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    DEA Class;  Rx

    Common Brand Names; Tegretol, Equetro, Epitol, Tegretol XR, Carbamazepine Chewtabs, Carbamazepine CR, Carbatrol, Teril, Carnexiv

    • Anticonvulsants, Other; 
    • Antimanic Agents; 
    • Bipolar Disorder Agents

    Oral antiepileptic, specific analgesic, and mood stabilizer
    Used for partial and tonic-clonic seizures, trigeminal neuralgia, and bipolar I disorder
    Monitor for emerging or worsening depression, suicidal thoughts/behavior, or mood/behavior changes

    Indicated for the treatment of partial seizures with complex symptomatology (eg, psychomotor, temporal lobe), generalized tonic-clonic seizures (grand mal), and mixed seizure patterns, which include the seizure types listed here or other partial or generalized seizures

    Indicated as replacement therapy in adults for PO carbamazepine formulations, when PO administration is temporarily not feasible

    Not indicated for absence seizures (including atypical absence); carbamazepine has been associated with increased frequency of generalized convulsions in these patients

    Documented hypersensitivity

    History of bone marrow suppression

    Administration of MAO inhibitors within last 14 days

    Coadministration with nefazodone; carbamazepine decreases plasma levels of nefazodone and its active metabolite

    Coadministration with NNRTIs (eg, delavirdine, efavirenz, etravirine, nevirapine, rilpivirine); carbamazepine induces CYP3A4 and may substantially reduce NNRTI serum concentration

    Jaundice, hepatitis

    Pregnancy (especially first trimester: risk of fetal carbamazepine syndrome)

    • Orthostatic hypotension
    • Dizziness
    • Headache
    • Drowsiness
    • Sleep disturbance
    • Fatigue
    • Weakness
    • Tremor
    • Hyperreflexia
    • Constipation
    • Dry mouth
    • Confusion
    • Decr memory
    • Nystagmus
    • Paresthesia
    • Anorexia
    • N/V
    • Impotence
    • Urinary frequency or retention
    • Anxiety
    • Irritation
    • Hypomania
    • “Hypermetabolic syndrome” (hyperpyrexia, tachycardia, tachypnea, incr CPK, acidosis)
    • Arthralgia
    • Edema
    • SIADH (rare)
    • Risk of hypertensive crisis (rare,usu d/t drug interaction)
    • Ataxia (rare)
    • Seizure (rare)
    • Jaundice (rare)
    • Visual disturbance (rare)

    Monitor for notable changes in behavior that might indicate suicidal thoughts or depression and notify healthcare provider immediately if behavioral changes observed

    Discontinue if significant bone marrow depression occurs

    Withdraw gradually

    Increased risk of agranulocytosis and aplastic anemia

    May cause ECG abnormalities; use caution in patients with conduction abnormalities; AV heart block, including second and third degree block, reported following carbamazepine treatment; effect occurred generally, but not solely, in patients with underlying EKG abnormalities or risk factors for conduction disturbances

    May exacerbate absence seizures; in the event of allergic or hypersensitivity reaction, more rapid substitution of alternative therapy may be necessary

    Bipolar mania: Efficacy inconsistent; APA recommends use after failure of or if there is resistance to lithium and valproate

    May cause psychosis/confusion/agitation; elderly patients are at greater risk

    May render oral contraceptives ineffective

    Higher risk of potentially fatal skin reactions (SJS/TEN) in patients of Asian ancestry (genetic testing recommended); increased risk of developing hypersensitivity reactions with presence of HLAA*3101 or HLA-B*1502, inherited allelic variants of the HLA-A and HLA-B gene (see Pharmacogenomics in the Pharmacology section);

    Hyponatremia may occur and appears to be a result of SIADH; may be dose-related and elderly individuals are at greater risk

    Associated with hypotension, bradycardia, AV block, and signs and symptoms of HF

    There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antiepileptic drugs (AEDs), during pregnancy

    Drug and its epoxide metabolite are excreted in human milk; there are no data to assess effects of drug or its metabolites on milk production, or on breastfed infant, of mothers taking drug

    As with all anticonvulsant-type medications, carbamazepine dosage must be individualized.


    Oral formulations: 1200 mg/day PO for trigeminal neuralgia. In rare instances, 1600 mg/day PO for epilepsy or bipolar disorder.
    IV formulation: 1120 mg/day IV for epilepsy.


    Oral formulations: 1200 mg/day PO for trigeminal neuralgia. In rare instances, 1600 mg/day PO for epilepsy or bipolar disorder.
    IV formulation: 1120 mg/day IV for epilepsy.


    Oral formulations:
    16 years or older: 1200 mg/day PO for epilepsy.
    13 to 15 years: 1000 mg/day PO for epilepsy.


    Immediate-release formulations, extended-release tablets:
    6 to 12 years: 1000 mg/day PO for epilepsy.
    5 years or younger: 35 mg/kg/day PO for epilepsy.
    Extended-release capsules:
    12 years or younger: 35 mg/kg/day PO for epilepsy.


    Safety and efficacy have not been established.


    Safety and efficacy have not been established.


    tablet, chewable (Epitol)

    • 100mg

    tablet, immediate-release (Tegretol)

    • 200mg

    tablet, extended-release (Tegretol XR)

    • 100mg
    • 200mg
    • 400mg

    capsule, extended-release (Equetro, Carbatrol)

    • 100mg
    • 200mg
    • 300mg

    oral suspension (Teril)

    • 100mg/5mL

    IV solution (Carnexiv)

    • 10mg/mL (200mg/20mL single-dose vial)