Carbamazepine is used on its own or together with other medicines to treat epilepsy (fits or seizures).
Carbamazepine suppository is used for short-term treatment in people who are temporarily unable to swallow oral medicines such as tablets.
Use this medicine exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor.
Carbamazepine suppository is to be inserted into the rectum. Do not eat, chew or swallow it. Do not use it in any other way. Try to go to the toilet before you insert the suppository.
Follow these steps:
- Wash your hands thoroughly.
- Remove the suppository from the foil wrapper.
- If you are right-handed, lie on your left side and pull your right knee up to your chest.
- Gently insert the suppository with the pointed end first into your rectum. Gently push the suppository as far as it would go.
- Remain lying in this position for 10-15 minutes to allow the suppository to melt. If you feel that the suppository is slipping out, press your buttocks together. The suppository must remain in the rectum so that the medicine can be absorbed.
- Wash your hands.
Use it at the same time each day as directed by your doctor.
Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
Alert your doctor if you have the following conditions:
- history of bone marrow depression (a condition in which the blood cells are low)
- history of porphyria (an inherited disorder that causes skin or nervous system abnormalities) affecting the liver
- heart block
as Carbamazepine may not be suitable for you.
Do not use this medicine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Inform your doctor if you have the following conditions:
- mixed type of epilepsy (fits or seizures)
- kidney disease
- liver disease
- heart disease
- increased pressure in the eye
- bladder problems
Let your doctor know if you are pregnant or breastfeeding.
Some genetic traits can cause serious allergic reactions (e.g. rashes with skin peeling or blisters) from this medicine. If you have certain pairs of genes called HLA-B*15:02
, you are more likely to develop these reactions to Carbamazepine. Your doctor may perform genetic testing before giving you this medicine to know if it is suitable for you. However, you may still develop skin reactions if you do not have this gene type. Please monitor for any signs of skin rashes.
If you are going to have certain laboratory tests (e.g. test for certain medicines to treat depression), inform your doctor that you are using this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. complete blood count, liver/kidney function, eye examination) may be done while you are being treated with Carbamazepine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring for signs of depression, suicidal thoughts, and skin reactions may also be needed.
Carbamazepine may cause drowsiness, dizziness or blurred vision. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.
Other side effects include any of the following: headache, double vision, nausea, vomiting, dry mouth, diarrhoea, constipation, skin itching, and rectal irritation.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
- swelling of the eyes, face, lips or throat; breathing difficulties
- yellowing of the skin or eyes, abdominal pain, persistent tiredness, dark coloured urine
- confusion or hallucinations (seeing or hearing things that are not existent)
- unusual changes in mood or behaviour (being too depressed, agitated, or having thoughts of self-harm)
Carbamazepine may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not use Carbamazepine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Inform your doctor and pharmacist if you are taking or using these medicines:
- other medicines for epilepsy e.g. phenytoin, phenobarbital, valproic acid
- medicines to treat depression e.g. fluoxetine, fluvoxamine
- medicines to treat asthma e.g. theophylline, aminophylline
- medicines to treat fungal infections e.g. ketoconazole, itraconazole, fluconazole, miconazole
- certain antibiotics e.g. ciprofloxacin, erythromycin, clarithromycin
- medicine to treat TB (infection known as tuberculosis) e.g. isoniazid, rifampicin
- medicines for heart disease e.g. diltiazem, verapamil
- medicines for cancer e.g. cisplatin, doxorubicin
- muscle relaxants used during surgery e.g. cisatracurium, pancuronium, vecuronium
- blood-thinning medicines e.g. warfarin, apixaban, dabigatran
- cimetidine (medicine that reduces stomach acid production)
- lithium (medicine for mood disorders)
- St. John’s wort (herbal medicine)
This list does not include all medicines that may interact with Carbamazepine.
Inform your doctor if you are currently taking birth control pills as this medicine may reduce the effectiveness of hormonal contraceptives. Ask your doctor about using non-hormonal birth control as an alternative while being treated with Carbamazepine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicine, supplements and medicines that you buy without a prescription.
Avoid alcohol and grapefruit or grapefruit juice.
Store in a cool, dry place away from the reach of children.
Protect from heat.
Medicines must not be used past the expiry date.