Carbamazepine for epilepsy

Examples

Generic Name	Brand Name
carbamazepine	Carbatrol, Tegretol, Tegretol-XR

Tegretol requires 2 to 4 doses each day. It comes in liquid, tablet, and chewable tablet forms.

Carbatrol and Tegretol-XR are new extended-release forms of carbamazepine. They require two doses each day.

How It Works

Carbamazepine prevents seizures by calming the electrical activity in the brain.

Why It Is Used

Carbamazepine is the medicine of choice for children who have partial seizures and one of the drugs of choice for treating adults who have partial seizures. It may also be used to control generalized tonic-clonic seizures.

People who have absence seizures or myoclonic seizures probably should not use carbamazepine. It does not prevent these types of seizures and can even make them worse.

How Well It Works

Carbamazepine is effective in preventing all three types of partial seizures.¹

Carbamazepine may not interfere with your ability to think clearly (cognitive impairment) as much as some other drugs used to treat epilepsy, such as phenytoin.

Side Effects

Common side effects of carbamazepine include:

• Dizziness.
• Drowsiness.
• Headache.
• Double vision and blurry vision.
• Nausea.
• Decreased coordination.

Taking smaller but more frequent doses of carbamazepine may reduce its side effects. High doses of carbamazepine can affect a person's thinking and state of mind, but this can often be avoided.

People of Asian ancestry may be at a higher risk for skin problems from taking carbamazepine. These skin problems, which include Stevens-Johnson syndrome and toxic epidermal necrolysis, can be dangerous. The FDA recommends that people of Asian background be tested before they take carbamazepine.

The U.S. Food and Drug Administration (FDA) has issued a warning on antiepileptic medicines and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take antiepileptic medicine should be watched closely for warning signs of suicide. People who take antiepileptic medicine and who are worried about this side effect should talk to a doctor.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

It may take time and careful, controlled adjustments by you and your doctor to find the combination, schedule, and dosing of medicine to best manage your epilepsy. The goal is to prevent seizures while causing as few unwanted side effects as possible. Regular blood tests help monitor the amount of medicine in your blood—it is important to maintain a consistent dose. After you and your doctor figure out the most effective medicine program for you, it is important that you follow your program exactly as prescribed.

• Adverse effects. Some of carbamazepine's long-term effects may not yet be fully known. People tend to tolerate the drug quite well, and it has fewer side effects than phenobarbital, another drug used to treat the same types of seizures.
• Drug interactions. Many medicines for epilepsy can interact with other medicines you may be taking. This means that your epilepsy medicine may not work as well, or it may affect the way another medicine you are taking works. Some of these interactions can be dangerous. It is important to tell your doctor about all the medicines, herbal pills, and dietary supplements you are taking. Carbamazepine may reduce the effectiveness of birth control pills.
• Serious health risks. High levels of carbamazepine can cause serious, but uncommon, side effects such as liver problems, bone marrow problems (low blood counts), and skin rash. Using carbamazepine without other antiepileptic drugs lowers the risk of these problems. Regular blood tests can also lower the risk by identifying problems early on.
• Risk of birth defects. All medicines for epilepsy have some risk of birth defects. But the risk of birth defects needs to be carefully compared to other risks to the baby if the mother stops taking her epilepsy medicine. If you are thinking about becoming pregnant, it is important to plan ahead and talk with your doctor about the benefits and risks of taking epilepsy medicine during your pregnancy. It you are already pregnant, it is not too late. The best thing to do is talk to your doctor about your pregnancy before you make any changes to the medicines you are taking.
• Other concerns. For some people, carbamazepine may produce side effects or carry risks that are not yet fully known. Report any unexpected side effects or problems to your doctor.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Author:	Monica Rhodes	Last Updated: October 29, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Theresa O'Young, PharmD - Clinical Pharmacist Steven C. Schachter, MD - Neurology
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