Indications
Carbamazepine is indicated for-
- partial and secondary generalized tonic-clonic seizures
- Primary generalized tonic-clonic seizures
- Trigeminal neuralgia
- Prophylaxis of bipolar disorder
Therapeutic Class
Pharmacology
Dosage & Administration
Epilepsy:
- Adult: Initially, 100-200 mg once daily or bid, gradually increased by increments of up to 200 mg daily every wk. Maintenance: 0.8-1.2 gm daily in divided doses. Max: 2 gm daily.
- Child: 10-20 mg/kg daily in divided doses. Alternatively, <1 yr 100-200 mg daily. Max: 35 mg/kg daily; 1-5 yr 200-400 mg daily. Max: 35 mg/kg daily; >5-10 yr 400-600 mg daily. Max: 1 gm daily; >10-15 yr 0.6-1 gm daily. Max: 1 gm daily.
Prophylaxis of bipolar disorder:
- Adult: Initially, 400 mg daily in divided doses, increased gradually as necessary. Maintenance: 400-600 mg daily in divided doses. Max: 1.6 gm daily.
Trigeminal neuralgia:
- Adult: Initially, 100-200 mg bid, increased gradually as needed. Maintenance: 400-800 mg daily in divided doses. Max: 1.2 gm daily.
Interaction
Contraindications
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
- People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days
Side Effects
Common side effects are dizziness, drowsiness, ataxia, dry mouth, abdominal pain, nausea, vomiting, anorexia, leucopenia, proteinuria, bradycardia, heart failure and hypotension. Erythematous skin rash, aplastic anemia may also be observed.
The most severe adverse reactions have been observed in the hemopoietic system, the skin and the cardiovascular system.The most frequently observed adverse reactions, particularly during the initial phases of therapy, are dizziness, drowsiness, unsteadiness, nausea, and vomiting.This medicine may cause increased sensitivity to the sun. Exposure to the sun, sunlamps, or tanning booths should be avoided if the increased sensitivity is seen. A sunscreen or protective clothing may be helpful at outside for a prolonged period.
Pregnancy & Lactation
Precautions & Warnings
Overdose Effects
Symptoms: Dizziness, ataxia, drowsiness, stupor, nausea, vomiting, opisthotonos, restlessness, agitation, disorientation, tremor, involuntary movements, adiadochokinesis, abnormal reflexes (hypoactive or hyperactive), mydriasis, nystagmus, flushing, cyanosis, urinary retention. Hypotension or HTN may develop. Coma may follow.
Management: Induce emesis or employ gastric lavage. General supportive treatment.
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