Uses
What is carbamazepine used for?
Carbamazepine is used in people with epilepsy to treat and prevent seizures, sometimes called convulsions. It is also used to treat trigeminal neuralgia, which is an ongoing pain affecting certain nerves in the face.
Carbamazepine may also be used for other conditions as determined by your healthcare provider.
How does carbamazepine work (mechanism of action)?
Carbamazepine works for both seizures and trigeminal neuralgia by balancing signals between nerves.
How is carbamazepine supplied (dosage forms)?
Carbamazepine is available as Carbatrol, Epitol, Tegretol, Tegretol XR, and generic carbamazepine in the following dosage forms that are taken by mouth.
- 100 mg, 200 mg, 300 mg, and 400 mg oral tablets
- 100 mg and 200 mg chewable tablets
- 100 mg/5 mL oral suspension
- 100 mg, 200 mg, and 300 mg oral extended-release capsules
- 100 mg, 200 mg, and 400 mg extended-release tablets
How should I store carbamazepine?
Carbamazepine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place in a tight container. Protect from light.
Side Effects
What are the most common side effects of carbamazepine?
The most common side effects of carbamazepine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Dizziness
- Drowsiness
- Feeling unsteady when walking
- Nausea or vomiting
There may be other side effects of carbamazepine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of carbamazepine?
While less common, the most serious side effects of carbamazepine are described below, along with what to do if they happen.
Severe Skin Reactions. Carbamazepine can cause severe skin reactions called Acute Generalized Exanthematous Pustulosis (AGEP), Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) that can lead to death if not treated. The risk of severe skin reactions is more common in people of Asian descent. Your healthcare provider may have you complete a genetics test to determine if you are at risk prior to starting carbamazepine. If you develop a rash, stop carbamazepine and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of SJS or TEN.
- Painful red or purple skin that looks burned and peels off
- Flat red rash or blisters on your skin, mouth, nose, and genitals
- Red, painful, watery eyes
Blood Disorders. Carbamazepine can cause blood disorders, such as agranulocytosis, aplastic anemia, low platelet levels (thrombocytopenia), and low white blood cell levels (leukopenia). Call your healthcare provider right away if you have any of the following symptoms of blood disorders.
- Fever
- Shortness of breath
- Pale or yellowish skin
- Easy bruising or bleeding
- Frequent infection
- Unusual weakness or tiredness
- Dizziness, lightheadedness, or feeling like you are about to pass out
- Headache
- Fast or abnormal heartbeat
Heart Rhythm Changes. Carbamazepine may cause heart rhythm problems that can lead to an irregular heartbeat and fainting. Some people have a higher risk of this, including people with existing heart disease or who take other medicines that affect the heart. Get emergency help if you experience any of the following signs of heart rhythm changes.
- Chest pain
- Shortness of breath
- Feeling dizzy, lightheaded, or fainting (feeling like you are about to pass out)
- Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking carbamazepine. Keep all appointments to have your blood checked. Call your healthcare provider right away if you have any of the following symptoms of liver damage.
- Nausea or vomiting
- Stomach or belly pain
- Fever
- Weakness or unusual tiredness
- Itching
- Loss of appetite
- Light-colored poop
- Dark-colored pee
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Low Sodium Level (Hyponatremia). Carbamazepine may cause low sodium levels. Call your healthcare provider if you have any of the following symptoms of a low sodium level.
- Headache
- Drowsiness
- Muscle weakness or cramps
- Nausea, vomiting, or loss of appetite
- Tiredness or sleepiness
- Dizziness
- Weight gain
- Restlessness or irritability
- Change in your mental condition such as hallucinations, confusion, decreased awareness, or alertness
- Seizures
Suicidal Thoughts or Actions. Carbamazepine may increase the risk of suicidal thoughts or actions while taking the medicine or when the dose is changed. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.
- New or increased thoughts of suicide or death
- Suicide attempt
- New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior such as increased aggression or hostility
Severe Allergic Reactions. Carbamazepine may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Swelling of the face, lip, mouth, tongue, or throat
- Racing heart
- Itching, skin rash or pale red bumps on the skin called hives
- Fever or general ill feeling
- Swollen lymph nodes
- Shortness of breath, trouble swallowing, or throat tightness
- Swelling in your feet, ankles, or legs
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
- Dark-colored pee
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Warnings & Precautions
Who should not use carbamazepine?
Allergies to Ingredients. People who are allergic to any of the following should not take carbamazepine.
- Carbamazepine
- Carbatrol
- Epitol
- Tegretol
- Tegretol-XR
- Any other medicine known as a tricyclic antidepressant (amitriptyline, desipramine, imipramine, protriptyline, nortriptyline, etc)
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific carbamazepine products they stock.
Bone Marrow Depression. Do not take carbamazepine if you have bone marrow depression or a history of the condition.
Drug Interactions. Carbamazepine should not be taken while you are using certain other medicines. Before taking carbamazepine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
What should I know about carbamazepine before using it?
Do not take carbamazepine unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share carbamazepine with other people, even if they have the same condition as you. It may harm them.
Keep carbamazepine out of the reach of children.
Birth control pills or implants may be less effective and increase your risk of breakthrough bleeding and unintended pregnancies. Discuss with your healthcare provider about reliable forms of birth control to use.
Do not stop taking carbamazepine without talking to your healthcare provider. Stopping carbamazepine suddenly can cause serious problems, including seizures that will not stop in people who have epilepsy. If you need to stop taking carbamazepine, your healthcare provider will give you instructions on how to stop the medicine.
Do not chew, cut, or crush extended-release tablets or extended-release capsules. You may open the extended-release capsules and sprinkle the contents onto a teaspoon of applesauce or other soft food. Swallow the soft food right away without chewing. Do not save the soft food to swallow at a later time.
Liquid carbamazepine should be shaken well before each use. Measure the dose accurately using a measuring device. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device. Do not take at the same time as other liquid medicines.
Some forms of carbamazepine contain sorbitol and should not be taken by people with fructose intolerance. If you need to avoid fructose, ask your pharmacist or healthcare provider if your medicine contains sorbitol.
Carbamazepine can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how carbamazepine affects you.
What should I tell my healthcare provider before using carbamazepine?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if carbamazepine is right for you.
In particular, make sure that you discuss any of the following.
- Allergic reactions to medicines
- Heart problems
- Blood problems
- Suicidal thoughts or attempts
- Mental health problems such as depression or mood problems
- Liver problems
- Kidney problems
- Increased eye pressure, including glaucoma
- Porphyria
Pregnancy. Carbamazepine may cause harm to the unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use/take carbamazepine while you are pregnant or trying to get pregnant. If you become pregnant while taking carbamazepine, you can register for the North American Antiepileptic Drug Pregnancy Registry by calling 888-233-2334 or at www.aedpregnancyregistry.org. This registry collects safety information about the use of antiepileptic medicines during pregnancy.
Breastfeeding. Carbamazepine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop carbamazepine.
Interactions
Does carbamazepine interact with foods or drinks?
Most forms of carbamazepine need to be taken with food. Ask your pharmacist or healthcare provider if you need to take your medicine with food.
Do not drink alcohol. The risk of sleepiness and dizziness may be increased if you drink alcohol while taking carbamazepine.
Avoid drinking grapefruit juice or eating grapefruit while you are taking carbamazepine. Grapefruit can increase the risk of side effects from carbamazepine.
Does carbamazepine interact with other medicines (drug interactions)?
Carbamazepine interacts with many other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are taking.
In particular, make sure that you discuss if you are using any of the following before using carbamazepine.
- A monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used for depression or Parkinson’s disease
- Nefazodone, which is a medicine used for depression
Many medicines may alter the blood levels of carbamazepine, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with carbamazepine. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much carbamazepine?
If you or someone else has used too much carbamazepine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of carbamazepine?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
Are you currently using Carbamazepine?
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