Concise Prescribing Info
Symptomatic relief of pain only during periods of exacerbation of true or primary trigeminal neuralgia. Management of psychomotor epilepsy & as an adjunct in some patients w/ secondary or partial epilepsy w/ complex symptomatology or secondarily generalized seizures when administered in combination w/ other anti-epileptic medication.
Dosage/Direction for Use
Epilepsy Adult Initially 100-200 mg once daily or bd progressively increased up to a max of 600 mg daily but occasionally dosages up to 800-1,000 mg have been used for short periods. Trigeminal neuralgia Initially 200 mg in divided doses increasing gradually by 200 mg/day until pain relief.
Should be taken with food.
Hypersensitivity to any of the tricyclic compd eg, amitriptyline, trimipramine, imipramine, or their analogue or metabolites. History of hepatic disease or serious blood disorder. Not to be administered immediately before in conjunction w/ or immediately after administering a MAO inhibitor. AV heart block.
Special Precautions
Conduct complete blood studies, including platelet counts, & evaluation of hepatic & renal function & urinalysis before treatment. Discontinue immediately if any signs or symptoms or abnormal laboratory findings suggestive of blood dyscrasia or liver disorder occur. Urinary retention & increased IOP. May activate a latent psychosis, or in elderly, produce agitation or confusion; alcoholics. History of CAD, organic heart disease, or congestive failure. Perform ECG before administering treatment. May cause dizziness & drowsiness. Use an alternative nonsteroidal contraceptive method. Women of childbearing potential. Do not administer during pregnancy (1st 3 mth) & lactation.
Adverse Reactions
Drowsiness, unsteady feet, vertigo/dizziness, GI disturbance, & nausea. Transitory leukopenia, eosinophilia, leukocytosis, thrombocytopenic purpura, agranulocytosis, macrocytic & aplastic anemia; abnormal liver function tests & cholestatic or hepatocellular jaundice (long-term treatment); skin sensitivity reactions & rashes, erythematous rashes, pruritic eruptions, urticaria, photosensitivity, pigmentary changes, neurodermatitis; somnolence, coordination disturbances, confusion, headache, fatigue, blurred vision, transient diplopia & oculomotor & speech disturbances, abnormal involuntary movements & increase in motor seizures; recurrence of thrombophlebitis in patients w/ prior history of thrombophlebitis, CHF, aggravation of HTN, Stock's Adams in patients w/ AV block, hypotension, syncope & collapse, edema, aggravation of CAD; urinary frequency, acute urinary retention, oliguria w/ elevated BP & impotence, elevation of BUN, albuminuria & glycosuria; vomiting, gastric or abdominal discomfort, diarrhea, anorexia, dry mouth & throat, glossitis & stomatitis; fever & chills, lymphadenopathy, aching joints & muscles, leg cramps & conjunctivitis.
Drug Interactions
Increased risk of hepatotoxicity w/ acetaminophen. May decrease adrenocorticoid effects of adrenocorticoids, glucocorticoid, & mineralocorticoid. May stimulate hepatic metabolism of aminophylline, oxtriphylline & theophylline. Decreased serum conc & elimination t½ of anticoagulants, coumarin & indandione-derivatives. Increased metabolism of anticovulsants especially clonazepam, primidone, valproic acid. Increased risk of congenital defects w/ other anticonvulsants. Enhanced CNS depressant effects & decreased anticonvulsant effect w/ TCAs, haloperidol, loxapine, maprotiline, molindone, phenothiazide, pimozide, thioxanthenes. Increased risk of carbamazepine-induced osteopenia w/ carbonic anhydrase inhibitors. May potentiate antidiuretic effect of chlorpropamide, clofibrate, desmopressin, lypressin, posterior pituitary, thiazide diuretics. Increased plasma conc of cimetidine. Decreased effects of estrogen-containing oral contraceptive, cyclosporine, decarbazine, digitalis glycosides, disopyramide or estrogen (including estramustine, levothyroxine, maxiletine, quinitine). Inhibited metabolism w/ danazol, diltiazem & verapamil; erythromycin, troleandomycin; influenza virus vaccine; propoxyphene. May decrease plasma conc & elimination t½ of doxycycline. Increased risk of hepatotoxicity w/ enflurane, malothane, methoxyflurane. May induce metabolism of INH. May decrease the antidiuretic effect & increase neurotoxic side effects w/ lithium. Lowered plasma conc of mebendazole. Concurrent use w/ MAOIs (including furazolidone, pargyline & procarbazine) resulted in hyperpyretic crises, hypertensive crises, severe convulsions & death.
MIMS Class
Anticonvulsants / Drugs for Neuropathic Pain
ATC Classification
N03AF01 - carbamazepine ; Belongs to the class of carboxamide derivatives antiepileptic.
Apo-Carbamazepine tab 200 mg
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