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Carbamazepine - Uses - Dosages - Side Effects - Precautions

Carbamazepine: Frequently Asked Questions Answered

What Is Carbamazepine?

Carbamazepine is an anticonvulsant or anti-epileptic medicine, also prescribed for peripheral neuropathy (nerve pain caused by diabetes) and trigeminal neuralgia (facial nerve pain). However, it is not a simple analgesic and must not be used for trivial aches. 

Carbamazepine works by reducing abnormal electrical brain activity or abnormal nerve impulses. It is available as regular tablets, chewable tablets, extended-release tablets (Tegretol), extended-release capsules (Equetro), suspensions, and suppositories. The extended-release dosage forms help in the treatment of manic disorders, including Bipolar I disorder. The medicine is available only on prescription.

What Are the Uses of Carbamazepine?

Carbamazepine has primarily been prescribed for treating partial seizures in epileptic patients with complex symptomatology (temporal lobe), tonic-clonic seizures, or mixed seizure patterns. It is also highly beneficial for trigeminal neuralgia and glossopharyngeal neuralgia, both facial nerve pains. Off-label, it is often used as a second-line treatment for bipolar disorder and schizophrenia, in combination with other antipsychotic drugs. It is claimed to be effective for Attention Deficit Hyperactivity Disorder (ADHD), alcohol withdrawal syndrome, and restless leg syndrome.

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What Are the Side Effects of Carbamazepine?

Common side effects include dizziness, drowsiness, migraines, impaired motor coordination, pain, vomiting, nausea, and/or constipation. Consumption of alcohol along with Carbamazepine may enhance depression of the Central Nervous System (CNS). 

For people with mixed seizure patterns, an increased risk for seizures may be observed, albeit rarely, along with abnormal heart rhythms and blurry or double vision. Other potential side effects include impacts on the production of red blood cells (RBCs), increased suicide risk, mental health problems, liver problems, kidney problems, low sodium levels, and damage to the fetus in pregnant women.  Please consult a doctor to understand better the precautions needed while on a regimen of Carbamazepine.

What is Carbamazepine

Uses of Carbamazepine

Side effects of Carbamazepine

S.no Product Name Dosage Form
1. Tegrital Carbamazepine 200mg Tablet
2. Zeptol CR Carbamazepine 200mg Tablet
3. Tegrital Carbamazepine 100mg Chewable Tablet
4. Mazetol Carbamazepine 400mg Tablet
5. ZEN Retard Carbamazepine 400mg Tablet ER

 

Frequently Asked Questions about Carbamazepine

1. Is Carbamazepine a Controlled Substance?

Despite belonging to a family of dibenzazepine anticonvulsants, Carbamazepine is not a controlled substance, according to the Controlled Substances Act (CSA). While it is indicated for pain relief from nerve pains, the abuse of Carbamazepine as an analgesic is more likely to bring about adverse side effects than feelings of euphoria.

2. How to Reduce Carbamazepine Dose?

Due to the high risk of side effects associated with Carbamazepine, physicians suggest gradually reducing the dosage. Discontinuation of the drug abruptly may lead to withdrawal seizures or other symptoms requiring medical assistance. Attempts to discontinue it must be made around three months after the introduction of the drug regimen.

3. Does Carbamazepine Cause Weight Gain?

Carbamazepine increases your metabolism, which may need concomitant food intake. A study observed an average weight gain of 2.35% in patients on Carbamazepine monotherapy, with at least 66.7% of the study participants reporting weight gain in general (Gaspari C. & Guerreiro C., 2010). Another reason for the weight gain is increased water retention due to low sodium levels, as a side effect of Carbamazepine therapy.

4. Is There a Generic Alternative for Carbamazepine?

Carbamazepine is available worldwide in generic forms. While the innovator brand name is Tegretol, you can purchase Tegretol generics and other brands, such as Carbatrol, Equeto, Epitol, Acetol, Carbacontin, Carbanex SR, Carbdac, Carmaz, Carzep, Mazetol, Tegrital, Versitol, Zeptol, Zen, and Zen Retard.

5. What Are the Long-Term Effects of Taking Carbamazepine?

Studies have not reported the long-term effects of taking Carbamazepine, but there have been recorded instances of osteoporosis and osteopenia. Some cases implicate the role of Carbamazepine consumption in fibrosis of the heart. More than long-term effects, immediate side effects of Carbamazepine pose a more critical problem due to their severity.

6. Is Carbamazepine Addictive?

Carbamazepine may be an analgesic, but it does not induce any euphoric feelings on consumption. It gives rise to depressive symptoms, leaving no scope for abuse. The medicine is not associated with any psychological or physical dependence. However, isolated cases of consumption of Carbamazepine with alcohol have described a sense of euphoria.

7. What Happens When You Stop Taking Carbamazepine?

The sudden termination of Carbamazepine can cause excessive withdrawal symptoms and seizures. Seizures can be observed even in patients who do not use Carbamazepine for epilepsy, as the body gets used to an anticonvulsant that alters the brain’s electrical activity.

8. What Type of Seizures Does Carbamazepine Treat?

Carbamazepine has been indicated for treating mixed pattern seizures, partial seizures with complex symptoms originating in the temporal lobe or psychomotor seizures, and generalized tonic-clonic or grand-mal seizures. It is ineffective for absence or myoclonic seizures.

9. Can You Take Vitamin D With Carbamazepine?

Carbamazepine tends to increase the metabolic activity of the body. Doctors recommend consuming Vitamin D with it. As such, the medicine reduces the effects of the vitamin due to its quick metabolism in the body. Consequently, bone metabolism is affected due to decreased levels of Vitamin D in the body requiring supplementation.

10. How Long Does Carbamazepine Stay in Your System?

The half-life of an extended-release formulation of Carbamazepine is around 35 to 40 hours after one dose. Carbamazepine induces its metabolism in higher concentrations, leading to enhanced clearance. Thus, after several doses, the average half-life decreases to around 12 to 17 hours. To better understand your regimen and the associated precautions, consult our team of expert doctors at Yashoda Hospitals. Get in touch today!

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References
  1. Gaspari, C. N. De and Guerreiro, C. A. M. (2010) ‘Modification in body weight associated with antiepileptic drugs’, Arquivos de Neuro-Psiquiatria, 68(2), pp. 277–281. doi: 10.1590/S0004-282X2010000200024.
  2. Carbamazepine (Tegretol): Side Effects, Dosages, Treatment, Interactions, Warnings (no date). Available at: https://www.rxlist.com/consumer_carbamazepine_tegretol/drugs -condition.htm (Accessed: 21 August 2021).
  3. Carbamazepine Uses, Dosage & Side Effects – Drugs.com (no date). Available at: https://www.drugs.com/carbamazepine.html (Accessed: 21 August 2021).
  4. Carbamazepine: MedlinePlus Drug Information (no date). Available at: https://medlineplus.gov/druginfo/meds/a682237.html (Accessed: 21 August 2021).
  5. Millichap, J. (1996) ‘Carbamazepine: A Therapy for ADHD’, Pediatric Neurology Briefs, 10(3), p. 20. doi: 10.15844/PEDNEURBRIEFS-10-3-5.
  6. Carbamazepine: Uses, Interactions, Mechanism of Action | DrugBank Online (no date). Available at: https://go.drugbank.com/drugs/DB00564 (Accessed: 21 August 2021).
  7. Carbamazepine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD (no date). Available at: https://www.webmd.com/drugs/2/drug-1493-5/carbam azepine -oral/carbamazepine-oral/details (Accessed: 21 August 2021).
  8. Y, L. et al. (1991) ‘Weight gain, increased appetite, and excessive food intake induced by carbamazepine, Clinical Neuropharmacology, 14(3), pp. 251–255. DOI: 10.1097/00002826-199106000-00009.
  9. Tegretol and Weight Gain | Epilepsy Foundation (no date). Available at: https://www.epilepsy.com/connect/forums/women-epilepsy/tegretol-and-weight-gain (Accessed: 21 August 2021).
  10. Carbamazepine: medicine to treat epilepsy and nerve pain – NHS (no date). Available at: https://www.nhs.uk/medicines/carbamazepine/ (Accessed: 21 August 2021).
  11. G, S. and S, D. (1997) ‘Is carbamazepine a potential drug of abuse?’, Journal of psychopharmacology (Oxford, England), 11(1), pp. 93–94. DOI: 10.1177/026988119701100119.

Disclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.

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