Carbamazepine is used for the management of certain types of seizures alone or in combination with other medications. It is also used to treat the nerve pain of trigeminal neuralgia and for the treatment of acute mania and prevention of bipolar (manic-depressive) disorders.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Recommended doses of carbamazepine range from 100 mg to 200 mg daily up to 1,200 mg daily in divided doses, depending on the condition being treated and the age and circumstances of the person being treated. Carbamazepine should be taken with meals whenever possible.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is very important that this medication be taken on a regular schedule as prescribed by the doctor. If you miss a dose of this medication, take it as soon as you remember it. If it is almost time for your next dose, skip the missed dose and carry on with your regular schedule. Do not double-up on doses.

Tegretol^® is available as liquid, tablets, chewable tablets, or contolled-release tablets.

Liquid: Each 5 mL of orange suspension contains carbamazepine 100 mg. Nonmedicinal ingredients: citric acid, citrus-vanilla flavour, FD&C Yellow No. 6, pluronic polyol, potassium sorbate, propylene glycol, sucrose, sorbitol, water, and xanthan gum.

Chewable tablets:
100 mg: Each white-with-red-specks, round, flat-faced, bevelled-edged tablet, engraved "GEIGY" on one side and "M/R" with a bisect on the other, contains carbamazepine 100 mg. Sodium: <1 mmol (0.12 mg).
200 mg: Each white-with-red-specks, oval tablet, engraved "GEIGY" on one side and "P/U" with bisect on the other, contains carbamazepine 200 mg. Sodium: <1 mmol (0.12 mg).
Nonmedicinal ingredients: cherry-mint flavour, cornstarch, erythrosine, gelatin, glycerin, magnesium stearate, silicon dioxide, sodium starch glycolate, stearic acid, and sugar.

Tablets: Each white, round, flat-faced, bevelled-edged tablet, engraved "GEIGY" on one side and quadrisected on the other, contains carbamazepine 200 mg. Sodium: <1 mmol (0.3 mg). Nonmedicinal ingredients: cellulose compounds, magnesium stearate, and silicon dioxide.

Controlled-release tablets:
200 mg: Each beige-orange, oval, controlled-release tablet, fully bisected on both sides and engraved with "C/G" on one side and "H/C" on the other, contains carbamazepine 200 mg. Sodium: <1 mmol (2.1 mg).
400 mg: Each brown-orange, oval controlled-release tablet, fully bisected on both sides and engraved with "CG/CG" on one side and "ENE/ENE" on the other, contains carbamazepine 400 mg. Sodium: <1 mmol (4.3 mg).
Nonmedicinal ingredients: acrylic esters, castor oil derivative, cellulose compounds, iron oxides, magnesium stearate, silicon dioxide, talc, and titanium dioxide.

This medication does not contain alcohol, bisulfite, gluten, lactose, parabens, or tartrazine.

Carbamazepine should not be taken by anyone who:

• is allergic to carbamazepine or to any of the ingredients of the tablets or suspension
• is allergic to tricyclic compounds such as amitriptyline, trimipramine, or imipramine
• has liver disease
• has a history of acute intermittent porphyria
• has a serious blood disorder
• has a history of bone marrow depression
• has taken an MAO inhibitor (e.g., phenelzine, tranylcypromine) within the past 14 days or will take one within the next 14 days. If you have taken an MAO inhibitor recently but more than 14 days ago, your dosage of carbamazepine should be low initially, and increased very gradually.
• has certain kinds of heart rhythm disturbances

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your health professional. They may be able to help you to deal with some of the effects.

The following side effects may go away as your body becomes used to the medicine; check with your doctor if they continue or become bothersome.

More common:

• clumsiness or unsteadiness
• dizziness
• drowsiness
• lightheadedness
• nausea or vomiting

  Less common or rare:

• aching joints or muscles
• constipation
• diarrhea
• dryness of mouth
• headache
• increased sensitivity of skin to sunlight (skin rash, itching, redness, or severe sunburn)
• increased sweating
• irritation or soreness of tongue or mouth
• loss of appetite
• loss of hair
• sexual problems (males)
• stomach pain or discomfort

Check with your doctor as soon as possible if any of the following side effects occur:

More common:

• blurred vision or double-vision
• continuous "back-and-forth" eye movements

  Less common:

• behavioural changes
• confusion, agitation, or hostility
• headache
• increase in seizures
• severe diarrhea
• severe nausea and vomiting
• skin rash, hives, or itching
• unusual drowsiness

  Rare:

• chest pain
• difficulty speaking or slurred speech
• fainting
• frequent urination
• irregular, pounding, or unusually slow heartbeat
• mood or mental changes including depression
• muscle or stomach cramps
• numbness, tingling, pain, or weakness in hands and feet
• rapid weight gain
• rigidity
• ringing, buzzing, or other unexplained sounds in the ears
• sudden decrease in amount of urine
• swelling of face, hands, feet, or lower legs
• trembling
• uncontrolled body movements
• visual hallucinations

Check with your doctor immediately if any of the following side effects occur:

Rare:

• black, tarry stools
• blood in urine or stools
• bone or joint pain
• cough or hoarseness
• darkening of urine
• lower back or side pain
• nosebleeds or other unusual bleeding or bruising
• painful or difficult urination
• pain, tenderness, swelling, or bluish colour in leg or foot
• pale stools
• pinpoint-sized red spots on skin
• shortness of breath or cough
• sores, ulcers, or white spots on lips or in the mouth
• sore throat, chills, and fever
• swollen or painful glands
• unusual tiredness or weakness
• wheezing, tightness in chest, or troubled breathing
• yellow eyes or skin

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Birth control: Carbamazepine, like other anticonvulsants, may reduce the effectiveness of birth control pills. Women taking carbamazepine should use an alternative, non-hormonal birth control method, such as condoms.

Eyes: Periodic eye examinations are recommended for people who take this medication.

Laboratory tests: Carbamazepine may infrequently cause serious blood disorders. It is important that lab tests be performed on a regular basis while taking this medication so that any potential problems may be caught in the early stages. Initial and periodic kidney function tests should also take place.

Medical conditions: Carbamazepine should be taken with caution by people with increased eye pressure (glaucoma), bladder problems, kidney disease, or heart disease. Carbamazepine may reactivate certain mental disorders or cause confusion and agitation for seniors.

Occupational hazards: Because dizziness and drowsiness are possible side effects of carbamazepine, avoid driving or operating machinery until you determine how this medication affects you.

Pregnancy: Women with epilepsy who are pregnant, or intend to become pregnant, need special care. The potential benefits of carbamezapine must be weighed against its risks, particularly during the first three months of pregnancy. If needed to prevent major seizures, do not stop taking the medication. Usually, women with epilepsy who are pregnant should be treated with one medication only to prevent seizures.

In general, folic acid supplementation is recommended before and during pregnancy. Talk to your doctor about the benefits and risks of using carbamezapine during pregnancy.

Breast-feeding: Carbamazepine passes into breast milk. The benefits of breast-feeding should be weighed against the possible risks to the infant. If a mother taking carbamazepine nurses her infant, the infant must be observed for possible side effects (e.g., drowsiness or skin rash).

The following medications may be affected by carbamazepine: