Carbamazepine is indicated for • Partial & secondary generalized tonicclonic seizures • Primary generalized tonic-clonic seizures • Trigeminal neuralgia • Prophylaxis of bipolar disorder
Carbamazepine depresses activity in the nucleus ventralis of the thalamus, reduces synaptic propagation of excitatory impulses or decreases summation of temporal stimulation leading to neural discharge by limiting influx of Na ions across cell membrane or other unknown mechanisms. It stimulates the release of antidiuretic hormone (ADH) and potentiates its action in promoting reabsorption of water.
Epilepsy: Adults & children over 12 years of age - Initial: Either 200 mg b.i.d. for tablets & XR tablets, or 1 easpoon q.i.d. for suspension (400 mg/day). Maintenance: usually 800-1200 mg daily. Children 6-12 years of age - Initial: Either 100 mg b.i.d. for tablets or XR tablets, or ½ teaspoon q.i.d. for suspension (200 mg/day). Maintenance: usually 400-800 mg daily. Children under 6 years of age - Initial: 10- 20 mg/kg/day b.i.d. or t.i.d. as tablets, or q.i.d. as suspension. Maintenance: Ordinarily, optimal clinical response is achieved at daily doses below 35 mg/kg. If satisfactory clinical response has not been achieved, plasma levels should be measured to determine whether or not they are in the therapeutic range. No recommendation regarding the safety of Carbamazepine for use at doses above 35 mg/ kg/24 hours can be made. Combination therapy: Carbamazepine may be used alone or with other anticonvulsants. When added to existing anticonvulsant therapy,the drug should be added gradually while the other anticonvulsants are maintained or gradually decreased, except phenytoin, which may have to be increased. Trigeminal Neuralgia: Initial: On the first day, either 100 mg b.i.d. for tablets or XR tablets, or 1/2 teaspoon q.i.d. for suspension, for a total daily dose of 200 mg. This daily dose may be increased by up to 200 mg/day using increments of 100 mg every 12 hours for tablets or XR tablets, or 50 mg (1/2 teaspoon) q.i.d. for suspension, only as needed to achieve freedom from pain. A total dose of 1200 mg daily shouldn’t be exceeded. Maintenance: Control of pain can be maintained in most patients with 400-800 mg daily. However, some patients may be maintained on as little as 200 mg daily, while others may require as much as 1200 mg daily. At least once every 3 months throughout the treatment period, attempts should be made to reduce the dose to the minimum Effective level or even to discontinue the drug. The tablets or syrup can be taken without regards to meal.
Galactorrhoea has been reported in few women on oral contraceptives within the first two months of Carbamazepine treatment Hepatic enzyme inducers such as Carbamazepine and Phenytoin may interact with Carbamazepine by increasing its metabolism. So an increase in dosage of Carbamazepine may be required.
This medicine should not be used if anybody is allergic to one or any of its ingredients. It can not be used also in the following conditions: • Problems with the electrical message pathways in the heart (atrioventricular block). • History of decreased blood cell production by the bone marrow (bone marrow depression). • Hereditary blood disorders called porphyrias. •Allergy to tricyclic antidepressants, eg amitriptyline. •People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days.
Dizziness, drowsiness, ataxia, dry mouth, abdominal pain, nausea, vomiting, anorexia, leucopenia, proteinuria, bradycardia, heart failure & hypotension. Erythematous skin rash, aplastic anemia may also be observed.
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
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