CARBAMAZEPINE

Anticonvulsant

Dosage Forms

Tablet

200 mg
100 mg (chewable)

Syrup

100 mg/5 ml

Uses

  • Epilepsy (grand mal and partial seizures)
  • Nerve pain

Dose and Duration

Grand mal and temporal lobe epilepsy
Adult: Initially, 100–200 mg 1–2 times daily. Increase as needed in 100 mg increments every 2 weeks until reaching usual maintenance dose of 800–1200 mg in divided doses
Child 12–18 years: Initially, 100–200 mg 1–2 times dai ly, increased gradually as needed to usual maintenance dose of 400–600 mg two to three times daily
Child 1 month–12 years: Initially, 5 mg/kg at night or 2.5 mg/kg every 12 hours increased by 2.5–5 mg/kg every 3–7 days if necessary. Usually maintenance dose of 5 mg/kg 2–3 times daily; in some cases up to 20 mg/kg daily may be needed
Nerve pain
Initially 100 mg 1–2 times daily, increased gradually according to response. Usual dose is 200 mg 3–4 times daily (up to 1.6 g per day may be needed)

Contraindications

  • History of bone marrow depression
  • Problems with heartbeat

Side Effects

  • Dizziness, drowsiness, headache
  • Movement disorders (staggering, shaking)
  • Blurred vision
  • Skin rashes
  • Stomach upset

Interactions

  • Amitriptyline (reduced effect of carbamazepine)
  • Chlorpromazine (reduced effect of carbamazepine)
  • Oral contraceptives (reduced contraceptive effect)
  • Erythromycin (increased risk of side effects)
  • Isoniazid (increased risk of side effects and liver toxicity)
  • Phenytoin (increased risk of side effects)

Patient Instructions

  • Drowsiness and dizziness usually disappear. Do not drive or operate machinery if these symptoms occur
  • Report to the health worker immediately if any yellowing of eyes or skin, rash, fever, mouth ulcers, bruising, or bleeding occur
  • Do not drink alcohol during treatment

Pregnancy

  • Do not use in 1st and 3rd trimester

Breastfeeding

  • Can be used

⚠️ Caution

  • Give vitamin K to new-born baby if mother has taken carbamazepine during pregnancy
  • Avoid sudden withdrawal as it might cause seizures