What is Carbamazepine?
Carbamazepine is a prescriptional medication that is mainly used to control and prevent seizures in people with epilepsy. It may be used alone or in combination with other similar drugs to treat the same.
What are the uses of Carbamazepine?
Carbamazepine belongs to the category of anti-epileptic/anticonvulsant medications. It works by decreasing nerve impulses that cause seizures and helps restore the normal balance of nerve activity. Carbamazepine can be prescribed in the following conditions;
- Epilepsy (Partial seizures, Grand mal Seizures, mixed seizures pattern)
- Trigeminal neuralgia (a condition that causes facial nerve pain)
- Mania (frenzied, abnormally excited, or irritated mood)
- Serious mood disorders when some other medicines don’t work
- Mental illness
- Posttraumatic stress disorder
- Drug and alcohol withdrawal
- Diabetes insipidus
- Restless legs syndrome
- Pain syndromes
- Chorea (a condition which is about movement disorder that mainly causes involuntary, irregular, and unpredictable muscle movements)
The medication may also be prescribed for other uses; ask your physician or pharmacist for detailed information.
How do you use Carbamazepine?
- Take this medicine orally, two to four times a day, usually with food or as prescribed by your physician.
- Take this tablet daily at the same time.
- Follow all the instructions on the prescription label.
- Do not stop taking this medication abruptly without consulting your doctor.
- Do not take it more or less or take it more than often than prescribed by your doctor
- Do not stop using it even if you feel well
Carbamazepine may take a few weeks or longer before you begin to notice the full benefits of the medication. It may not cure the condition but may help you to control your condition.
If You Miss the Dose
- If you happen to miss a dose of Carbamazepine, take the missed dose as soon as you remember.
- However, if it is almost time for the next dose, do not take the missed dose and continue with your next scheduled dose.
- Do not take a double dose to compensate for the missed dose.
What are the side-effects and risks of Carbamazepine?
Like all other medications, Carbamazepine may cause side effects. Although it is unlikely to happen in everyone, you must be aware of the possible side effects.
Very Common side effects:
- Skin reactions which may be severe
- A feeling of being sick
- Feeling unsteady
- Finding it difficult to control movements
- Leucopenia (a reduced number of the cells which fight infection, making it easier to catch infections)
- Changes in liver enzyme levels (usually without any symptoms)
Common side effects:
- Dry mouth
- Weight gain
- Low blood sodium levels resulting in confusion
- Double or blurred vision
- Fluid retention and swelling
- Changes in the blood including an increased tendency to bruise or bleed
Uncommon side effects:
- Abnormal eye movements
- Abnormal involuntary movements including tremor or tics
Rare side effects:
- Loss of appetite
- Speech disorders
- Low blood pressure
- Changes of heartbeat
- A disease of the lymph glands
- Folic acid deficiency
- Numbness or tingling in the hands and feet
- Muscle weakness
- High blood pressure
Very rare side effects:
- Taste disturbances
- Changes to the composition of the blood including anemia
- Increased blood fat levels
- Porphyria (severe abdominal pain, red urine, severe constipation or hallucinations)
- Osteoporosis (a medical condition in which the bones become brittle and fragile)
- Swelling of the breasts and discharge of milk which may occur in both male and females
- Osteomalacia (softening of the bones)
- Abnormal thyroid function tests
- Increased or decreased desire to pass urine or difficulty in passing urine
- Hearing disorders
- Blood spots in the urine
- Heart and circulatory problems including deep vein thrombosis (DVT)
- Kidney failure
- Sexual difficulties which may include reduced male fertility, loss of libido, or impotence
- Lung or breathing problems
- Muscle pain or spasm
- Increased hair growth on the body and face
- Severe skin reactions including Stevens-Johnson syndrome
- Sore tongue
- Increased hair growth on the body and face
- Liver failure
- Hair loss
- Increased sensitivity of the skin to sunlight
- Excessive sweating
- Alterations in skin pigmentation
An increased risk of bone disorders, osteopenia, and osteoporosis (thinning of the bone), and fractures has been observed in patients taking this medication.
This is not a complete list of side effects, and others may occur. Please consult your doctor to know more about other possible side effects.
Who should not take Carbamazepine?
Inform your physician if you have the following conditions before starting Carbamazepine:
- Heart block
- Bone marrow complications resulting in decreased production of blood cells
- Porphyria (Disorders resulting from a build-up of certain chemicals related to red blood cell proteins)
- Stevens-Johnson syndrome
- Mental illness
- Liver problems
- Kidney problems
- Glaucoma (increased pressure in the eye)
Talk to your doctor before taking Carbamazepine if:
- You are taking any other medication, are pregnant, breastfeeding, or planning a pregnancy.
- You are allergic to Carbamazepine or any of its ingredients, or have any other allergies.
- You are allergic to any other medication.
- You are taking any other drugs, over-the-counter medicines, herbal products, or nutritional supplements.
- You are lactose intolerant
Besides, certain medicines may interfere with its working and thus might not be safe to take them together. Some of them are:
- Monoamine oxidase inhibitors, such as phenelzine, iproniazid, isocarboxazid, nialamide, and tranylcypromine. Even if you have finished taking anyone of the MAOIs mentioned above, you will need to wait for 2 weeks before you start taking your Carbamazepine tablets
Hormone contraceptives (pills, patches, injections, or implants)
- Supplement of vitamin B (nicotinamide)
- St John’s Wort or Hypericum (Herbal medicine)
- Hormone Replacement Therapy (HRT)
- Corticosteroids such as prednisolone, dexamethasone
- Anticoagulants such as warfarin, acenocoumarol, rivaroxaban, dabigatran, apixaban, and edoxaban
- Painkillers such as paracetamol, dextropropoxyphene, tramadol, methadone, or buprenorphine
- Antibiotics such as isoniazid, rifampicin, erythromycin, clarithromycin, ciprofloxacin, doxycycline, and rifabutin
- Anti-epileptics such as vigabatrin, clobazam, clonazepam, ethosuximide, lamotrigine, eslicarbazepine, oxcarbazepine, primidone, tiagabine, topiramate, valproic acid, zonisamide
- Anti-hypertensive such as diltiazem, verapamil
- Antihyperlipidemics such as simvastatin, atorvastatin, lovastatin, and cerivastatin
- Anti-cancer drugs such as temsirolimus, cyclophosphamide, and lapatinib
- Anti-asthmatics such as theophylline or aminophylline
This may not be a comprehensive list, and other drugs may interact with Carbamazepine. Please inform your doctor if you are taking any of the medicines listed above.
When should you not take Carbamazepine?
You should not take Carbamazepine if:
- It has passed the expiry date of the medicine printed on the pack.
- The packaging shows signs of tampering
Carbamazepine may cause drowsiness and/or dizziness, or you may also cause blurred vision or double vision. You may lack muscular coordination, especially during the initial treatment phase affecting the ability to carry out normal daily activities. You should not drive or operate machinery or perform jobs that need you to be alert until these effects wear off.
Ask your doctor about the safe use of alcoholic beverages during your treatment with Carbamazepine as it can make the side effects of Carbamazepine worse.
Eating grapefruit, or drinking grapefruit juice, may increase your chance of experiencing side effects.