Carbamazepine, Oral

What are other names for this medicine?

Type of medicine: antiseizure; analgesic

Generic and brand names: carbamazepine, oral; Carbatrol; Epitol; Equetro; Tegretol; Tegretol Suspension; Tegretol XR, Teril

What is this medicine used for?

This medicine is taken by mouth to:

• prevent or control certain types of seizures (epilepsy)
• relieve facial pain from trigeminal neuralgia
• treat bipolar disorder

This medicine may also be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• glaucoma
• heart problems
• hepatic porphyria or other liver disease

Do not take this medicine if you have:

• taken nefazodone or an MAO inhibitor antidepressant in the past 2 weeks
• a history of bone marrow problems

If you are of Asian ancestry, you may be at high risk of a serious skin reaction. You may need a blood test before you start taking the medicine. Talk with your provider about this.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. Tell your health care provider if you are pregnant or breast-feeding. Do not become pregnant while you are taking this medicine. If you become pregnant, stop taking this medicine and contact your healthcare provider right away. Do not breast-feed while taking this medicine.

How do I take it?

This medicine is not an ordinary painkiller and should not be used for any other type of pain. Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider directs for the condition for which it was prescribed. Do not take more than prescribed. Taking too much may increase the risk of side effects.

Take this medicine with food.

This medicine comes in several forms, such as regular tablets, extended release tablets, chewable tablets, capsules, and liquid. Do not break, crush, or chew the extended-release tablets. Swallow them whole. If you have trouble swallowing, the capsule may be opened and the medicine sprinkled on soft food such as applesauce. Ask your pharmacist if you have any questions.

If you are taking the liquid form of this medicine, shake the bottle well before taking the medicine. Use a specially marked measuring spoon to measure each dose. The average household teaspoon may not hold the right amount of liquid. Do not take this medicine at the same time that you take other liquid medicines.

Take this medicine regularly to control seizures. Do not stop taking it without your healthcare provider's approval. You may have to gradually reduce your dosage. Seizures may get worse if you suddenly stop taking this medicine.

What if I miss a dose?

If you miss a dose, take it as soon as you remember, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: shallow breathing, fast heartbeat, nausea, vomiting, urinating less or not at all, muscle twitches, restlessness, tremors, slurred speech, staggering walk, lightheadedness, fainting, seizures, coma.

What should I watch out for?

Rarely, this medicine may cause a form of anemia. You may need to have blood tests regularly to see how this medicine affects you. Keep all appointments for tests. Contact your healthcare provider if you develop any of these symptoms:

• unusual bleeding or bruising
• fever
• sore throat
• rash
• ulcers in your mouth

Antiseizure medicines may increase suicidal thoughts or actions in some people. Call your healthcare provider right away if you have new or increased thoughts of suicide.

About 1 in 10 people who take this medicine get a rash. Rarely, the rash can develop into a serious (and sometimes fatal) skin condition. Warning signs that a rash is serious are:

• a swollen face
• flaky or painful skin
• purple blotches
• raised lumps
• sores on the lips or inside the mouth
• wheezing or trouble breathing

See your healthcare provider right away if you get a rash while taking this medicine.

Before you have any kind of dental work, surgery, or emergency treatment, tell the healthcare provider or dentist that you are taking this medicine.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

Do not drink alcohol while taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Nausea or vomiting, confusion, mood changes, vision problems, ringing in your ears, fainting, uncontrollable eye or muscle twitches, slurred speech, increased seizures, slow, irregular, or pounding heartbeat, chest pain, trembling, sudden decrease in urination, severe dizziness, dark urine, mouth sores, sore throat, fever, unusual bruising or bleeding, yellowish skin or eyes, peeling skin, swelling of the feet or legs.

Other: Slight drowsiness or dizziness, clumsiness, mild nausea or vomiting.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• acetaminophen (Tylenol)
• alcohol
• antianxiety medicines such as alprazolam (Xanax) and clonazepam (Klonopin)
• antibiotics such as clarithromycin (Biaxin), erythromycin (Erythrocin, E.E.S., EryPed), doxycycline (Vibramycin, Doryx), and rifampin (Rifadin, Rimactane)
• antidepressants such as nefazodone, fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), trazodone (Desyrel), amitriptyline, nortriptyline (Aventyl, Pamelor), desipramine (Norpramin), imipramine (Tofranil), doxepin (Sinequan), trimipramine (Surmontil), amoxapine (Asendin), protriptyline (Vivactil), clomipramine (Anafranil), and bupropion (Wellbutrin)
• antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• antimalarial drugs such as chloroquine (Aralen) or mefloquine (Lariam)
• antipsychotics such as clozapine (Clozaril), haloperidol (Haldol), olanzapine (Zyprexa), ziprasidone (Geodon), and lithium (Lithobid, Eskalith)
• antiseizure medicines such as phenytoin (Dilantin), primidone (Mysoline), ethosuximide (Zarontin), lamotrigine (Lamictal), methsuximide (Celontin), oxcarbazepine (Trileptal), phensuximide (Milontin), felbamate (Felbatol), valproic acid (Depakote, Depakene), phenobarbital (Luminal), topiramate (Topamax), and tiagabine (Gabitril)
• birth control pills, shots, and patches (talk to your healthcare provider if you need birth control)
• medicine that reduces the chance of blood clots forming such as warfarin (Coumadin)
• calcium channel blockers such as diltiazem (Cardizem, Dilacor), amlodipine (Norvasc), nifedipine (Procardia XL, Adalat CC), felodipine (Plendil), and verapamil (Calan, Isoptin, Verelan, Covera-HS)
• cimetidine (Tagamet)
• chemotherapy medicines such as imatinib (Gleevec), cisplatin (Platinol), and doxorubicin (Adriamycin, Rubex, Doxil)
• corticosteroids such as prednisone and dexamethasone
• cyclosporine (Sandimmune, Neoral, Gengraf)
• danazol (Danocrine)
• isoniazid
• MAO inhibitor antidepressants such as phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan) (Do not take an MAO inhibitor and this medicine within 14 days of each other.)
• propoxyphene (Darvon)
• theophylline

The effects of this medicine may be increased if you take it with grapefruit juice. Talk with your healthcare provider about this.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.

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