TEGRETOL 200MG TABLETS

Active substance: CARBAMAZEPINE

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ARIAL REGULAR FONT SIZE 8
ARIAL BOLD
FONT SIZE 8
BRIDGED TO
CRESTOR 6464/2069 2070

PROOF HISTORY:
v.1 - waymade - 30/07/13

Leaflet Flat Size = 180 x 429
June 2013

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
In this leaflet:
1. What Tegretol Tablets are and what they are used for
2. Things to consider before you start to take Tegretol Tablets
3. How to take Tegretol Tablets
4. Possible side effects
5. How to store Tegretol Tablets
6. Further information
1. What Tegretol Tablets are and what they are used for
Carbamazepine, the active ingredient in Tegretol Tablets, can affect the body in several different ways. It is an anti-convulsant
medicine (prevents fits), it can also modify some types of pain and can control mood disorders.
Tegretol is used
• To treat some forms of epilepsy
• To treat a painful condition of the face called trigeminal neuralgia
• To help control serious mood disorders when some other medicines don’t work.
2. Things to consider before you start to take Tegretol Tablets
Some people MUST NOT take Tegretol Tablets. Talk to your doctor if:
• you think you may be hypersensitive (allergic) to carbamazepine or similar drugs such as oxcarbazepine (Trileptal), or to any
of a related group of drugs known as tricyclic antidepressants (such as amitriptyline or imipramine). If you are allergic to
carbamazepine there is a one in four (25%) chance that you could also have an allergic reaction to oxcarbazepine.
• you think you may be allergic to any of the other ingredients of Tegretol Tablets (these are listed at the end of the leaflet).
Signs of a hypersensitivity reaction include swelling of the face or mouth (angioedema), breathing problems, runny nose, skin
rash, blistering or peeling.
• you have any heart problems,
• you have ever had problems with your bone marrow,
• you have a blood disorder called porphyria,
• you have taken drugs called monoamine oxidase inhibitors (MAOIs), used to treat depression, within the last 14 days.

Serious skin rashes (Stevens-Johnson syndrome, toxic epidermal necrolysis) have been reported with the use of carbamazepine.
Frequently, the rash can involve ulcers of the mouth, throat, nose, genitals and conjunctivitis (red and swollen eyes). These serious
skin rashes are often preceded by influenza-like symptoms fever, headache, body ache (flu-like symptoms). The rash may
progress to widespread blistering and peeling of the skin. The highest risk for occurrence of serious skin reactions is within the first
months of treatment.

DATE:

CUSTOMER
APPROVED:

A small number of people being treated with anti-epileptics such as carbamazepine have had thoughts of harming or killing
themselves. If at any time you have these thoughts, immediately contact your doctor.

These serious skin reactions can be more common in people from some Asian countries. The risk of these reactions in patients of
Han Chinese or Thai origin may be predicted by testing a blood sample of these patients. Your doctor should be able to advise if a
blood test is necessary before taking carbamazepine.
If you develop a rash or these skin symptoms, stop taking carbamazepine and contact your doctor immediately.

Q.A.
APPROVED:

DATE:

04-1957

DT

30/07/13

PRE-PRESS NO.:

ARTWORKER:

DATE OF PROOF:

CUSTOMER: Waymade

Tegretol 400 mg

6464 2792 F

PRODUCT:

CODE:

You should also ask yourself these questions before taking Tegretol Tablets. If the answer to any of these questions is
YES, discuss your treatment with your doctor or pharmacist because Tegretol Tablets might not be the right medicine for
you.
• Are you pregnant or planning to become pregnant?
• Are you breastfeeding?
• Do you suffer from the sort of epilepsy where you get mixed seizures which include absences?
• Do you have any mental illness?
• Are you allergic to an epilepsy medicine called phenytoin?
• Do you have liver problems?
• Are you elderly?
• Do you have any eye problems such as glaucoma (increased pressure in the eye)?
Are you taking other medicines?
Because of the way that Tegretol works, it can affect, and be affected by, lots of other things that you might be eating or medicines
that you are taking. It is very important to make sure that your doctor knows all about what else you are taking, including anything
that you have bought from a chemist or health food shop. It may be necessary to change the dose of some medicines, or stop
taking something altogether.
Tell the doctor if you are taking:
• Hormone contraceptives, e.g. pills, patches, injections or implants. Tegretol affects the way the contraceptive works in your
body, and you may get breakthrough bleeding or spotting. It may also make the contraceptive less effective and there will be
a risk of getting pregnant. Your doctor will be able to advise you about this, and you should think about using other
contraceptives.
• Hormone Replacement Therapy (HRT). Tegretol can make HRT less effective.
• Any medicines for depression or anxiety.
• Corticosteroids (‘steroids’). You might be taking these for inflammatory conditions such as asthma, inflammatory bowel
disease, muscle and joint pains.
• Anticoagulants to stop your blood clotting.
• Antibiotics to treat infections including skin infections and TB (e.g. ciprofloxacillin).
• Antifungals to treat fungal infections.
• Painkillers containing paracetamol, dextropropoxyphene, tramadol, methadone or buprenorphine.
• Other medicines to treat epilepsy.
• Medicines for high blood pressure or heart problems.
• Antihistamines (medicines to treat allergy such as hayfever, itch, etc).
• Diuretics (water tablets).
• Cimetidine or omeprazole (medicines to treat gastric ulcers).
• Isotretinoin (a medicine for the treatment of acne).
• Metoclopramide or aprepitant (anti-sickness medications).
• Acetazolamide (a medicine to treat glaucoma—increased pressure in the eye).
• Danazol or gestrinone (treatments for endometriosis).
• Theophylline or aminophylline (used in the treatment of asthma).
• Ciclosporin, tacrolimus or sirolimus (immunosuppressants used after transplant operations, but also sometimes in the
treatment of arthritis or psoriasis).
• Drugs to treat schizophrenia (e.g. paliperidone, aripiprazole).
• Cancer drugs (e.g. temsirolimus, cyclophasphamide, lapatinib).
• The anti-malarial drug, mefloquine.
• Drugs to treat HIV.
• Levothyroxine (used to treat hypothyroidism).
• Muscle relaxant drugs.
• Tadalafil (used to treat impotence).
• Albendazole (used to treat worms).
• Bupropion (used to help stop smoking).
• A herbal remedy called St John’s Wort or Hypericum.
• Drugs or supplements containing Vitamin B (nicotinamide).
Pregnancy and breastfeeding
You must discuss your epilepsy treatment with your doctor well before you become pregnant. If you do get pregnant while you’re
taking Tegretol Tablets you must tell the doctor straightaway. It is important that your epilepsy remains well controlled, but, as with
other anti-epilepsy treatments, there is a risk of harm to the foetus. Make sure you are very clear about the risks and the benefits of
taking Tegretol Tablets.
Mothers taking Tegretol Tablets can breastfeed their babies, but you must tell the doctor as soon as possible if you think that the
baby is suffering side effects such as excessive sleepiness or skin reactions because you are taking Tegretol Tablets.
Will there be any problems with driving or using machinery?
Tegretol Tablets can make you feel dizzy or drowsy, especially at the start of treatment or when the dose is changed. If you are
affected in this way, or if your eyesight is affected, you should not drive or operate machinery.

WARNING!

Please read this leaflet carefully before you start to take your medicine. It contains important information.
Keep the leaflet in a safe place because you may want to read it again.
If you have any other questions, or if there is something you don’t understand, please ask your doctor or pharmacist.
This medicine has been prescribed for you. Never give it to someone else. It may not be the right medicine for them even if their
symptoms seem to be the same as yours.

THE COLOURS SHOWN ON THIS PROOF ARE FOR GENERAL REPRESENTATION PURPOSES ONLY. THEY ARE NOT ACCURATE AND MUST NOT BE
USED AS A COLOUR MATCH FOR THE FINISHED JOB. PLEASE REFER TO THE PANTONE COLOUR GUIDES FOR ACCURATE COLOUR REFERENCES.

What you need to know about Tegretol Tablets
Your doctor has decided that you need this medicine to help treat your condition.

WARNING!

27mm

This medicine is known by the above name but will usually be refered to as Tegretol Tablets in this leaflet. Other strengths of the
medicine (Tegretol 100mg and 400mg tablets) are also available.

WE CANNOT ACCEPT RESPONSIBILITY FOR ANY ERRORS IN THIS PROOF AFTER APPROVAL. THE ARTWORK RECEIVED HAS BEEN SIGNIFICANTLY
ADJUSTED, REVISED OR RESET BY US FROM DISK OR HARD COPY. WHILST WE TAKE EXTREME CARE AT ALL TIMES TO ENSURE ACCURACY, THE FINAL RESPONSIBILITY
MUST BE TAKEN BY OUR CUSTOMER. IF YOU SIGN THIS PROOF YOU ARE SIGNIFYING FULL APPROVAL OF DESIGN AND TEXT.

TEGRETOL® 200mg TABLETS
(Carbamazepine)
Patient Information leaflet

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BRIDGED TO
CRESTOR 6464/2069 2070

Children:
Aged 5–10 years: 400–600 mg a day
Aged 10–15 years: 600–1,000 mg a day.
Tegretol Tablets are not recommended for children under 5.
To treat trigeminal neuralgia the usual dose is:
600–800 mg a day.
To treat mood swings the usual dose is:
400–600 mg a day
What if you forget to take a dose?
If you forget to take a dose, take one as soon as you remember. If it is nearly time for your next dose, though, just take the next
dose and forget about the one you missed.
What if you take too many tablets?
If you accidentally take too many Tegretol Tablets, tell your doctor or your nearest hospital casualty department. Take your
medicine pack with you so that people can see what you have taken.
4. Possible side effects
Tegretol Tablets do not usually cause problems, but like all medicines, they can sometimes cause side effects.
Some side effects can be serious
Stop taking Tegretol Tablets and tell your doctor straight away if you notice:
• Serious skin reactions such as rash, red skin, blistering of the lips, eyes or mouth, or skin peeling accompanied by fever.
These reactions may be more frequent in patients of Chinese or Thai origin
• Mouth ulcers or unexplained bruising or bleeding
• Sore throat or high temperature, or both
• Yellowing of your skin or the whites of your eyes
• Swollen ankles, feet or lower legs
• Any signs of nervous illness or confusion
• Pain in your joints and muscles, a rash across the bridge of the nose and cheeks and problems with breathing (these may
be the signs of a rare reaction known as lupus erythematosus)
• Fever, skin rash, joint pain, and abnormalities in blood and liver function tests (these may be the signs of a multi-organ
sensitivity disorder)
• Bronchospasm with wheezing and coughing, difficulty in breathing, feeling faint, rash, itching or facial swelling (these may be
the signs of a severe allergic reaction)
• Pain in the area near the stomach.

DATE:

CUSTOMER
APPROVED:

PROOF HISTORY:
v.1 - waymade - 30/07/13

Leaflet Flat Size = 180 x 429
March 2013

To treat epilepsy the usual doses are:
Adults: 800–1,200 mg a day, although higher doses may be necessary. If you are elderly you might require a lower dose.

The side effects listed below have also been reported.
More than 1 in 10 people have experienced:
Leucopenia (a reduced number of the cells which fight infection making it easier to catch infections); dizziness and tiredness;
feeling unsteady or finding it difficult to control movements; feeling or being sick; changes in liver enzyme levels (usually without
any symptoms); skin reactions which may be severe.

30/07/13
6464 2792 F

DATE OF PROOF:

DATE:

Up to 1 in 1,000 people have reported:
Disease of the lymph glands; folic acid deficiency; a generalised allergic reaction including rash, joint pain, fever, problems with the
kidneys and other organs; hallucinations; depression; loss of appetite; restlessness; aggression; agitation; confusion; speech
disorders; numbness or tingling in the hands and feet; muscle weakness; high blood pressure (which may make you feel dizzy,
with a flushed face, headache, fatigue and nervousness); low blood pressure (the symptoms of which are feeling faint, light
headed, dizzy, confused, having blurred vision); changes to heart beat; stomach pain; liver problems including jaundice; symptoms
of lupus.
Up to 1 in 10,000 people have reported:
Changes to the composition of the blood including anaemia; porphyria; meningitis; swelling of the breasts and discharge of milk
which may occur in both male and females; abnormal thyroid function tests; osteomalacia (which may be noticed as pain on
walking and bowing of the long bones in the legs); osteoporosis; increased blood fat levels; taste disturbances; conjunctivitis;
glaucoma; cataracts; hearing disorders; heart and circulatory problems including deep vein thrombosis (DVT), the symptoms of
which could include tenderness, pain, swelling, warmth, skin discoloration and prominent superficial veins; lung or breathing
problems; severe skin reactions including Stevens-Johnson syndrome (These reactions may be more frequent in patients of
Chinese or Thai origin); sore mouth or tongue; liver failure; increased sensitivity of the skin to sunlight; alterations in skin
pigmentation; acne; excessive sweating; hair loss; increased hair growth on the body and face; muscle pain or spasm; sexual
difficulties which may include reduced male fertility, loss of libido or impotence; kidney failure; blood spots in the urine; increased or
decreased desire to pass urine or difficulty in passing urine.
The following have also been reported, but the frequency cannot be estimated from the available information:
Severe skin reactions, accompanied by feeling unwell and changes in blood results.
Do not be alarmed by this list. Most people take Tegretol Tablets without any problems.
CODE:

04-1957
PRE-PRESS NO.:

DT
Tegretol 400 mg
PRODUCT:

CUSTOMER: Waymade

Up to 1 in 100 people have reported:
Abnormal involuntary movements including tremor or tics; abnormal eye movements; diarrhoea; constipation.

ARTWORKER:

Q.A.
APPROVED:

Up to 1 in 10 people have experienced:
Changes in the blood including an increased tendency to bruise or bleed; fluid retention and swelling; weight increase; low sodium
in the blood which might result in confusion; headache; double or blurred vision; dry mouth.

If any of the symptoms become troublesome, or if you notice anything else not mentioned here, please go and see your
doctor. He/she may want to give you a different medicine.
There have been reports of bone disorders including osteopenia and osteoporosis (thinning of the bone) and fractures. Check with
your doctor or pharmacist if you are on long-term antiepileptic medication, have a history of osteoporosis, or take steroids.
Reporting of side effects
Also you can help to make sure that medicines remain as safe as possible by reporting any unwanted side effects via the internet at
www.mhra.gov.uk/yellowcard. Alternatively you can call Freephone 0808 100 3352 (available from 10 a.m. to 2 p.m. Mondays to
Fridays) or fill in a paper form available from your local pharmacy.
5. How to store Tegretol tablets
Do not store above 25°C. Store in the original package.
Do not use after the expiry date printed on the blister strip or carton.
Keep out of sight and reach of children.
If your tablets become discoloured or show any other signs of deterioration, you should seek the advice of your doctor or
pharmacist who will advise you what to do.
If your doctor tells you to stop taking the tablets, please take any unused tablets back to your pharmacist to be destroyed. Do not
throw them away with your normal household water or waste. This will help to protect the environment.
6. Further information
Your medicine is called Tegretol 200mg tablets.
Each tablet contains 200mg of the active ingredient, carbamazepine in a white, round tablet marked 'CG' on one side and 'GK'
either side of the breakline on the reverse.
It also contains as inactive ingredients:
microcrystalline cellulose, croscarmellose sodium, magnesium stearate, and anhydrous colloidal silicon dioxide.
Tegretol 200mg tablets are available as packs of 50, 80 and 100 tablets.
POM

PL: 06464/2792

This product is manufactured by Novartis Pharma GmbH, Roonstrasse 25, D-90429, Nurnberg, Germany and is procured from
within the EU and repackaged by the Product Licence holder:
Waymade PLC, Miles Gray Road, Basildon Essex. SS14 3FR.
Leaflet revision and issue date (Ref.) 30.07.2013
Tegretol is a registered trademark of Novartis AG.

WARNING!

Your doctor will usually start Tegretol at a fairly low dose which can then be increased to suit you individually. The dose needed
varies between patients. You can take Tegretol Tablets during, after or between meals. Swallow the tablets with a drink.
You are usually told to take a dose two or three times a day. If necessary you may break the tablets in half along the scored line.

THE COLOURS SHOWN ON THIS PROOF ARE FOR GENERAL REPRESENTATION PURPOSES ONLY. THEY ARE NOT ACCURATE AND MUST NOT BE
USED AS A COLOUR MATCH FOR THE FINISHED JOB. PLEASE REFER TO THE PANTONE COLOUR GUIDES FOR ACCURATE COLOUR REFERENCES.

3. How to take Tegretol Tablets
The doctor will tell you how many Tegretol Tablets to take and when to take them. Always follow his/her instructions
carefully. The dose will be on the pharmacist’s label.
Check the label carefully. It is important to take the tablets at the right times. If you are not sure, ask your doctor or
pharmacist. Keep taking your tablets for as long as you have been told, unless you have any problems. In that case,
check with your doctor.

WARNING!

27mm

WE CANNOT ACCEPT RESPONSIBILITY FOR ANY ERRORS IN THIS PROOF AFTER APPROVAL. THE ARTWORK RECEIVED HAS BEEN SIGNIFICANTLY
ADJUSTED, REVISED OR RESET BY US FROM DISK OR HARD COPY. WHILST WE TAKE EXTREME CARE AT ALL TIMES TO ENSURE ACCURACY, THE FINAL RESPONSIBILITY
MUST BE TAKEN BY OUR CUSTOMER. IF YOU SIGN THIS PROOF YOU ARE SIGNIFYING FULL APPROVAL OF DESIGN AND TEXT.

Other special warnings
• Drinking alcohol may affect you more than usual. Discuss whether you should stop drinking with your doctor.
• Eating grapefruit, or drinking grapefruit juice, may increase your chance of experiencing side effects.
• Your doctor may want you to have a number of blood tests before you start taking Tegretol and from time to time during your
treatment. This is quite usual and nothing to worry about.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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