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Why it's used

Carbamazepine is a prescription medicine that is used to treat a condition characterized by episodes of depression and abnormally elevated behaviour (acute manic or mixed episodes associated with bipolar I disorder), long-term pain affecting the trigeminal nerve in the face, and a disorder in which nerve cell activity in the brain is disturbed, causing different types of seizures such as partial seizures, generalized tonic-clonic seizures, and mixed seizure patterns (epilepsy). This medicine works by altering the transmission of certain chemicals in the brain and producing certain changes in the ion channels such as sodium and calcium.
When not to use
Carbamazepine will not work to treat a type of seizure involving brief or sudden lapses in attention (absence seizures) and shock-like jerks of a muscle (myoclonic seizures).
Neuroleptics
Carbamazepine belongs to the Neuroleptics class of medicines. Neuroleptics can reduce or relieve symptoms of psychosis, such as false beliefs and seeing or hearing something that is not there (hallucinations). It is also used to treat people with schizophrenia, psychosis that occurs in bipolar disorder, depression and Alzheimer’s disease. Other uses of neuroleptics include reducing anxiety and decreasing tics in Tourette syndrome.

How to use

Read the medicine guide provided by your pharmacist, your doctor, or the medicine company. If you have any questions related to Carbamazepine, ask your doctor or pharmacist. Use Carbamazepine as per the instructions provided by your doctor.
Carbamazepine is eaten with or without food. This medicine should be swallow whole with a teaspoon of applesauce and do not chew or crush the Carbamazepine.

Typical Dosage

The typical dose of Carbamazepine for adults is 200 mg once daily (not more than 1200 mg in one day). The usual dose for children is 200 mg twice daily (not more than 600 mg twice in one day). The maximum dose for adult patients of Carbamazepine is 1600 mg per day.
This medicine should be used on an as-needed basis.
To decrease the possibility of side-effects, you might be recommended to use the extended-release form of this medicine by your doctor. The extended-release medicine helps in maintaining a steady level of the medicine in your body for a longer period of time. Do not crush or chew the medicine, unless indicated on the package or by your doctor.
If you are using the chewable tablet form of this medicine, make sure you chew the medicine before you swallow it.
If using the liquid form of this medicine, measure the dose using the provided measuring cup, spoon, or dropper. Before pouring the medicine into the measuring device, you should check the measurement markings carefully. Then, pour the dose amount into the device. After use, clean and store the measuring device in a safe place for your next use. You should not use a tablespoon or teaspoon as the dose measuring devices since it can result in an incorrect dose. If indicated on the product package, shake the medicine before use.

Talk to Your Doctor

Discuss with your doctor if you develop new or worsening symptoms. Discuss with your doctor if skin rash, fever, swollen glands, swelling of the lips or tongue, yellowing of the skin or eyes, unusual bruising or bleeding, weakness, severe muscle pain, and frequent infections. If you have issues with the health of your liver, a low dose will usually be given to lessen the risk of liver damage. Consult with your doctor before stopping the use of Carbamazepine.
Your doctor may prescribe a lower starting dose of this medicine to understand the impact on the body. Please follow your doctor's recommendations. Older patients may see an increase in the incidence of side-effects. As a result, a lower dose may be recommended for older patients.
You may need to taper (gradually decrease) the dose of this medicine when stopping.

Use in Children

If you are giving Carbamazepine to a child, be sure to use a product that is for use in children. Use the child's weight or age to find the right dose from the product package or medicine label. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.

Avoid Alcohol

Avoid consuming alcohol together with Carbamazepine.

Lab Tests

Your doctor may request that specific lab tests be performed before you start using Carbamazepine. Your doctor may ask you to undergo Complete Blood Count test. The patient in the therapy shows low or decreased white blood cell or platelet counts, so the complete blood count is required including platelets and possibly reticulocytes and iron levels in the blood. Your doctor may request Eye exam test. An eye examination is needed before this medicine use, as Carbamazepine has been shown to cause eye changes. Your doctor may request Liver Panel test. A liver function test is needed especially in patients with a history of liver disease before taking this medicine because liver damage may occur.
Medicines may be recommended for uses other than those listed in the medicine guide. You should not use Carbamazepine for conditions or symptoms for which it was not prescribed. Do not give Carbamazepine to other people, even if they have the same conditions or symptoms that you have. The use of this medicine without the advice of a doctor may cause harm.

Storage

Follow storage instructions on the product package if available. Store Carbamazepine 15–30° C (59–86° F), away from moisture, and away from light. Store this medicine away from children and pets.
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How to take Carbamazepine

The dose and frequency of using Carbamazepine will depend on the following factors:
  • age of the patient
  • the weight of the patient
  • patient's health
  • the health of the patient's kidneys

Carbamazepine Dosage

Dosage for manic/mixed episodes with bipolar-I disorder

Adult
  • Initial: 200 mg twice daily, later increase the dose by 200 mg per day to gain optimal clinical response.
  • Maximum: 1600 mg per day

Dosage for long-term pain affecting a face's nerve

Adult
  • Recommended: 400 mg to 800 mg per day
  • Initial: 200 mg once daily, this dose may increase up to 200 mg/day by additions of 100 mg every 12 hours only as required to gain an effective and tolerated dose
  • Maximum: 1200 mg in a day

Dosage for epilepsy

Adult
  • Initial: 200 mg twice daily, this dose may increase weekly up to 200 mg/day taken in an equally divided, twice daily dose, to gain an optimal response
  • Maximum: 800 mg twice daily
Children (children 15 to 18 years old)
  • Initial: 200 mg twice daily, this dose may increase weekly up to 200 mg/day taken in an equally divided, twice daily dose, to gain an optimal response
  • Maximum: 600 mg twice daily
Children (children 12 to 15 years old)
  • Initial: 200 mg twice daily, this dose may increase weekly up to 200 mg/day taken in an equally divided, twice daily dose, to gain an optimal response
  • Maximum: 500 mg twice daily
Children (children under 12 years)
  • Recommended: below 35 mg/kg (15.9 mg/lb) in a day

Minimum Age

5 years

Maximum Age

100 years

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 100 mg, 200 mg, 300 mg, 400 mg
Tablet, extended release
Strength: 100 mg, 200 mg, 400 mg
Tablet chewable
Strength: 100 mg and 200 mg
Capsule, extended release
Strength: 100 mg, 200 mg, 300 mg
Suspension
Strength: 100mg, 100 mg/5ml, 200 mg/10mL
Injection, powder, for a solution
Strength: 10 mg/ml

Missed Dose

If you forget to take a dose, take one as early as you remember. If it is almost time for your next dose, though, just take the next dose and neglect about the one you missed.

Overdose

What to do if you overdose on Carbamazepine?
The patient should be carefully examined and given symptomatic and supportive treatment. Proper medical supervision should be provided and ensure a sufficient airway, oxygenation, and ventilation also monitor heart rhythm and vital signs like pulse rate, temperature, respiration rate, and blood pressure.
Symptoms of an overdose of Carbamazepine
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • abnormal heartbeat
  • below normal or absent reflexes
  • decrease in white blood cell count
  • degenerative disease of the nervous system
  • dilation of the pupil
  • dizziness
  • drowsiness
  • excess of sugar in urine (glycosuria)
  • excretion of large amounts of acetone in the urine (acetonuria)
  • failure of the kidneys to produce urine
  • inability to completely empty the bladder
  • inability to perform rapidly alternating movements (adiadochokinesia)
  • increase in the number of white blood cells
  • increased heartbeat
  • involuntary eye movement
  • irresistible urge to move (motor restlessness)
  • lack of coordination of movement (dysmetria)
  • low blood pressure
  • movement disease (ballism)
  • muscle twitching
  • nausea
  • overactive or over-responsive reflexes (hyperreflexia)
  • reduced urination
  • seizures especially in children
  • shock
  • slow, ineffective and irregular breathing
  • slow, involuntary movements of the fingers, hands, toes, and feet
  • spasm of the muscles (opisthotonos)
  • state of consciousness in severity to deep coma
  • tremor
  • unintentional and purposeless motions and restlessness (psychomotor disturbances)
  • vomiting
If you think you have overdosed on Carbamazepine, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Carbamazepine

Before you use Carbamazepine, tell your doctor of your medical and health history including the following:
  • blood-related problems
  • bone marrow depression
  • enzyme deficiency occurs in the liver (hepatic porphyria)
  • heart disease
  • increased fluid pressure in the eye (increased intraocular pressure)
  • kidney damage
  • liver disease
  • mental health disorder (depression)
  • mood problems
  • suicidal thoughts
Cyclic evaluations of liver function in patients with a history of liver disease should be examined during Carbamazepine therapy because liver damage may occur. Acute attacks have been observed in patients with a history of enzyme deficiency occurs in the liver (hepatic porphyria) with using Carbamazepine and also in patients with a history of increased fluid pressure in the eye (increased intraocular pressure), examine intraocular pressure before starting the therapy and regularly during treatment.
Before you use Carbamazepine, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
The use of Carbamazepine may change thyroid function ( (T3, T4). Use of Carbamazepine may decrease the levels of thyroid hormone.
The use of this medicine may change platelet count. Use of Carbamazepine may increase or decrease the number of the platelet count.
The use of Carbamazepine may change white blood cell count. Use of Carbamazepine can lead to increased or decreased the level of white blood cell count.
The use of this medicine may change sodium level. Use of Carbamazepine may lower sodium level in the blood.

Use when Pregnant

Consult with your doctor on the use of Carbamazepine during pregnancy or if you are planning to become pregnant. Carbamazepine may increase the risk of developing possible harm to the newborn including spine and spinal cord don't form properly (spina bifida). Talk to your doctor immediately if you become pregnant while taking Carbamazepine.

If Breastfeeding

Consult with your doctor on the use of Carbamazepine during breastfeeding. A patient should take caution when using Carbamazepine during breastfeeding as this medicine passes into breast milk and may lead to newborn vomiting (neonatal vomiting), diarrhea, decreased feeding, increased seizures, and slow and ineffective breathing.

If trying to Conceive

Consult with your doctor on the use of Carbamazepine, if you are trying to conceive. Before taking Carbamazepine in women who are attempting to conceive, consult with a doctor as the effects of Carbamazepine on the unborn child are harmful.

Alcohol

Avoid drinking alcohol with Carbamazepine. Consumption of alcohol may cause sleepiness, and dizziness.

Seizures

Carbamazepine can make you feel sleepy. Be careful, especially while driving, while using heavy machinery, or when doing any activity that needs you to be completely alert. The consumption of alcohol with Carbamazepine can worsen the sleepiness. Carbamazepine may cause seizures in some people. Hence, you should discuss with your doctor before performing any activities where a loss of consciousness may cause harm to you or others.

Increase in Risk

This medicine may increase your sensitivity to sunlight and make you prone to sunburn. If this happens, limit your time outdoors to prevent sunburn. Use a sunscreen and cover your skin.

Side-effects in Older Patients

Older patients may have a higher incidence of side-effects when using Carbamazepine. Elderly patients may see an increased risk of decreased liver function, decreased functioning of kidneys, and decreased heart function.

Carbamazepine Side-effects

The following side-effects may commonly occur when using Carbamazepine. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in older patients on the use of Carbamazepine. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • decreased functioning of the kidneys
  • decreased heart function
  • decreased liver function
Rarely, the use of Carbamazepine may cause the following side-effects:
  • a disorder characterized by bumps on the skin (erythema nodosum)
  • abnormal involuntary movements
  • acne
  • aggression
  • an abnormal increase in the number of white blood cells
  • an inflammatory disease that occurs when the immune system attacks its own tissues (lupus erythematosus-like syndrome)
  • blockage of arteries in the lungs due to a blood clot (pulmonary embolism)
  • change in pitch perception
  • circulatory collapse
  • diarrhea
  • double vision (diplopia)
  • excessive production of milk
  • fatigue
  • fluid retention
  • folate deficiency
  • hearing disorder (hyperacusis)
  • hirsutism
  • inability of bone marrow to produce red blood cells (aplasia pure red cell)
  • increase in the number of immature red blood cells (reticulocytosis)
  • increased weight
  • inflammatory liver disease (granulomatous liver disease)
  • involuntary movement of eyes (nystagmus)
  • large production of abnormal red blood cells by bone marrow (megaloblastic anaemia)
  • memory problems
  • muscle weakness due to nerve damage (paresis)
  • muscular weakness
  • painful swelling and sores in the mouth
  • red or purple discolored spots on the skin
  • restlessness
  • ringing in the ears
  • scaling of the skin due to existing skin disorders, drugs, cancer, etc. (dermatitis exfoliative)
  • sedation
  • sexual disturbances/erectile dysfunction
  • shedding of nails (onychomadesis)
  • speech disorder
  • stomach pain (abdominal pain or gastric distress)
  • vision problem (oculomotor disturbances)
The following severe side-effects may also occur when using Carbamazepine:
  • central nervous system disorders
    Symptoms: inflammation of membranes of brain and spinal cord accompanied by contractions of muscles (aseptic meningitis with myoclonus), weakness, numbness and pain due to nerve damage, usually in the hands and feet (peripheral neuropathy), involuntary movements in a sequence (choreoathetosis), hallucinations, depression, agitation, life-threatening reaction or autonomic dysfunction (neuroleptic malignant syndrome), suicidal thoughts (suicidal behavior and ideation), disorder of disturbed activity of nerve cells in the brain (abrupt discontinuation and seizure risk), memory and movement disorders (cognitive and motor problems) confusion
    The patients should be advised to monitor the blood levels and divide the daily dose into smaller dose i.e. 3-4 fractional doses.
  • allergic reactions (Possibly fatal)
    Symptoms: drug reaction with eosinophilia and systemic symptoms/multiorgan allergic reactions, severe allergic reaction (anaphylactic reaction) sun allergy (photosensitivity)
    The patient should be evaluated instantly if these signs or symptoms are present. Carbamazepine should be discontinued if another cause for the symptoms cannot be discovered.
  • heart and blood disorders
    Symptoms: increased or decreased heartbeat (arrhythmia), decreased heartbeat (bradycardia), damage in heart's major blood vessels (coronary artery disease), high blood pressure, low blood pressure, destruction and removal of red blood cells before their life span (hemolytic anemia), deficiency of red blood cells, white blood cells and platelets (pancytopenia), interruption of transmission of impulses (AV heart block), abnormally low levels of sodium in the blood, a condition in which the body stops producing enough new blood cells (aplastic anemia), an abnormal reduction in white blood cells, an abnormal increase in eosinophils in peripheral blood (peripheral eosinophilia) heart failure (congestive heart failure)
    Reduce the dose when needed. Patients should be advised to report symptoms of low sodium level like nausea, lack of energy, tiredness, seizures, confusion, or more severe seizures to their doctor immediately. Patient having low white blood cell during the course of treatment, should be closely monitored. Discontinue the medicine if any sign of a decrease in the production of leukocytes, erythrocytes, thrombocytes (bone marrow depression) develops. Patients and caregivers should be informed about the risk of possibly fatal lowered white blood cell count or when the body stops producing enough new blood cells and the symptoms that may indicate these reactions.
  • skin disorders (possibly fatal)
    Symptoms: serious and life-threatening skin reactions (Stevens-Johnson Syndrome)
    Inform patients to consult with the doctor or pharmacist immediately if any skin reaction occurs during therapy with Carbamazepine. Patients and caregivers should be informed about the risk of possibly fatal, signs and symptoms, and serious skin reactions that may indicate a serious skin reaction.
  • liver disorders (drug-induced serious liver injury)
    Symptoms: jaundice, liver failure or damage, inflammation of the liver and a problem with the transportation of bile (hepatitis of cholestatic) deficiency of an enzyme in the liver (hepatic porphyria)
    Discontinuation of the drug should be done immediately in cases of active liver disease or worsening liver dysfunction.
  • stomach and intestinal disorders
    Symptoms: loss of appetite (anorexia), a long-term inflammatory bowel disease that causes inflammation in the digestive tract (colitis) inflammatory disease of lymph nodes
  • muscle and coordination disorders
    Symptoms: abnormality in muscular movement (dyskinesia)
  • sensory disorders
    Symptoms: loss of hearing (hypoacusis)
  • kidney disorders
    Symptoms: kidney failure
  • lung disorders
    Symptoms: lung disorder in which air sacs are filled with pus or fluid (pneumonia) shortness of breath
Your doctor has prescribed this Carbamazepine because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Carbamazepine.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Mental disorder (psychiatric effects)

The elderly patient who is on treatment with Carbamazepine is at an increased risk of developing the mental disorder (psychosis). Such patients may develop confusion or nervous excitement or worry in the mind.

Increased fluid pressure inside the eye

The patient who is on treatment with Carbamazepine is at an increased risk of developing fluid pressure inside the eye (intraocular pressure). The patient should be advised to examine intraocular pressure before starting the therapy and regularly during the treatment.

Low levels of thyroid hormones

Carbamazepine may lower the blood level of thyroid hormones through enzyme induction. Patients should be advised to raise the dose of thyroid replacement therapy. They should also monitor thyroid function to regulate the dosage of thyroid replacement treatment.

Anticholinergic effects

Carbamazepine may increase the actions of the neurotransmitter acetylcholine (anticholinergic action). Patients with increased fluid pressure inside the eye (intraocular pressure) and inability to empty the bladder should be carefully observed during treatment.

Enzyme deficiency occurs in the liver

Patients with a history of an enzyme deficiency that occurs in the liver (hepatic porphyria) are at an increased risk when using this medicine. The patient who is on treatment with Carbamazepine is at an increased risk of developing an acute attack of enzyme deficiency occurs in the liver (porphyria). Patients should be advised to avoid the use of the Carbamazepine with a history of enzyme deficiency occurs in the liver (hepatic porphyria).

Sudden withdrawal of Carbamazepine

Patients with a seizure disorder who is on treatment with Carbamazepine are at an increased risk. Such patients are at an increased risk of developing seizures or seizures that last longer than 5 minutes (status epilepticus) with low oxygen in the blood, a threat to life and other withdrawal symptoms. Do not stop using Carbamazepine suddenly.

Low level of sodium in the blood

Patients undergoing treatment with diuretics and elderly patients are at an increased risk of developing a low level of sodium in the blood. Such patients are at an increased risk of developing seizure, focusing problems, memory damage, confusion, headache, weakness, loss of balance (unsteadiness) which may lead to falls. Patients should be advised to discontinue the use of this drug if these reactions occur while taking this drug and appropriate measures should be adopted.

Mental activity and body movement problems

Patients who are on treatment with Carbamazepine are at an increased risk of developing problems in judgment, trouble in remembering or learning new things and partial or total loss of function of a body part.

Possibility for loss of antiviral activity

The combined use of Carbamazepine with non-nucleoside reverse transcriptase inhibitors including delavirdine is not recommended as it may lead to loss of antiviral activity and possibly cause resistance. The combined use of delavirdine and Carbamazepine can decrease the delavirdine levels.

Abnormal heart rhythm

Patients with underlying electrocardiogram abnormalities or risk factors for electrical impulses (conduction) disturbances are at higher risk while using this medicine. Patients who are on treatment with Carbamazepine are at an increased risk of developing abnormal heart rhythm (AV heart block) including a second and third-degree block.

Serious allergic reactions

Serious and sometimes fatal skin, nails and hair allergic reactions have been reported with Carbamazepine treatment. These serious skin reactions may be accompanied by fever, painful rash, or mucous membrane ulcers. Discontinue Carbamazepine if you notice that the patient has a serious skin, nails, hair related allergic reaction. If signs or symptoms suggest serious skin reaction, do not continue therapy with Carbamazepine.

Serious blood disorders

When patients with a serious blood disorder (aplastic anemia) and severe lowered white blood cell count were on Carbamazepine therapy they were seen with almost all minor blood-related changes which were observed during the monitoring of patients. Pretreatment blood-related testing should be done. If a patient during the therapy exhibits decreased platelet counts or white blood cell, close monitoring of the patient should be done. Carbamazepine should be discontinued if any sign of significantly decreased production of blood cells (bone marrow depression) develops.

Severe allergic reaction

Patients who were on anticonvulsant therapy are at an increased risk while using this medicine. These patients may have fever, rash, blood vessels inflammation, disease of the lymph nodes, joint pain, decrease in white blood cells, increase in eosinophils, swelling of both the liver and spleen, abnormal liver function tests and drug-induced liver injury, that may occur in several combinations. Carbamazepine should be discontinued if an alternative cause for the symptoms and signs cannot be built. Patients who have earlier experienced a severe allergic reaction to anticonvulsants including primidone, phenytoin, and phenobarbital, should carefully consider the benefits and risks of Carbamazepine. If Carbamazepine treatment has been started, the signs and symptoms of severe allergic should be monitored carefully.

Suicidal behavior and creative processing (ideation)

Patients taking antiepileptic drugs, including Carbamazepine, increase the risk of suicidal thoughts and behavior. Patients, their families, and caregivers should be informed that antiepileptic drugs develop the risk of suicidal thoughts or behaviors. They should be advised about the necessity to be alert for the development or worsening of the symptoms of depression, changes in behavior or mood, thoughts about self-harm or the rise of suicidal thoughts.

Embryo and fetus damage

Pregnant women are at an increased risk when using this medicine. Such patients are at an increased risk to develop possible harm to the newborn including spine and spinal cord don't form properly (spina bifida). Routine prevention of health care during pregnancy is recommended in childbearing women while using Carbamazepine.

Interactions with Carbamazepine

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Carbamazepine. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.
Carbamazepine interacts with Androgens, which are used to regulate the development and maintenance of male characteristics. Androgens may raise Carbamazepine blood levels. When androgen and Carbamazepine are used together, the dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
There may be an interaction of Carbamazepine with Analgesics, which are used to relieve pain and reduce inflammation or swelling. Carbamazepine may lower the blood level or even stop the activity of analgesics. Analgesics may also raise Carbamazepine blood levels. The dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Carbamazepine may interact with Monoamine-oxidase inhibitors (MAOIs) which are used as antidepressants to treat depression, panic disorders, and social phobia. The use of Carbamazepine should be avoided in combination with monoamine-oxidase inhibitors (MAOIs). Before giving Carbamazepine, MAOIs should be discontinued for at least two weeks, or longer if the clinical situation allows.
Your doctor's guidelines may need to be followed while taking this medicine along with Antidepressants, which are used to treat depression. Carbamazepine may lower the blood level or even stop the activity of antidepressants. Antidepressants may also increase Carbamazepine blood levels. When antidepressants and Carbamazepine are used together, the dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Special instructions need to be followed while taking this medicine along with Antibiotics, which are used in the treatment and prevention of bacterial infections. Antibiotics may raise Carbamazepine blood levels. Carbamazepine may also lower the blood level or even stop the activity of antibiotics. The dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Your doctor's guidelines may need to be followed while taking this medicine along with Antituberculosis, which are used for the treatment of easily affected mycobacterial infections. The combined use of Carbamazepine and isoniazid has been stated to increase isoniazid-induced liver damage. Antituberculosis may reduce or increase Carbamazepine blood levels. When antituberculosis agents and Carbamazepine are used together, the dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Special instructions need to be followed while taking this medicine along with Antipsychotics, which are used to manage severe mental disorder. Carbamazepine may reduce the blood level or even stop the activity of antipsychotics drugs. Antipsychotics may also increase Carbamazepine blood levels. The dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Carbamazepine interacts with Antihistamines, which are used to relieve or prevent the symptoms of allergic response and other types of allergy. Antihistamines may increase Carbamazepine blood levels. When antihistamines and Carbamazepine are used together, the dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
There may be an interaction of Carbamazepine with Antifungals, which are used to treat fungal infections such as yeast infection and athlete's foot. Carbamazepine may reduce the blood level or even stop the activity of antifungal drugs. Antifungal may increase Carbamazepine blood levels. The dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Carbamazepine may interact with Antiepileptics, which are used in the treatment of disturbed nerve cell activity (epilepsy). The combined use of Carbamazepine and levetiracetam has shown to increase Carbamazepine-induced damage. Carbamazepine may decrease the blood level or even stop the activity of antiepileptic drugs. Antiepileptics may also raise Carbamazepine blood levels. The dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Your doctor's guidelines may need to be followed while taking this medicine along with Other interactions such as grapefruit juice which is used to help protect cells from damage or reduce cholesterol and nicotinamide, which is used to prevent and treat pellagra (niacin deficiency). Grapefruit juice and nicotinamide may raise Carbamazepine blood levels. The dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Special instructions need to be followed while taking this medicine along with Gastrointestinal drugs (cimetidine and omeprazole), which are used to relieve heartburn, sour stomach, and stomach upset. Gastrointestinal drugs may increase Carbamazepine blood levels. The dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Carbamazepine interacts with Drugs used for heart problems (e.g. calcium channel blockers), which are used to treat medical conditions related to the heart or the blood vessels. Blood level may get reduced by Carbamazepine usage or it may stop the activity of drugs used for heart problems. The dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
There may be an interaction of Carbamazepine with Carbonic anhydrase inhibitors (such as acetazolamide), which is used to treat glaucoma. Carbonic anhydrase inhibitors may increase Carbamazepine blood levels. The dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Carbamazepine may interact with Antivirals, which are used for treating viral infections. Antiviral agents may raise Carbamazepine blood levels. Carbamazepine may lower the blood level or even stop the activity of antiviral drugs. The dosage of Carbamazepine should be adjusted as increased levels in the blood may result in side-effects such as drowsiness, double vision, dizziness and loss of body movements or the blood levels should be monitored.
Carbamazepine may interact with Antineoplastics, which are used to prevent and block the development of a tumor. Antineoplastics may decrease Carbamazepine blood levels. Carbamazepine may lower the blood level or stop the activity of antineoplastic agents. The dose of Carbamazepine needs to be adjusted when used in combination with antineoplastics.
There may be an interaction of Carbamazepine with Bronchodilators (theophylline and aminophylline), which are used for the treatment of breathing difficulties. Bronchodilators may decrease Carbamazepine blood levels. Carbamazepine may lower the blood level or stop the activity of bronchodilators. Carbamazepine dosage needs to be adjusted when bronchodilators are used in combination with Carbamazepine.
Carbamazepine interacts with Dermatological drugs (e.g. isotretinoin), which are used to treat skin conditions. Dermatological drugs may reduce Carbamazepine blood levels. The dose of Carbamazepine needs to be modified when used in combination with dermatological drugs.
Special instructions need to be followed while taking this medicine along with Herbal preparations containing St. John's wort which is used to treat bruises, sprains, and wounds. Herbal preparations containing St. John's wort may decrease Carbamazepine blood levels. Carbamazepine dosage needs to be adjusted when herbal preparations containing St. John's wort are used in combination with Carbamazepine.
Your doctor's guidelines may need to be followed while taking this medicine along with Antiemetics, which are used for the symptomatic management of nausea and vomiting caused by a variety of medical conditions.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Carbamazepine is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

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