbamazepine does not cure chronic seizures, it merely controls the symptoms.Any unusual changes in mood should be made aware to the patient's doctor. These include worsened irritability, anxiety, acting dangerously, difficulty sleeping, angry behavior, suicidal behavior and withdrawal from friends and family.The extended-release tablet contains coating that may not dissolve in the stomach and therefore can sometimes be visible in the stool.Carbamazepine will make patients more sensitive to the sun, so patients are recommended to stay out of the sun and tanning booths, and are recommended to wear protection when outdoors.
Alcohol mixed with the drug will produce a sedative effect, so patients are advised to limit any and all
alcoholic beverages.Patients are advised to not operate heavy machinery or any other task that requires alertness due to the drowsiness effect Carbamazepine will give.
Contraindications:Carbamazepine can interact with other drugs so patients should fully disclose what medications, including herbal products, they are taking, especially St. John's Wort.Liquid medications and nefazodone should not be taken while patients are on carbamazepine.Patients should not use carbamazepine if they have used an MAO inhibitor within the last 2 weeks.
Carbamazepine is contraindicated in some vitamins and nutritional supplements, phenytoin, primidone, valproic acid, calcium channel blockers, birth control hormones, acetaminophen, anticoagulants, nefazodone, cold or allergy medications, pain medications, muscle relaxers, antidepressants, HIV medication, sedatives and other seizure medications. It is also contraindicated in those with previous bone marrow, previous depression, and those with a known hypersensitivity to carbamazepine.
Family planning:Male fertility may be negatively affected as a result of Carbamazepine.This drug may give patients false readings on home pregnancy tests. Further testing is recommended.Carbamazepine can decrease the effectiveness of birth control pills, patches, rings, injections, implants or intrauterine devices. Patients are advised to find another form of non-hormonal birth control while taking carbamazepine. If unexpected vaginal bleeding occurs, patients should consult their physician.The FDA has classified Carbamazepine as a pregnancy category D, the second most at-risk pregnancy category. This drug may cause harm to a fetus in pregnant women (like spina bifida and neurodevelopmental problems), however a seizure may harm the fetus equally so pregnant women on Carbamazepine should consult with their doctor to determine whether the benefits outweigh the risks.Carbamazepine is passed through breast milk and may harm a newborn infant. Nursing mothers on Carbamazepine should decide, along with their doctor, if it is necessary for the mother to continue taking the medication.
Carbamazepine Treatment and Use
What is Carbamazepine?
Carbamazepine | Equetro is an anticonvulsant used to treat chronic seizures, a condition known as epilepsy, by reducing the electrical activity in the brain. In some cases it can also be used to treat trigeminal neuralgia (facial nerve pain), mania, mental illness, depression, PTSD (post traumatic stress disorder), withdrawal symptoms from drugs and alcohol, attention-defitict hyperactivity disorder, chorea, diabetes insipidus (where the kidneys are unable to retain water), restless leg syndrome, and mixed episodes in patients with bipolar disorder.
How does Carbamazepine work?
This drug works by blocking or reducing poly-synaptic responses in the brain. It also deactivates ion channels causing low reaction/action states.
Dosage information for Carbamazepine
Carbamazepine is produced as a tablet and a chewable tablet (taken 2-4 times a day), an extended-release tablet and capsule (taken twice a day), and a liquid (taken 2-4 times daily). An initial low dosage with gradual increase is recommended to get new users acclimated to the drug. Carbamazepine should be taken with meals.
Children under 6 years of age will initially take 10-20 mg a day, and can be increased to 35 mg daily at a doctors discretion.
Children aged 6-12 years should start with low doses like 100 mg or 1/2 teaspoon, and can take up to 800 mg daily.
Adults may start at 200 mg or 1 teaspoon a day and, with doctor recommendation, can take up to 1200 mg daily.
