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TEGretol
Tegretol (generic name: carbamazepine) is an anticonvulsant and mood-stabilizing medication used primarily to treat epilepsy (seizure disorders), trigeminal neuralgia (a painful condition affecting the facial nerves), and bipolar disorder. It works by reducing abnormal electrical activity in the brain, helping to prevent seizures and stabilize mood. Tegretol is widely used for controlling partial seizures and generalized tonic-clonic seizures, as well as providing pain relief for nerve pain conditions.
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Frequently Asked Questions
How long does it take for Tegretol to start working?
Tegretol may begin to control seizures or relieve nerve pain within a few days, but it can take up to 2 to 4 weeks to reach its full effect in controlling mood swings or epilepsy symptoms.
Can Tegretol be used long-term?
Yes, Tegretol is commonly prescribed for long-term use, especially for seizure control and mood stabilization. However, regular monitoring of blood counts and liver function is essential due to the risk of serious side effects.
Is it safe to take Tegretol during pregnancy?
Tegretol can harm an unborn baby and may cause birth defects. Women of childbearing age should use effective contraception while taking Tegretol. If pregnancy occurs, consult your doctor immediately for appropriate management.
Can Tegretol cause weight gain?
Weight gain is not a common side effect of Tegretol, but it may occur in some patients. Maintaining a healthy diet and exercise routine can help manage any potential weight changes.
What should I do if I miss a dose of Tegretol?
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Comprehensive Drug Guide
How Does TEGretol Work?
Tegretol works by stabilizing hyperactive neurons in the brain. It blocks sodium channels, which play a key role in conducting electrical signals in the nervous system. By reducing the flow of sodium into overactive neurons, Tegretol helps control seizures, reduce nerve pain, and stabilize mood in people with bipolar disorder. It also decreases the activity of certain brain chemicals that contribute to mood swings and pain.
Common Dosages
- Immediate-release tablets: 200 mg
- Extended-release tablets: 100 mg, 200 mg, 400 mg
- Chewable tablets: 100 mg
- Oral suspension: 100 mg/5 mL
Typical Dosing
- For epilepsy: The typical starting dose is 200 mg twice daily for immediate-release formulations, with the dose gradually increased to control seizures. Maintenance doses can range from 800 mg to 1200 mg daily in divided doses.
- For trigeminal neuralgia: The initial dose is usually 100 mg twice daily, increased as needed up to 400 mg to 800 mg daily in divided doses.
- For bipolar disorder: The initial dose is 200 mg twice daily, with gradual dose adjustments to manage symptoms.
Typical Dosing
FDA Approved Indications
- Epilepsy (partial seizures, generalized tonic-clonic seizures)
- Trigeminal Neuralgia (a chronic pain condition affecting the trigeminal nerve in the face)
- Bipolar Disorder (as a mood stabilizer in individuals who have not responded to other medications)
Who Shouldn't Take TEGretol?
- Known hypersensitivity to carbamazepine or other tricyclic antidepressants
- Bone marrow suppression
- Acute intermittent porphyria
- Concurrent use of MAO inhibitors (or within 14 days of stopping an MAOI)
- Severe liver or heart disease
Advice From The Pharmacist
- Tegretol should be taken with food to reduce stomach upset and help with absorption.
- Avoid grapefruit or grapefruit juice while taking Tegretol, as it can increase the levels of the drug in the blood, leading to an increased risk of side effects.
- Tegretol may cause drowsiness, dizziness, or blurred vision, especially when first starting treatment or after a dose increase. Avoid driving or operating heavy machinery until you know how the medication affects you.
- Regular blood tests are required to monitor blood counts and liver function, as Tegretol can cause serious blood disorders and liver problems in some patients.
- Do not stop taking Tegretol suddenly, as this could increase the risk of seizures or mood swings. Speak to your doctor about tapering the dose gradually if discontinuation is necessary.
Side Effects of TEGretol
Common Side Effects
- Drowsiness or dizziness
- Nausea or vomiting
- Blurred vision
- Dry mouth
- Constipation
Uncommon/Severe Side Effects
- Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), severe skin reactions that require immediate medical attention
- Aplastic anemia or agranulocytosis (severe blood disorders)
- Liver damage, with symptoms such as yellowing of the skin or eyes (jaundice)
- Hyponatremia (low sodium levels), leading to confusion, headaches, or seizures
Risks and Warnings of TEGretol
- Serious Skin Reactions: Tegretol has been associated with severe, life-threatening skin reactions, particularly in patients of Asian descent who carry the HLA-B*1502 allele. Genetic testing may be recommended before starting Tegretol in these populations.
- Blood Disorders: Tegretol can cause a decrease in white blood cells, red blood cells, and platelets, leading to serious infections, anemia, or bleeding. Regular blood monitoring is necessary.
- Liver Toxicity: Tegretol can cause liver damage, particularly in individuals with pre-existing liver conditions. Signs of liver issues, such as dark urine, jaundice, or fatigue, should be reported immediately.
- Drug Interactions: Tegretol can interact with many other medications, including oral contraceptives, warfarin, and certain antibiotics, which may require dosage adjustments or alternative therapies.
Interactions with TEGretol
Common Drug Interactions
- Oral contraceptives: Tegretol can reduce the effectiveness of birth control pills, potentially leading to unintended pregnancies. Alternative contraception methods should be used.
- Warfarin: Tegretol may decrease the blood-thinning effects of warfarin, requiring closer monitoring of INR levels.
- Antidepressants and antipsychotics: Tegretol can interact with these medications, affecting how they work and increasing the risk of side effects.
- Macrolide antibiotics: Drugs like erythromycin and clarithromycin can increase carbamazepine levels, leading to toxicity.
- Grapefruit juice: Grapefruit can increase carbamazepine levels in the blood, increasing the risk of side effects.
Alternatives to TEGretol
- Depakote (valproic acid): Another anticonvulsant and mood stabilizer used for epilepsy, bipolar disorder, and migraine prevention.
- Lamictal (lamotrigine): An anticonvulsant used for epilepsy and bipolar disorder, with fewer risks of severe blood or liver problems compared to Tegretol.
- Keppra (levetiracetam): A newer anticonvulsant used to treat seizures, often with fewer interactions than carbamazepine.
- Oxcarbazepine (Trileptal): A derivative of carbamazepine that may be better tolerated in some patients, with fewer side effects.
