Carbamazepine prevents fits. It can also ease some types of pain, and control some mood disorders.
Take carbamazepine regularly every day. Do not stop taking it unless your doctor tells you to.
Side-effects can occur when you first start taking carbamazepine, but usually settle down as your body adjusts to the new medicine.
|Type of medicine||An antiepileptic medicine|
|Used for||Epilepsy; trigeminal neuralgia; bipolar disorder|
|Also called||Tegretol®; Carbagen®|
|Available as||Tablets, chewable tablets, oral liquid medicine, suppositories, and prolonged-release tablets|
If you have epilepsy, it means that you have had more than one unexplained fit, or seizure. A seizure is a short episode of symptoms caused by a burst of abnormal electrical activity in your brain. Different parts of the brain control different functions of your body, so the symptoms that occur during a seizure will depend on where the abnormal burst of electrical activity occurs. Symptoms that may occur during a seizure can affect your muscles, sensations, behaviour, emotions, consciousness, or a combination of these. The seizures can be prevented in most people by suitable antiepileptic medication. Carbamazepine is a commonly used medicine. It works by stabilising the electrical activity of your brain, which prevents the seizures from occurring.
Carbamazepine is also prescribed as a treatment for severe burning or stabbing pains in the face (called trigeminal neuralgia), and occasionally as part of the treatment for bipolar disorder (sometimes called manic depression). This is because it can modify some types of pain, and control some mood disorders. If you have been given carbamazepine for these (or any other reasons), ask your doctor if you have questions about your treatment.
Before taking carbamazepine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking carbamazepine it is important that your doctor knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have any problems with the way your kidneys work, or with the way your liver works.
- If you have a heart condition.
- If you have increased pressure in your eyes, called glaucoma.
- If you have ever had any problems affecting your bone marrow.
- If you have a rare inherited blood disorder called porphyria.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take carbamazepine
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about carbamazepine and will provide you with a full list of the side-effects which you may experience from taking it.
- Take carbamazepine exactly as your doctor tells you to. It is usual to start treatment on a low dose, and then for the dose to be increased gradually to a regular maintenance dose. If you are taking it for epilepsy, it is likely you will be asked to take one or two doses every day. Doses for children are tailored to their age and weight. If you have been prescribed it for another reason, you could be asked to take a dose three, or even four, times a day. Your dose will be printed on the label of the pack to remind you about what the doctor said to you.
- Try to take your doses of carbamazepine at the same times each day. Having a routine will help you to remember to take your doses regularly. Swallow the tablet with a drink of water. You can take most preparations of carbamazepine either before or after meals. If, however, you have been supplied with chewable tablets, you should take these during a mealtime.
- If you have been given carbamazepine prolonged-release tablets (for example, Carbagan® SR or Tegretol® Prolonged Release), you must swallow the tablet whole - do not chew or crush the tablet to help you swallow.
- If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- When you first start a new treatment for epilepsy there may be a change in the number or type of seizures you experience. Your doctor will advise you about this.
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. You may need to have blood tests from time to time.
- Different formulations and brands of carbamazepine can act in a slightly different way in your body. Because of this, it is important that you continue to take tablets from the same manufacturer as you have had before. So, each time you collect a prescription, check to make sure your supply looks the same and that the brand name is the same. If you are unsure, or if you have any questions about your prescription, please ask your pharmacist to check it for you.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take. This is because some medicines interfere with carbamazepine, and carbamazepine can also alter the way other medicines work.
- Ask your doctor for advice before drinking alcohol while you are on carbamazepine. Your doctor may recommend you do not drink alcohol because it increases the risk of side-effects.
- People with epilepsy must stop driving at first. Your doctor will advise you about when it may be possible for you to start driving again. This will usually be after a year free of seizures.
- Carbamazepine may harm an unborn child so you must avoid getting pregnant. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner. If you want to have a family, discuss this with your doctor so that you can be given advice from a specialist before you become pregnant.
- While you are being treated for epilepsy there is a small risk that you may develop mood changes, distressing thoughts and feelings about suicide. If this happens, you must tell your doctor about it straightaway.
- You need to take carbamazepine regularly every day. Do not stop taking it unless your doctor tells you to stop. Stopping treatment suddenly can cause problems and your doctor will want you to reduce your dose gradually if this becomes necessary.
Can carbamazepine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with carbamazepine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. Many of the side-effects can occur when first starting carbamazepine, but should settle down as your body adjusts to the new medicine. Speak with your doctor if they continue or become troublesome.
|Common carbamazepine side-effects||What can I do if I experience this?|
|Feeling dizzy, sleepy, or tired; blurred or double vision||Do not drive or use tools or machines|
|Feeling or being sick||Stick to simple meals - avoid rich and spicy food|
|Headache||Ask your pharmacist to recommend a suitable painkiller. If this continues, ask your doctor for advice|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets|
|Feeling unsteady, swollen feet or ankles, itchy skin rash, increased risk of infection||If any of these become troublesome, speak with your doctor for advice|
Important: your doctor will discuss with you the possibility that carbamazepine can cause liver, blood and skin disorders. Although these occur less commonly than the side-effects listed above, it is important that you contact your doctor straightaway if you experience any of the following symptoms:
- A high temperature, sore throat or swollen glands.
- A severe skin rash.
- Mouth ulcers.
- Unexplained bruising or bleeding.
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
How to store carbamazepine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Tegretol® Tablets; Novartis Pharmaceuticals UK Ltd, The electronic Medicines Compendium. Dated July 2014.
- British National Formulary; 68th Edition (Sep 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Prof Cathy Jackson