Carbamazepine brands and prices in Pakistan

About Carbamazepine

Carbamazepine is an antiseizure (anticonvulsant) medicine. It is mainly used for epilepsy, and also for a type of facial nerve pain and for bipolar disorder. It works by calming the abnormal electrical signals in the brain and changing how nerves pass on pain signals. It is a prescription medicine. It comes as tablets (some are chewable and some are slow-release), a liquid, slow-release capsules and suppositories. It controls the condition but does not cure it, so it is usually taken long term.

Who should not take it, or should take care

• Do not take it if you have ever had an allergy to carbamazepine, to oxcarbazepine, or to tricyclic antidepressants such as amitriptyline.
• Do not take it if you have heart problems, have ever had bone marrow problems, or have porphyria (a rare blood disorder).
• Do not take it if you have recently taken an MAOI antidepressant. Your doctor will tell you how long to wait.
• Genetic risk: serious skin reactions are more likely in some people of Asian ancestry who carry a certain inherited gene. Sources name Han Chinese and Thai people in particular. Your doctor may suggest a blood test before starting.
• Tell your doctor if you have liver, kidney or thyroid disease, glaucoma or other eye problems, or difficulty passing urine.
• Tell your doctor if you have a heart rhythm problem or an abnormal heart tracing (ECG).
• Tell your doctor if you have, or have had, depression, thoughts of self-harm, or another mental health condition such as schizophrenia.
• Tell your doctor if you have absence seizures or mixed seizure types, or if you have had an allergy to other epilepsy medicines such as phenytoin or phenobarbital.
• Older people may be more likely to get side effects, low sodium or falls.
• Long-term use can thin the bones, especially in people who already have weak bones or take steroids.
• Pregnancy: carbamazepine raises the risk of serious birth defects, such as spina bifida, cleft lip and palate, and heart problems. If you take it for epilepsy and could get pregnant, use reliable contraception, and tell your doctor straight away if you are planning a baby or become pregnant. Your doctor may advise extra folic acid. Do not stop taking it on your own, because seizures can harm both mother and baby.
• Breastfeeding: it passes into breast milk but can usually be used if your doctor agrees. Contact a doctor if the baby is unusually sleepy, has a rash, yellow skin or eyes, dark urine or pale stools.
• The liquid contains propylene glycol, which is a particular risk for young children, and sorbitol, which matters for people with fructose intolerance.

Medicines and drinks that can interact

• MAOI antidepressants (such as phenelzine), linezolid and methylene blue: tell your doctor if you have taken any of these recently
• Hormonal contraception (pill, patch or implant) and HRT: carbamazepine can make them work less well
• Warfarin and some other blood thinners
• Aripiprazole, paliperidone and some other medicines for schizophrenia
• Some antibiotics, such as ciprofloxacin, and some antifungal medicines
• Some painkillers, such as paracetamol, tramadol and methadone
• Other epilepsy medicines, antidepressants and anxiety medicines
• Omeprazole, cimetidine, ibuprofen and loratadine
• Water tablets (diuretics), which raise the risk of low sodium
• Steroid medicines, ciclosporin and tacrolimus, HIV medicines, levothyroxine and isotretinoin
• St John's wort (a herbal remedy)
• Grapefruit and grapefruit juice: avoid them, as they can increase side effects
• Alcohol: avoid it, as it may affect you more than usual
• Tell your doctor or pharmacist about all other medicines, vitamins, herbal remedies and supplements you take

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it exactly as your doctor tells you. Your doctor may start with a low dose and raise it slowly.
• Check the packet to see if your tablets are chewable. Chewable tablets can be chewed or swallowed whole with water; other tablets should be swallowed whole with water.
• Slow-release (prolonged-release) tablets must not be chewed or crushed. Slow-release capsules can be opened and the beads sprinkled on soft food such as apple puree, but do not crush or chew the beads.
• Shake the liquid well and measure it with the syringe or spoon that comes with it, not a kitchen spoon. Do not take other liquid medicines together with it.
• Follow the label about food. The slow-release tablets can be taken with or without food.
• If you forget a dose, take it when you remember unless the next one is nearly due. Never take two doses together.
• Do not stop taking it suddenly, especially for epilepsy, because seizures can come back. Your doctor will tell you how to stop if needed.
• Do not drive, ride a bike or use machines if you feel dizzy, sleepy, have blurred or double vision, or poor coordination.
• You may need regular blood tests, and your doctor may arrange eye checks.
• Tell any doctor, dentist, surgeon or lab staff that you take carbamazepine. It can affect some lab tests and home pregnancy tests, so ask your doctor about pregnancy testing.
• The shell of a slow-release tablet may sometimes appear in your stool. This does not mean the medicine did not work.
• Keep it in its original container away from light, heat and damp, and out of the reach of children. Never share it, and return unused medicine to a pharmacy.

Common questions

Can I drink alcohol while taking carbamazepine?
It is best to avoid alcohol. It may affect you more than usual and can make dizziness and sleepiness worse.

Will carbamazepine stop my contraception working?
It can make hormonal contraception, such as the pill, patch or implant, work less well. Talk to your doctor about a reliable method of contraception that is not affected.

Can I stop taking it once my seizures stop?
No, not on your own. Carbamazepine controls seizures but does not cure epilepsy. Stopping suddenly can bring seizures back. If it is time to stop, your doctor will plan it with you.

Why might my doctor want a blood test before I start?
Some people of Asian ancestry carry an inherited gene that makes serious skin reactions to carbamazepine more likely. A blood test can show if you carry it. Blood tests during treatment also check your blood cells, liver and salt levels.

Can I take carbamazepine if I am pregnant or planning a baby?
Talk to your doctor first. It raises the risk of birth defects, but uncontrolled seizures are also dangerous, so it may still be used if the benefits outweigh the risks. Do not stop taking it on your own. Your doctor may advise extra folic acid.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.