tegretol

Tegretol (carbamazepine) is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and pain.

Tegretol is used to treat seizures and nerve pain such as trigeminal neuralgia and diabetic neuropathy. Carbamazepine is also used to treat bipolar disorder.

Tegretol may also be used for purposes not listed in this medication guide.

Important information

You should not take Tegretol if you have a history of bone marrow suppression, if you are also taking nefazodone, or if you are allergic to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor).

This medication may cause severe or life-threatening skin rash. Your doctor may recommend a blood test before you start the medication to determine your risk.

Do not start or stop taking Tegretol during pregnancy without your doctor"s advice. Tegretol may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant while taking Tegretol for seizures.

TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE. Some drugs can raise or lower your blood levels of carbamazepine, which may cause side effects or make Tegretol less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

Before taking this medicine

Do not use Tegretol if you also take nefazodone, or if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.

You should not take Tegretol if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), doxepin (Sinequan, Silenor), imipramine (Tofranil), or nortriptyline (Pamelor).

Tegretol may cause severe or life-threatening skin rash, and especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk.

To make sure Tegretol is safe for you, tell your doctor if you have any of these conditions:

• heart disease, high blood pressure, high cholesterol or triglycerides;

• liver or kidney disease;

• glaucoma;

• a thyroid disorder;

• lupus;

• porphyria; or

• a history of mental illness, psychosis, or suicidal thoughts or actions.

You may have thoughts about suicide while taking Tegretol. Tell your doctor if you have symptoms of depression or suicidal thoughts. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category D. Do not start or stop taking Tegretol during pregnancy without your doctor"s advice. Tegretol may cause harm to an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking Tegretol for seizures.

See also: Pregnancy and breastfeeding warnings (in more detail)

Tegretol can make birth control pills or implants less effective. Use a barrier form of birth control (such as a condom or diaphragm with spermicide) to prevent pregnancy while taking this medicine.

Carbamazepine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine.

How should I take Tegretol?

Take Tegretol exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

Do not crush, chew, break, or open a Tegretol extended-release tablet. Swallow the tablet whole. Breaking the tablet would cause too much of the drug to be released at one time.

Shake the Tegretol oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

It may take up to 4 weeks before your symptoms improve. Keep using Tegretol as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures.

While using Tegretol, you may need frequent blood tests at your doctor"s office.

Do not stop using Tegretol without first talking to your doctor, even if you feel fine. You may have increased seizures or unpleasant withdrawal symptoms if you stop using Tegretol suddenly.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include shallow breathing, urinating less or not at all, muscle twitcing, tremors, slurred speech, or staggering walk.

What should I avoid?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol can increase some of the side effects of Tegretol, and can also increase your risk of seizures.

Avoid exposure to sunlight or tanning beds. Tegretol can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Grapefruit and grapefruit juice may interact with Tegretol and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

Tegretol side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Tegretol: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, depression, anxiety, insomnia, or if you feel agitated, hostile, restless, irritable, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

• fever, tired feeling, pale skin, feeling light-headed or short of breath;

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

• slow, fast, or pounding heartbeats;

• confusion, vision problems, hallucinations;

• nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• little or no urinating;

• swelling, rapid weight gain;

• headache, slurred speech, vomiting, severe weakness, muscle cramps, loss of coordination, feeling unsteady, fainting, shallow breathing (breathing may stop);

• problems with your fingernails or toenails; or

• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious Tegretol side effects may include:

• dizziness;

• drowsiness; or

• dry mouth, swollen tongue.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Tegretol?

Sometimes it is not safe to use certain medications at the same time. Some drugs can raise or lower your blood levels of Tegretol, which may cause side effects or make this medicine less effective. Tegretol can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

Taking Tegretol with other drugs that make you sleepy or slow your breathing can increase these effects. Ask your doctor before taking Tegretol with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with Tegretol. Not all possible interactions are listed here. TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE, and any you start or stop using during treatment with Tegretol, especially:

• theophylline (Aquaphyllin, Asmalix, Elixophyllin, Theolair, Theosol);

• birth control pills or hormone replacement therapy;

• an antibiotic, or drugs to treat tuberculosis;

• antifungal medication such as fluconazole (Diflucan) or ketoconazole (Nizoral);

• a blood thinner such as warfarin (Coumadin, Jantoven);

• cancer medicines;

• a diuretic or "water pill";

• heart or blood pressure medication;

• HIV or AIDS medications;

• medication to treat depression or mental illness, such as aripiprazole or lithium (Eskalith, Lithobid);

• medicines to prevent organ transplant rejection;

• other seizure medications, such as valproic acid (Depakene, Stavzor);

• steroid medication; or

• thyroid replacement medication.

This list is not complete and there are many other drugs that can interact with Tegretol. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.