Carbamazepine Effects and Side Effects

Products

Carbamazepine is commercially available as tablets, sustained-release tablets, suspension, and syrup (Tegretol, generics). It has been approved in many countries since 1963.

Structure and properties

Carbamazepine (C15H12N2O, Mr = 236.3 g/mol) exists as a white crystalline powder that is very sparingly soluble in water. It has a tricyclic structure and an active metabolite, carbmazepine-10,11-epoxide.

Effects

Carbamazepine (ATC N03AF01) has antiepileptic properties. It stabilizes hyperexcited nerve membranes, inhibits repetitive discharges, and decreases synaptic propagation of excitatory impulses. The effects are attributed in part to the blockade of sodium channels in nerve cells.

Indications

  • Epilepsy
  • Neuropathic pain, neuralgia
  • Acute mania, bipolar affective disorder
  • Alcohol withdrawal syndrome
  • Other indications (off-label use).

Dosage

According to the professional information. Treatment is started at a low dose and slowly increased. Discontinuation should be gradual.

Contraindications

Carbamazepine is contraindicated in hypersensitivity, AV block, bone marrow depression, hepatic porphyria, and in combination with MAO inhibitors. For complete precautions, see the drug label.

Interactions

Carbamazepine is a substrate of CYP3A4 and a potent CYP3A4 inducer. Corresponding and other drug-drug interactions are possible.

Adverse effects

The most common possible adverse effects include:

  • Nausea, vomiting
  • Dizziness, movement disorders (ataxia), drowsiness, fatigue.
  • Allergic skin reactions, itching, hives.
  • Liver enzyme elevation
  • Leukopenia