Carbamazepine

CAUTION:
Carbamazepine may decrease the number of blood cells produced by your body. In rare cases, the number of blood cells may decrease enough to cause serious or life-threatening health problems. Inform your doctor if you have ever had a decreased number of blood cells, especially if it was caused by another medication. If you have any of the following symptoms, call your doctor without delay: sore throat, fever, chills or other signs of infection; unusual bruising or bleeding ; tiny purple dots or spots on the skin; mouth sores; or rash.Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests before and during your treatment to check your body's response to carbamazepine.

O  General Information and Indications:

Carbamazepine is used alone or in combination with other medications to treat certain types of seizures in patients with epilepsy. It is also used to treat trigeminal neuralgia (a condition that causes facial nerve pain). Carbamazepine extended-release capsules (Equetro brand only) are used to treat episodes of mania (frenzied, abnormally excited or irritated mood) or mixed episodes (symptoms of mania and depression that happen at the same time) in patients with bipolar I disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Carbamazepine is in a class of medications called anticonvulsants. It works by reducing abnormal excitement in the brain.

O  Information For Users:

Carbamazepine comes as a tablet, a chewable tablet, an extended-release (long-acting) tablet, an extended-release capsule, and a suspension (liquid) to take by mouth. The regular tablet, chewable tablet, and liquid are usually taken two to four times a day with meals. The extended-release tablet is usually taken twice a day with meals. The extended-release capsule is usually taken twice a day with or without meals. To help you remember to take carbamazepine, take it at around the same times every day. Follow the directions on your prescription label, ask your doctor or pharmacist If you have any questions. Take carbamazepine exactly as directed. Do not take more or less of it or take it more often than prescribed by your health care provider.

Swallow the extended-release tablets whole; do not split, chew, or crush them. The extended-release capsules may be opened and the beads inside sprinkled over food, such as a teaspoon of applesauce or similar food. Do not crush or chew the extended-release capsules or the beads inside them.

Shake the liquid well before each use to mix the medication evenly.

Your doctor will start you on a low dose of carbamazepine and slowly increase your dose.

It may take a few weeks or longer before you feel the full benefit of carbamazepine. Continue taking carbamazepine even if you feel well. Do not discontinue taking carbamazepine without informing your doctor. If you have a seizure disorder and you suddenly stop taking carbamazepine, your seizures may become worse. Your doctor will probably decrease your dose gradually.
Other uses for this medicine

Carbamazepine is also sometimes used to treat mental illnesses, depression, posttraumatic stress disorder, drug and alcohol withdrawal, restless legs syndrome, diabetes insipidus, certain pain syndromes, and a disease in children called chorea. Talk to your doctor about the possible risks of using this medication for your condition.

O  Special precautions:

o Inform your doctor or pharmacist if you have allergy to carbamazepine, amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), other medications for seizures such as phenobarbital (Luminal, Solfoton) or phenytoin (Dilantin), protriptyline (Vivactil), trimipramine (Surmontil), or any other medications.
o you should know that carbamazepine is the active ingredient in several products that have different names and may be prescribed to treat different conditions. Check the list of Brand names B B B B B B B B B B B at the beginning of this document carefully. All of the products listed contain carbamazepine and you should not take more than one of them at the same time.
o do not take carbamazepine if you are taking monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil) selegiline (Eldepryl); and tranylcypromine (Parnate), or have stopped taking them within the past 2 weeks.
o Inform your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: acetaminophen (Tylenol); acetazolamide (Diamox); alprazolam (Xanax); anticoagulants ('blood thinners') such as warfarin (Coumadin); antidepressants such as amitriptyline (Elavil),buproprion (Wellbutrin, Zyban), buspirone (BuSpar), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), mirtazapine (Remeron), nortriptyline (Pamelor); antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); cimetidine (Tagamet); cisplatin (Platinol); clarithromycin (Biaxin); clonazepam (Klonopin); clozapine (Clozaril); cyclosporine (Neoral, Sandimmune); daltopristin and quinupristin (Synercid); danazol (Danocrine); delviradine (Rescriptor );diltiazem (Cardizem, Dilacor, Tiazac); doxorubicin (Adriamycin, Rubex); doxycycline (Vibramycin); erythromycin (E.E.S., E-Mycin, Erythrocin); felodipine (Plendil); haloperidol (Haldol); HIV protease inhibitors including atazanavir (Reyataz), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Fortovase, Invirase); isoniazid (INH, Nydrazid); levothyroxine (Levoxyl, Synthroid); lithium (Lithobid); loratadine (Claritin); lorazepam (Ativan); certain medications to treat malaria such as chloroquine (Aralen) and mefloquine (Lariam); medications for anxiety or mental illness; other medications for seizures such as ethosuximide (Zarontin), felbamate (Felbatol), lamotrigine (Lamictal), methsuximide (Celontin), oxcarbazepine (Trileptal), phenobarbital (Luminal, Solfoton), phensuximide (Milontin) (not available in the United States), phenytoin (Dilantin), primidone (Mysoline), tiagabine (Gabitril), topiramate (Topamax), and valproic acid (Depakene, Depakote); methadone (Dolophine); nefazodone; niacinamide (nicotinamide, Vitamin B3); propoxyphene (Darvon); praziquantel (Biltricide); quinine; rifampin (Rifadin, Rimactane); sedatives; sleeping pills; terfenadine (Seldane) (not available in the United States); theophylline (Theobid, Theo-Dur); tramadol (Ultram); tranquilizers; troleandomycin (TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zileuton (Zyflo). Many other medications may also interact with carbamazepine, so be sure to Inform your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
o if you are taking any other liquid medications, do not take them at the same time as carbamazepine liquid.
o Inform your doctor what herbal products you are taking, especially St. John's Wort.
o inform your doctor if you are breast-feeding glaucoma; psychosis; or heart, kidney, thyroid, or liver disease.
o you should know that carbamazepine may decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, injections, implants, or intrauterine devices). Use another form of birth control while taking carbamazepine.Inform your doctor if you have unexpected vaginal bleeding or think you may be pregnant while you are taking carbamazepine.
o Inform your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking carbamazepine, call your doctor. Do not breastfeed while you are taking carbamazepine.
o if you are having surgery, including dental surgery, Inform your doctor or dentist that you are taking carbamazepine.
o you should know that carbamazepine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
o remember that alcohol can add to the drowsiness caused by this medication.

O  Possible Adverse Effects:

Carbamazepine may cause adverse effects. Inform your doctor if any of the following symptoms are severe or do not go away:

o drowsiness
o dizziness
o unsteadiness
o upset stomach
o vomiting
o headache
o anxiety
o memory problems
o diarrhea
o constipation
o heartburn
o dry mouth
o back pain

Some adverse effects could be serious. The following symptoms are uncommon, but if you experience any of them or those listed in the CAUTION section, call your doctor without delay:

o rash
o confusion
o loss of contact with reality
o depression
o thinking about killing yourself or planning or trying to do so
o chest pain
o yellowing of the skin or eyes, jaundice
o vision problems

O  Possible Symptoms of Overdose:

o unconsciousness
o seizures
o restlessness
o muscle twitching
o abnormal movements
o shaking of a part of your bodythat you cannot control
o unsteadiness
o drowsiness
o dizziness
o blurred vision (Impaired vision)
o irregular or slowed breathing
o rapid or pounding heartbeat
o upset stomach
o vomiting
o difficulty in urination

O  Brand Name(s):

o Carbatrol®
o Epitol®
o Equetro®
o Tegretol®