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: