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Bone marrow depression

Patients who are known to have bone marrow depression should not use Carbamazepine. There is a risk of a decrease in the production of leukocytes, erythrocytes, thrombocytes (bone marrow depression). These patients may have the following symptoms if they use this medicine:

Known severe allergic reaction

Patients who are known to have a severe allergic reaction to Carbamazepine, such as life-threatening allergic reaction or a serious allergic reaction should not use Carbamazepine. Fever, facial swelling, a disease of the lymph nodes, inflammation of the liver (hepatitis), inflamed nephrons (nephritis), blood disorders (hematologic abnormalities), inflammation and damage of the heart muscle (myocarditis), and inflammation in muscles (myositis) were seen in such patients. These patients may have the following symptoms if they use this medicine:
  • fever
  • facial swelling
  • disease of the lymph nodes

Known severe allergy to any of the tricyclic compounds

Patients who are known to have life-threatening allergic reaction or rash to any of the tricyclic compounds such as desipramine, amitriptyline, imipramine, nortriptyline, and protriptyline, should not use Carbamazepine.

CYP3A4 substrates

The combined use of delavirdine or other non-nucleoside reverse transcriptase inhibitors that are substrates for CYP3A4 should be avoided with Carbamazepine. Carbamazepine can mainly decrease the levels of these drugs through the induction of CYP3A4. This can lead to the end of virus response and possible resistance to these medicines.

Monoamine oxidase inhibitors (MAOIs)

Before starting treatment with Carbamazepine, discontinuation of MAOIs should be done for a minimum of 14 days. The combined use of both the medicines may cause serotonin syndrome.

Use of nefazodone

The combined use of nefazodone and Carbamazepine should not be used. The combined use of nefazodone and Carbamazepine may result in inadequate blood levels of nefazodone and its active metabolite to produce a desirable effect.

Heart block or enzyme-deficiency in liver

Carbamazepine usage should not be recommended in patients with heart block or a history of enzyme deficiency in the liver (e.g. deficiency of enzyme hydroxymethylbilane synthase (acute intermittent porphyria), skin blistering (variegate porphyria), blistering and weakening of skin (porphyria cutanea tarda).

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