Download Antiepileptic Medication: Tegretol, Tegretol XR, Carbatrol

Antiepileptic Medication:
Tegretol, Tegretol XR, Carbatrol (carbamazepine)
General Information
Carbamazepine has been in use since the 1950s.
It is used for the treatment of partial seizures and
nerve pain.
How does it work?
Carbamazepine blocks sodium channels in
neurons preventing it from entering the cells.
This prevents repetitive electrical firing of
neurons.
Available forms
This drug is available as a generic. Generic
medications are not usually recommended for
patients with uncontrolled seizures. It cannot be
given intravenously. It is available in an
extended release formulation: Carbatrol and
Tegretol XR. Carbamazepine (Tegretol) is
available in 100 mg chewable tablets, 200 mg
tablets and elixir. Tegretol XR is available in 100
mg, 200 mg, and 400 mg tablets. Carbatrol is
available in 100 mg, 200 mg and 300 mg
capsules.
Drug basics
The medication will be at the highest level 4 to 8
hours after you take your dose. You might be
more aware of dose related side effects at this
time if you have them. Initially it takes 24 to 36
hours for half of the drug to leave your body.
After approximately 6 weeks this is greatly
reduced to 12 to 15 hours. The half-life
of Carbatrol and Tegretol XR is longer. 75% of
the drug binds to proteins. This portion of the
drug is not active. It is metabolized in the liver
and excreted in the urine.
Tegretol XR note: When you have a bowel
movement, you may notice the drug shell in the
stool. This does not mean that you didn’t get the
medication.
Side Effects
Carbatrol and Tegretol XR have fewer side
effects than generic carbamazepine. There are 3
different types of side effects:
•
Drug specific:
▬ Low sodium and water retention
▬ Low levels of platelets, red blood
cells and white blood cells
▬ Painful rash that is over most of
your body (like a sunburn)
▬ Lupus or liver failure
•
Dose-related:
▬ Blurry or double vision
▬ Dizziness
▬ Feeling unsteady
•
Initiation: You may notice some of the
dose related side effects during the first
couple of weeks of treatment. Your body
should get used to the medication if you
give it a chance.
You need to report any signs of drug specific
reactions to the doctor immediately: Painful
rash, intense fatigue and flu-like illness
that does not go away, intense thirst and
muscle cramping. You may be asked to stop
the medication.
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Many Drug Interactions
Other AEDs: phenytoin, felbamate,
tiagabine, topiramate, and valproate.
Antibiotics
Antacids
Calcium channel blockers
Propoxyphene (Darvon/Darvocet)
Low dose oral contraceptives
Chemotherapy
Coumadin
Grapefruit
Lab Monitoring
We can check the amount of carbamazepine in
your blood. It is not necessary to do this on a
regular basis.
Final Note
If you are having difficulty with your medication,
please notify your doctor. Your dose may be able
to be adjusted.
Created by Diana Murray RN, CNS, MS, CNRN & Mark Yerby MD, MPH
Portland, Oregon
1/2010