Tegretol

Generic name: Carbamazepine

What is Tegretol?

Tegretol is used to treat seizures during which you lose awareness and may carry out actions such as walking, talking, or driving (complex partial seizures) and seizures in which loss of consciousness may occur (generalized seizures). It is also prescribed for trigeminal neuralgia (severe pain in the jaws) and pain in the tongue and throat.

What is the most important information I should know about Tegretol?

Tegretol can result in a very rare and potentially fatal blood abnormality (aplastic anemia) where the red blood cell count declines drastically. If you experience symptoms such as fever, sore throat, rash, ulcers in the mouth, easy bruising, or reddish or purplish spots on the skin, tell your doctor right away. Serious and sometimes fatal skin reactions have also been reported with use of Tegretol. At the first sign of a rash, inform your healthcare provider.

Who should not take Tegretol?

Do not use Tegretol if you have a history of bone marrow depression (reduced function), porphyria (an inherited metabolic disorder affecting the liver or bone marrow), are sensitive to Tegretol or tricyclic antidepressant drugs such as amitriptyline. You should not take Tegretol if you are on a monoamine oxidase inhibitor (MAOI) antidepressant such as phenelzine or tranylcypromine, or if you have taken this type of drug within the past 14 days.

What should I tell my doctor before I take the first dose of Tegretol?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Tegretol. Also, talk to your doctor about your complete medical history, especially if you have anemia, heart disease, kidney or liver disease, or glaucoma (increased pressure in the eyes).

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Seizures

Adults and children over 12 years: The usual starting dose is 200 milligrams (mg) 2 times a day for tablets and extended-release tablets, or 1 teaspoon (tsp) 4 times a day for suspension. Your doctor may increase the dose at weekly intervals by adding 200-mg doses 2 times a day for Tegretol-XR or 3 to 4 times per day for the other forms. The dosage should generally not be more than 1000 mg daily in children 12 to 15 years old and 1200 mg daily for adults and children over 15. The usual daily maintenance dosage range is 800 to 1200 mg.

Children 6-12 years: The usual dose is 100 mg 2 times a day or ½ tsp 4 times a day. Your doctor may increase the dose at weekly intervals by adding 100 mg 2 times a day for Tegretol-XR or 3 to 4 times a day for the other forms. The total daily dosage should generally not exceed 1000 mg. The usual daily dosage range for maintenance is 400 to 800 mg.

Children ≤6 years: The usual daily starting dose for is 10 to 20 mg per 2.2 pounds of body weight per day. The total daily dose is divided into smaller doses taken 2 to 3 times a day for tablets or 4 times a day for suspension. Daily dosage should not exceed 35 mg per 2.2 pounds.

Trigeminal Neuralgia

Adults and children over 12 years: The usual dose is 100 mg 2 times a day for tablets and extended-release tablets, or ½ tsp 4 times a day for the suspension on the first day. Your doctor may increase this dose using increments of 100 mg every 12 hours or ½ tsp 4 times daily only as needed to achieve freedom from pain. Doses should not exceed 1200 mg daily and are usually in the range of 400 to 800 mg a day for maintenance.

How should I take Tegretol?

This medication should only be taken with meals, never on an empty stomach. Shake the Tegretol suspension well before using.

Tegretol-XR tablets must be swallowed whole. Do not crush or chew them and do not take tablets that have been damaged.

What should I avoid while taking Tegretol?

Tegretol may cause dizziness or drowsiness. Use caution when driving, operating machinery, or performing other activities that require mental alertness until you know how this medication affects you.

Do not drink alcohol while taking Tegretol. Alcohol may increase drowsiness caused by Tegretol and it may increase the risk of seizures.

Avoid prolonged exposure to artificial or natural sunlight. Tegretol may increase the sensitivity of your skin to sunlight, so use sunscreen and wear protective clothing when you are outside.

Grapefruit and grapefruit juice may interact with Tegretol and lead to potentially adverse effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Do not stop taking Tegretol suddenly. It is possible that you can experience continuous epileptic attacks without return to consciousness, leading to possible severe brain damage and death. Only your doctor should determine if and when you should stop taking Tegretol.

What are possible food and drug interactions associated with Tegretol?

If Tegretol is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Tegretol with the following: acetaminophen, acetazolamide, aminophylline, amprenavir, antibiotics (such as azithromycin, clarithromycin, and erythromycin), antidepressants (such as bupropion, citalopram, clomipramine, fluoxetine, fluvoxamine, and trazodone), antifungals (such as fluconazole, itraconazole, and ketoconazole), antipsychotics (such as olanzapine, quetiapine, risperidone, and ziprasidone), antiseizure medications(such as felbamate, fosphenytoin, lamotrigine, oxcarbazepine, phenytoin, topiramate, and valproate), benzodiazepines (such as alprazolam, clonazepam, diazepam, and midazolam), blood thinners, calcium channel blocking drugs (such as diltiazem, felodipine, and verapamil), cimetidine, cisplatin, corticosteroids, danazol, dantrolene, doxorubicin, doxycycline, everolimus, haloperidol, ibuprofen, imatinib, isoniazid, levothyroxine, lithium, loratadine, methsuximide, niacinamide, nicotinamide, omeprazole, oral and other hormonal contraceptives, oxybutynin, pain relievers (such as methadone, propoxyphene, and tramadol), pancuronomium, phenobarbital, phensuximide, praziquantel, primidone, rifampin, ritonavir, terfenadine, ticlopidine, theophylline, tiagabine, tranquilizers (such as chlorpromazine, clozapine, and loxapine), water pills (diuretics), zonisamide.

Do not combine Tegretol suspension with other liquid medications such as chlorpromazine solution. The mixture may thicken inside your body.

What are the possible side effects of Tegretol?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: allergic reactions, blood pressure changes, bone marrow suppression, dizziness, drowsiness, hives, rash, nausea, sensitivity to sunlight, unsteadiness, vomiting

Tegretol has been known to cause serious blood, liver, and skin reactions, both early in treatment and after extended use. Tell your doctor immediately if you develop warning signs such as fever, sore throat, rash, ulcers in the mouth, easy bruising or spots in the skin, swollen lymph glands, loss of appetite, nausea or vomiting, or yellowing of the skin and eyes.

Can I receive Tegretol if I am pregnant or breastfeeding?

What should I do if I miss a dose of Tegretol?

If you miss a dose of Tegretol, take it as soon as your remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once. If you miss more than one dose in a day, check with your doctor.

How should I store Tegretol?

Store at room temperature away from light and moisture.