Carbamazepine

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Carbamazepine is an anticonvulsant and mood stabilizing drug used primarily in the treatment of some forms of epilepsy and prophylaxis (medical or public health measures taken in order to prevent disease or health) of bipolar disorder (manic-depressive disorder) in patients unresponsive to lithium. can also be taken as a pain killer to relieve the intermittent severe pain caused by damage to the cranial nerves (trigeminal neuralgia) and the less commonly known glossopharyngeal neuralgia it will reduce the frequency and severity of attacks. Carbamazepine is also used off-label for a variety of indications, including attention-deficit hyperactivity disorder (ADHD), schizophrenia, phantom limb syndrome, paroxysmal extreme pain disorder, and post-traumatic stress disorder. It has been in use for long-term treatment of epilepsy for some time now, it also reduces the likelihood of fits caused by abnormal nerve signals in the brain. Its side-effects are less of a problem than some other drugs for epilepsy so it is considered suitable for treating children.

Carbamazepine is also used in the treatment of certain psychological or behavioural disorders. It may be used for the prophylaxis of bipolar disorder (manic-depressive disorder) in individuals unresponsive to lithium; it seems to be particularly effective in patients with rapid-cycling manic-depressive illness, and is occasionally be used to treat diabetes insipidus as well as pain relief in diabetic neuropathy. Therapy for carbamazepine is usually started at low doses and is gradually increased over time, this method of prescription is used to avoid side effects. It is also recommended that the patient should stick to the particular brand of medication prescribed.

If you own a car or depend on one for getting around then you should be aware of the Driver and Vehicle Licensing Agency (DVLA) guidelines.

Individuals suffering from epilepsy may drive a motor vehicle (but not a heavy goods or public service vehicle) provided that they have had a seizure-free period of one year or, if subject to attacks only while asleep, have established a 3-year period of asleep attacks without awake attacks. Patients affected by drowsiness should not drive or operate machinery. Guidance issued by the Drivers Medical Unit of the Driver and Vehicle Licensing Agency (DVLA) recommends that patients should be advised not to drive during withdrawal of antiepileptic drugs, or for 6 months afterwards.

Quick Guide

• Anticonvulsant danger of overdose – MEDIUM.
• Antipsychotic danger of overdose – MEDIUM.
• Dependency is said to be – LOW.
• Prescription only drug – YES.
• Available as generic – YES. (generic drugs, short: generics) is a drug which is produced and distributed without patent protection.
• Alcohol Avoidance – YES.
• Alcohol may increase the sedative effects of carbamazepine

Side Effects

You may if taking carbamazepine suffer one or more of these side effects, in the initial stages. However, you may find you do not suffer any at all, as it does not follow that being on this medication will cause unwanted adverse effects.

Common: nausea and vomiting, dizziness, drowsiness, headache, ataxia, confusion and agitation (elderly), visual disturbances.
Rare: Unsteadiness, ankle swelling, jaundice, rash, sore throat.

The majority of people experience very few side effects however, it is possible for blood levels to get rather high. If this does happen side effects would be more common and dosage may need to be reduced or altering the timing of medication; use of modified-release tablets also significantly lessens the incidence of dose-related side-effects.

The side effects listed here are the most common and rare problems reported by patients using Carbamazepine. It does not include all of the side effects reported by the drug’s manufacturer. If common side effects persist you need to inform your doctor. Notify your doctor if you suffer any of the rare or some other side effects not listed here. For total peace of mind, seek information from your doctor or chemist.

Important: If you experience fever, sore throat, severe skin rash, ulcers in the mouth, or easy bruising or bleeding, speak with your doctor without delay.

Prolonged Use

There is a possibility of blood problems occurring over a extended period of use. With a slight risk of changes in liver function, or skin abnormalities. From time to time blood test samples may be taken to monitor levels of the drug in the body, as it may cause changes in blood cells counts and liver and kidney functions

Driving, Hazardous Work & Alcohol

Discuss with your doctor. You should avoid driving/hazardous work until you know how carbamazepine affects you. This drug may cause reduced alertness, making it unsafe to drive or operate machinery. You would be advised not to drive during withdrawal of antiepileptic drugs, or for 6 months afterwards. Alcohol possibly increases the sedative effects of carbamazepine.

Driving Individuals (UK) Individuals suffering from epilepsy may drive a motor vehicle (but not a heavy goods or public service vehicle) provided that they have had a seizure-free period of one year or, if subject to attacks only while asleep, have established a 3-year period of asleep attacks without awake attacks. Patients affected by drowsiness should not drive or operate machinery.

Pregnancy and Breast-Feeding

There is an increased risk of teratogenicity (side effect of many drugs causing abnormalities of physiological development) associated with the use of antiepileptic drugs (reduced if treatment is limited to a single drug). In view of the increased risk of neural tube and other defects associated, in particular, with carbamazepine.

If pregnant you will need to speak with your doctor and be guided by his or her advice. Those who wish to become pregnant should be referred to an appropriate specialist for advice. If you are breast feeding, at normal doses adverse effects on the baby are said to be unlikely. Folic acid supplementation is recommended, before and during pregnancy, because it has been shown to reduce the occurrence and recurrence of neural tube defects. Discuss these issues with your doctor. Carbamazepine should not be started unless the expected benefit clearly outweighs the increased risks.

Carbamazepine is classified as a pregnancy Category D medicine by the U.S. Food and Drug Administration (FDA). Category D… There is positive evidence of human foetal/fetal risk based on adverse reaction data from investigational marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Surgery and Dental Work

Discuss with your doctor or dentist before surgery and dental work is carried out.

Tell Your Doctor Or Pharmacist

You should tell your doctor if you have a current health problem. For example: heart disease, kidney problems, if you are pregnant or you intend to become pregnant, or if you think you may be at risk from drug treatment for any other reason. Some types of medication can cause serious adverse effects when taken side by side so it is important to tell your doctor of any other medication you are already taking. This should also include any over-the-counter medication. For example: Painkillers, cold remedies, herbal and complimentary/alternative medication.

Over 60′s & Children

There may be a need to a reduced dosage for the over 60′s as it can cause confusion as well as agitation in the elderly. It would not be usually prescribed for infants and children. Although a reduced dosage can be given if necessary.

Overdose

Take carbamazepine exactly as directed by your doctor. Never take more than the prescribed dose. An unintentional extra dose should not cause a problem. If you suspect that you or someone else has taken an overdose of this medicine, Notify your doctor immediately or go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty. Large overdose may cause tremor, convulsions and coma.

Other Medication Reactions

Carbamazepine could cause significant interactions that occur between antiepileptics themselves and the lowering of plasma concentration of clobazam, clonazepam, lamotrigine, an active metabolite of oxcarbazepine, and of phenytoin, tiagabine, topiramate, valproate, and zonisamide. Carbamazepine may also reduce or increase effects from other medication so be sure to discuss this with your doctor or pharmacist before taking carbamazepine. The dose of antiepileptic drugs should be monitored carefully during pregnancy and after birth, and adjustments made on a clinical basis.

Antiepileptic drugs should be withdrawn under specialist supervision. Abrupt withdrawal, particularly of the barbiturates and benzodiazepines, should be avoided because this may precipitate severe rebound seizures. Reduction in dosage should be gradual and, in the case of barbiturates, withdrawal of the drug may take months. Individuals receiving several antiepileptic drugs, only one drug should be withdrawn at a time.

Missed A Dose

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue the regular dosing schedule. Do not take a double dose to make up for a missed one.

Reducing or Stopping Medication

It is important that you do not stop taking the drug without consulting your doctor. It is possible that the symptoms will recur. Antiepileptic drugs should be withdrawn under specialist supervision. Abrupt withdrawal, particularly of the barbiturates and benzodiazepines, should be avoided because this may precipitate severe rebound seizures. Reduction in dosage should be gradual and, in the case of barbiturates, withdrawal of the drug may take months. Individuals receiving several antiepileptic drugs, only one drug should be withdrawn at a time.

Effect Of Medication (from one dose)

The effects of this medication can be felt within 4 hour of taking it. The duration of the effect may last 12 to 24 hours.

How do I take Carbamazepine

• Try to read the manufacturer’s printed information leaflet Before beginning your treatment.
• Take carbamazepine exactly as directed by your doctor.
• Try to take carbamazepine at the same times each day this will help to avoid missing any doses.
• Carbamazepine chewtabs must be chewed before swallowing. They can be washed down with a little water if required.
• Carbamazepine may be taken before, during or after meals.
• Carbamazepine modified release formulations must be swallowed whole with a glass of water. Do not crush or chew.
• If you are taking carbamazepine liquid, make sure you shake the bottle before you measure out your dose.
• If you are using the suppositories, they are to be inserted into the back passage (rectum). Never swallow them. If you are unsure how to use them, ask your doctor or pharmacist for advice.

Storage and Safety

• Never take more than the original dosage prescribed by your doctor.
• If your due to have treatment like an operation or dental work tell the person carrying out the treatment which medicines you are taking.
• When you buy any medicines over-the-counter check with the pharmacist that they are safe to take with your other medicines.
• Never take Carbamazepine if it has past the expiry date shown on the box or container.
• Do not store medication above a temperature of 25°C or above a working area where high condensation may exits.
• Keep Carbamazepine in its original container, in a cool dry place, away from the reach and eye sight of children.
• Always read the printed information leaflet that comes with your medicine.
• Do not discard old or unwanted drugs into your trash, sink or toilet.
• Return all unused or old medicines/drugs to your pharmacist. who will dispose of them safely.
If Carbamazepine has been prescribed for you never allow anyone else to use it, even if you know or others feel their symptom are similar to your own.

Do not leave your doctors surgery until you have a clear understanding of what the drug your doctor has prescribed for you does, and why you have been prescribed it. It is common for people who do not understand the reason behind there treatment to take their medication correctly.

• If you are pregnant, trying for a baby or breast-feeding.
• If you have kidney or liver problems.
• If you suffer from glaucoma (increased pressure in the eye).
• If you suffer from porphyria (blood disorder).
• If you have ever suffered from problems affecting your bone marrow such as leukaemia.
• If you have heart problems
• If you have ever had an allergic reaction to this or any other medicine.
• If you are taking any other preparations (including herbal/alternative/complementary and those bought over the counter).

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Tags: anticonvulsant, antipsychotic, bipolar, bipolar disorder, chewable tablets, diabetes insipidus, epilepsy, liquid, neuralgia, schizophrenia, suppositories, tablets