Carbamazepine
(Tegretol, Carbatrol, Atretol) |
Category:
Description:
Indications:
Contraindications:
Precautions:
-
Pregnancy
category C
-
Glaucoma,
hepatic disease, renal disease, cardiac disease, psychosis
-
Child
< age 6
Adverse
Reactions (Side Effects):
-
CNS:
ataxia, confusion, dizziness, drowsiness, hallucinations, headache,
parlaysis
-
CV:
CHF, hypertension, hypotension, aggravation of coronary artery disease
-
EENT:
bBlurred vision, conjunctivitis, diplopia, dry mouth, nystagmus,
tinnitis
-
GI:
abdominal pain, anorexia, constipation, diarrhea, glossitis,
hepatitis, nausea
-
HEME:
agranulocytosis, aplastic anemia, eosinophilia, leukocytosis,
neutropenia, thrombocytopenia
-
RESP:
fever, dyspnea, pneumonitis
-
SKIN:
rash, Stevens-Johnson syndrome, urticaria
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Dosage:
Administered
orally (tablet, chewable tablet, suspension)
-
Adult
Dose:
-
Seizures:
-
PO
200mg twice daily
-
may
increase by 200mg daily in divided doses every 6-8 hours
-
maintenance
800-1200mg daily
-
maximum
dose 1200mg per day
-
Trigeminal
neuralgia:
-
PO
100mg twice daily
-
may
increase 100mg every 12 hours until pain subsides
-
not
to exceed 1.2 grams daily
-
maintenance
200-400mg twice daily
-
Antidiuretic:
-
Antipsychotic:
-
Child
< age 12:
Drug
Interactions:
-
Calcium
channel blockers (CCB): Verapamil and diltiazem reduce the metabolism
of carbamazepine leading to increased carbamazepine toxicity when
these CCB’s are added to chronic carbamazepine therapy; enzyme
induction by carbamazepine can reduce the bioavailability of CCB’s
that undergo extensive 1st-pass hepatic clearance, like
felodipine (94% reduction)
-
Propoxyphene:
reduces carbamazepine levels
-
Valproic
acid: can increase, decrease, or have no effect on carbamazepine;
carbamazepine decreases valproic acid levels
-
Theophylline:
carbamazepine reduces levels and therapeutic effect
-
Omeprazole:
may increase carbamazepine concentrations
-
Oral
anticoagulants: decreased prothrombin time
-
Phenytoin:
concurrent use reduces serum concentrations of both
-
Metronidazole
and isoniazid: increases carbamazepine concentrations with toxicity
-
Ethinyl
estradiol, oral contraceptives: carbamazepine-induced metabolic
induction may lead to menstrual irregularities and unplanned
pregnancies
-
Doxycycline:
carbamazepine reduces doxycycline levels and antibiotic effects
-
Erythromycin
and clarithromycin: increased carbamazepine levels
-
Corticosteroids:
carbamazepine reduces levels and therapeutic effects
-
Cimetadine:
Transient (1 week) increases in carbamazepine levels
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The information contained here is an
abbreviated summary. For more detailed and complete information, consult the
manufacturer's product information sheets or standard textbooks
Source: Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
This information is provided by The Brookside Associates. The Brookside
Associates, LLC. is a private organization, not affiliated with any governmental
agency. The opinions presented here are those of the author and do not
necessarily represent the opinions of the Brookside Associates or the Department
of Defense. The presence of any advertising on these pages does not constitute
an endorsement of that product or service by either the US Department of Defense
or the Brookside Associates. All material presented here is unclassified.
C. 2009, 2014, All Rights Reserved
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