Skip to Content

Carbamazepine

Generic Name: carbamazepine (oral) (kar ba MAZ e peen)
Brand Names: Carbatrol, Epitol, Equetro, Tegretol, Tegretol XR

Medically reviewed on May 17, 2018

What is carbamazepine?

See also: Ingrezza

Carbamazepine is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and pain.

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

Carbamazepine is also used to treat bipolar disorder.

Important Information

You should not take carbamazepine if you have a history of bone marrow suppression, or if you are allergic to it or to an antidepressant such as amitriptyline, desipramine, doxepin, imipramine, or nortriptyline.

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 this medicine less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

Carbamazepine may cause serious blood problems or a life-threatening skin rash or allergic reaction. Call your doctor if you have a fever, unusual weakness, bleeding, bruising, or a skin rash that causes blistering and peeling.

Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Do not stop taking this medicine without asking your doctor first, even if you feel fine.

If you are pregnant, do not start or stop taking carbamazepine without your doctor's advice.

Before taking this medicine

You should not take carbamazepine if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptyline, desipramine, doxepin, imipramine, or nortriptyline.

Do not use carbamazepine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Carbamazepine 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.

Tell your doctor if you have ever had:

You may have thoughts about suicide while taking carbamazepine. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Follow your doctor's instructions about taking seizure medication if you are pregnant. Do not start or stop taking this medicine without your doctor's advice, and tell your doctor right away if you become pregnant. Carbamazepine may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. The benefit of preventing seizures may outweigh any risks to the baby.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of this medicine on the baby.

Carbamazepine 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.

You should not breast-feed while you are using carbamazepine.

How should I take carbamazepine?

Take carbamazepine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Take with food.

Swallow the extended-release tablet or capsule whole and do not crush, chew, or break it. Tell your doctor if you cannot swallow a pill whole.

The chewable tablet must be chewed before you swallow it.

Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

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

You will need frequent medical tests.

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

Do not stop using carbamazepine suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.

Carbamazepine dosing information

Usual Adult Dose of Carbamazepine for Epilepsy:

Initial dose: 200 mg orally 2 times a day (immediate and extended release) or 100 mg orally 4 times a day (suspension)
Increase dose at weekly intervals by adding up to 200 mg/day using a 2 times a day regimen of extended release or a 3 times a day or 4 times a day regimen of the other formulations.
Maintenance dose: 800 to 1200 mg/day.
Dosage generally should not exceed 1200 mg/day.
However, doses up to 1600 mg/day have been used in rare instances.

Use: Epilepsy:
-Partial seizures with complex symptomatology (psychomotor, temporal lobe)
-Generalized tonic-clonic seizures (grand mal)
-Mixed seizure patterns which include the above, or other partial or generalized seizures

Usual Adult Dose of Carbamazepine for Trigeminal Neuralgia:

-Initial dose: 100 mg orally 2 times a day (immediate or extended release) or 50 mg orally 4 times a day (suspension)
-May increase by up to 200 mg per day using increments of 100 mg every 12 hours (immediate or extended release), or 50 mg 4 times a day (suspension), only as needed to achieve freedom from pain. Do not exceed 1200 mg per day.
-Maintenance dose: 400 to 800 mg per day
Comments:
-Some patients may be maintained on as little as 200 mg per day while others may require as much as 1200 mg per day.
-At least once every 3 months throughout the treatment period, attempts should be made to reduce the dose to the minimum effective level or to discontinue the drug.

Use:
-True trigeminal Neuralgia
-Beneficial results have also been reported in glossopharyngeal neuralgia

Usual Pediatric Dose of Carbamazepine for Epilepsy:

Less than 6 years of age:
-Initial dose: 10 to 20 mg/kg/day orally in 2 to 3 divided doses (tablets) or 4 divided doses (suspension)
-Increase dose at weekly intervals to achieve optimal clinical response administered 3 or 4 times a day.
-Maximum dose: 35 mg/kg/day
-If satisfactory response not achieved, measure plasma levels to determine if in therapeutic range.
-Comments: The manufacturer makes no recommendation regarding the safety of doses above 35 mg/kg/24 hours.

6 to 12 years of age:
-Initial dose: 100 mg orally 2 times a day (immediate or extended release tablets) or 50 mg orally 4 times a day (suspension)
-Increase dose at weekly intervals in 100 mg per day increments using a 2 times a day regimen of extended release or a 3 times a day or 4 times a day regimen of the other formulations.
Maintenance dose: 400 to 800 mg per day
Maximum dose: 1000 mg per day

Greater than 12 years of age:
-Initial dose: 200 mg orally 2 times a day (immediate and extended release) or 100 mg orally 4 times a day (suspension)
-Increase dose at weekly intervals in 200 mg per day increments using a 2 times a day regimen of extended release or a 3 times daily to 4 times daily regimen of the other formulations.
-Maintenance dose: 800 to 1200 mg per day
-Dosage generally should not exceed 1000 mg in children 12 to 15 years and 1200 mg/day in patients older than 15 years.
-Doses up to 1600 mg/day have been used in rare instances.

Use: Epilepsy:
-Partial seizures with complex symptomatology (psychomotor, temporal lobe)
-Generalized tonic-clonic seizures (grand mal)
-Mixed seizure patterns which include the above, or other partial or generalized seizures

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

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

Overdose symptoms may include severe drowsiness, weak or shallow breathing, and loss of consciousness.

What should I avoid while taking carbamazepine?

Drinking alcohol with this medicine can cause side effects.

See also: Carbamazepine and alcohol (in more detail)

Grapefruit may interact with carbamazepine and lead to unwanted side effects. Avoid the use of grapefruit products.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

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

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

Carbamazepine side effects

Get emergency medical help if you have signs of an allergic reaction to carbamazepine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. Symptoms may occur several weeks after you start using carbamazepine.

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 skin rash, no matter how mild;

  • loss of appetite, right-sided upper stomach pain, dark urine;

  • slow, fast, or pounding heartbeats;

  • anemia or other blood problems - fever, chills, sore throat, mouth sores, bleeding gums, nosebleeds, pale skin, easy bruising, unusual tiredness, feeling light-headed or short of breath; or

  • low levels of sodium in the body - headache, confusion, severe weakness, feeling unsteady, increased seizures.

Common carbamazepine side effects may include:

  • dizziness, loss of coordination, problems with walking;

  • nausea, vomiting; or

  • drowsiness.

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 carbamazepine?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Using carbamazepine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with carbamazepine, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use carbamazepine only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Hide