Carbamazepine

Sounds like 'car-ba-maz-e-peen'

Key points about carbamazepine

Carbamazepine is used to treat epilepsy (mate hukihuki), to control some mood disorders (eg, bipolar disorder) and for some types of pain (eg, nerve pain).
Carbamazepine is also called Tegretol®.
Find out how to take it safely and possible side effects.

HN 0789 female pharmacist working in dispensary of community pharmacy

Carbamazepine has many different uses including the treatment of epilepsy by preventing seizures, the control of some mood disorders (eg, bipolar disorder) and the treatment of some types of nerve pain involving the face, head and neck (trigeminal neuralgia). Carbamazepine blocks certain kinds of nerve activity. In Aotearoa New Zealand, carbamazepine is available as:

Tegretol liquid (syrup) 100 mg in 5 mL.
Tegretol 200 mg and 400 mg tablets (white tablets).
Tegretol CR 200 mg tablets (beige-orange tablets).
Tegretol CR 400 mg tablets (brown-orange tablets).

The dose of carbamazepine is different for different people.
Your doctor will start you on a low dose and increase this slowly over a few weeks. This will help to reduce the risk of side effects.
Always take your carbamazepine exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it, and any special instructions.
Read what to do if you think a child or someone else has taken a medicine that's not for them.

Carbamazepine can be taken with food if it upsets your stomach.
Take your doses at the same times each day, to help you to remember to take it.
Carbamazepine is available as a liquid or as tablets.

Formulation	How to take it
Tegretol liquid	Shake the bottle well and measure the right amount using an oral syringe or medicine spoon. You can buy these from your pharmacy. Don't use a kitchen spoon as it won't give you the right amount. Read more: Tips on how to give medicines to babies and children. The liquid is usually taken 3 or 4 times a day.
Tegretol tablets	Swallow these tablets with a glass of water, juice or milk. If you have swallowing problems, you could ask for the liquid instead but the dose and times may need to be adjusted. These tablets are usually taken 2 or 3 times a day.
Tegretol CR tablets	These tablets can be halved but don't crush or chew them, as this could cause side effects. Take these tablets with a glass of water, juice or milk. These tablets are usually taken twice a day.

Missed dose: If you forget to take your dose, take it as soon as you remember that day. But if your next dose is due in the next 2 to 3 hours, miss that dose and just take the next dose at the usual time. Don't take double the dose.

Here are some things to know when you're taking carbamazepine. Other things may be important as well, so ask your healthcare provider what you should know about.

Alcohol: Limit alcohol while you're taking carbamazepine, especially when you first start treatment. Alcohol can increase your risk of side effects, eg, drowsiness. Be careful when driving or using tools until you know how this medicine affects you.
Other medicines: Carbamazepine interacts with many medicines, including some antibiotics, some antidepressants, anti-HIV medicines, anti-clotting medicines (eg, warfarin) and oral contraceptives. Some interactions have very serious effects so check with your pharmacist before taking any new medicines.
Over-the-counter medicines: It may also interact with herbal supplements, rongoā Māori and medicines that are available without a prescription, eg, common pain relievers like paracetamol and ibuprofen that are also found in cough or cold and flu medication. Check with your pharmacist before taking any over-the-counter medicines including herbal supplements and rongoā Māori.
Keep taking carbamazepine every day: It may take a few weeks before you experience the full benefits of carbamazepine. For people with nerve pain, carbamazepine can provide relief within a few days.
Grapefruit: Grapefruit, grapefruit juice or sour/Seville oranges may react with carbamazepine, talk to your pharmacist about this. See grapefruit and medicines(external link).
It's important to take it as prescribed: See tips to help you remember to take your medicines regularly.
Don't stop taking carbamazepine suddenly: Talk to your healthcare provider before stopping and they can advise you on how to stop taking it gradually.
Contraception: Use 2 forms of effective contraception (eg, condoms and another kind) for the whole time you're taking carbamazepine and for 2 weeks after stopping it. Talk to your healthcare provider before choosing your second method as some contraceptives may not work as well while you're taking carbamazepine, and for 4 weeks after you've stopped taking it. Read more about epilepsy and contraception.(external link)

If you are planning a pregnancy

It's important to contact your doctor 6 to 12 months before you want to become pregnant. Read more about epilepsy and pregnancy.
If you become pregnant: Contact your doctor immediately but don't stop taking carbamazepine until you've discussed it with them. There are risks to yourself and your unborn child from uncontrolled epilepsy.
For more information, read:
- medicines for epilepsy, mental health and pain can harm your unborn baby(external link).
- epilepsy medicines and pregnancy(external link)

Like all medicines, carbamazepine can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects	What should I do?
Feeling sleepy, drowsy or tired Feeling dizzy, or faint	These are common when starting carbamazepine. and may last a few hours after taking your dose. Be careful when driving or using tools until you know how this medicine affects you. Limit or avoid alcohol. Tell your doctor if these side effects bother you, as you may need to adjust your dose.
Problems with your eyesight – blurred vision or seeing double	This is common. Be careful when driving or using tools. Tell your doctor.
Feeling sick (nausea) Stomach upset	These are common when starting carbamazepine but usually go away as your body gets used to the medication. Try taking carbamazepine with food. Tell your doctor if it bothers you.
Headache Dry mouth	These are common. Tell your doctor if these bother you.
Low mood, suicidal thoughts — thoughts of harming yourself	Talk to your doctor.
Easy bruising, feeling tired, looking pale, getting sick often	Tell your doctor as you may need a blood test.
Signs of an allergic reaction, eg, skin rash, hives, itches, swelling of the face, mouth or lips, trouble breathing	This is rare but serious. Tell your doctor immediately or ring Healthline 0800 611 116.

Epilepsy | Mate hukihuki
Bipolar disorder | Mate rangirua
Nerve pain
Epilepsy and contraception
Epilepsy and pregnancy
Epilepsy support

Tegretol(external link) Medsafe Consumer Information Sheet, NZ
For adults: Carbamazepine(external link) New Zealand Formulary Patient Information
For children: Carbamazepine(external link) New Zealand Formulary for Children