Carbamazepine (Systemic)
Brand Names : Atretol, Carbatrol, Epitol, Tegretol, Tegretol-XR, Apo-Carbamazepine, Novo-Carbamaz, Nu-Carbamazepine, Taro-Carbamazepine, Taro-Carbamazepine CR, Tegretol Chewtabs, Tegretol CR
Before Using This MedicineIn deciding to use a medicine,
the risks of taking the medicine must be weighed against the good it will
do. This is a decision you and your doctor will make. For carbamazepine, the
following should be considered:
Allergies - Tell your doctor if you have ever had any unusual or
allergic reaction to carbamazepine or to any of the tricyclic antidepressants,
such as amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine,
nortriptyline, protriptyline, or trimipramine. Also tell your health care
professional if you are allergic to any other substances, such as foods, preservatives,
or dyes.
Pregnancy - Carbamazepine has not been studied in pregnant women.
However, there have been reports of babies having low birth weight, small
head size, skull and facial defects, underdeveloped fingernails, and delays
in growth when their mothers had taken carbamazepine in high doses during
pregnancy. In addition, birth defects have been reported in some babies when
the mothers took other medicines for epilepsy during pregnancy. Also, studies
in animals have shown that carbamazepine causes birth defects when given in
large doses. Therefore, the use of carbamazepine during pregnancy should be
discussed with your doctor.
Breast-feeding - Carbamazepine passes into the breast milk, and
in some cases the baby may receive enough of it to cause unwanted effects.
In animal studies, carbamazepine has affected the growth and appearance of
the nursing babies.
Children - Behavior changes are more likely to occur in children.
Older adults - Confusion; restlessness and nervousness; irregular,
pounding, or unusually slow heartbeat; and chest pain may be especially likely
to occur in elderly patients, who are usually more sensitive than younger
adults to the effects of carbamazepine.
Other medicines - Although certain medicines should not be used
together at all, in other cases two different medicines may be used together
even if an interaction might occur. In these cases, your doctor may want to
change the dose, or other precautions may be necessary. When you are taking
carbamazepine, it is especially important that your health care professional
know if you are taking any of the following:
-
Anticoagulants (blood thinners) - The effects of anticoagulants
may be decreased; monitoring of blood clotting time may be necessary during
and after carbamazepine treatment
-
Cimetidine (e.g., Tagamet) - Blood levels of carbamazepine may
be increased, leading to an increase in serious side effects
-
Clarithromycin (e.g., Biaxin) - Blood levels of carbamazepine
may be increased, increasing the risk of unwanted effects
-
Corticosteroids (cortisone-like medicine) - The effects of corticosteroids
may be decreased
-
Diltiazem (e.g., Cardizem) or
-
Erythromycin (e.g., E-Mycin, Erythrocin, Ilosone) or
-
Propoxyphene (e.g., Darvon) or
-
Verapamil (e.g., Calan) - Blood levels of carbamazepine may be
increased; these medicines should not be used with carbamazepine
-
Estrogens (female hormones) or
-
Oral contraceptives (birth control pills) containing estrogen or
-
Quinidine - The effects of these medicines may be decreased;
use of a nonhormonal method of birth control or an oral contraceptive containing
only a progestin may be necessary
-
Fluvoxamine (e.g., Luvox) - Blood levels of carbamazepine may
be increased, increasing the risk of unwanted effects
-
Isoniazid (e.g., INH) - The risk of serious side effects may
be increased
-
Itraconazole (e.g., Sporanox) or
-
Ketoconazole (e.g., Nizoral) - The effects of these medicines
may be decreased
-
Monoamine oxidase (MAO) inhibitors (furazolidone [e.g., Furoxone],
isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g.,
Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) - Taking
carbamazepine while you are taking or within 2 weeks of taking monoamine oxidase
(MAO) inhibitors may cause sudden high body temperature, extremely high blood
pressure, and severe convulsions; at least 14 days should be allowed between
stopping treatment with one medicine and starting treatment with the other
-
Other anticonvulsants (seizure medicine) - The effects of these
medicines may be decreased; in addition, if these medicines and carbamazepine
are used together during pregnancy, the risk of birth defects may be increased
-
Risperidone [e.g., Risperdal] - The effects of risperidone may
be decreased
-
Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine
[e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane],
doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g.,
Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) - Central
nervous system depressant effects of carbamazepine may be increased while
the anticonvulsant effects of carbamazepine may be decreased; seizures may
occur more frequently
Other medical problems - The presence of other medical
problems may affect the use of carbamazepine. Make sure you tell your doctor
if you have any other medical problems, especially:
-
Alcohol abuse (or history of) - Drinking alcohol may decrease
the effectiveness of carbamazepine
-
Anemia or other blood problems or
-
Behavioral problems or
-
Glaucoma or
-
Heart or blood vessel disease or
-
Problems with urination - Carbamazepine may make the condition
worse
-
Diabetes mellitus (sugar diabetes) - Carbamazepine may cause
increased urine glucose levels
-
Kidney disease or
-
Liver disease - Higher blood levels of carbamazepine may result,
increasing the chance of side effects
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