Tegretol (Carbamazepine): Comprehensive Overview

17 July, 2024

Tegretol (Carbamazepine) is an anticonvulsant and mood-stabilising drug primarily used to treat epilepsy, neuropathic pain, and bipolar disorder.

This article provides a detailed summary of Tegretol, its indications, dosage, contraindications, and potential side effects.

Indications and Usage

Epilepsy: Effective for partial seizures with complex symptomatology, generalised tonic-clonic seizures, and mixed seizure patterns.
Neuropathic Pain: Used for trigeminal neuralgia and diabetic neuropathy.
Bipolar Disorder: Alternative treatment for patients unresponsive to lithium.

Dosage and Administration

Adults: Typically starts with 100-200 mg once or twice daily, increasing gradually.
Children: Dosage is based on age and weight, starting at 5-10 mg/kg per day.

Contraindications

Hypersensitivity to carbamazepine or tricyclic antidepressants.
Bone marrow depression.
Use with monoamine oxidase inhibitors (MAOIs).

Warnings and Precautions

Serious Skin Reactions: Risk of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), especially in patients of Asian descent with the HLA-B*1502 allele.
Blood Disorders: Risk of aplastic anaemia and agranulocytosis. Regular blood monitoring is recommended.
Liver Function: Hepatic toxicity can occur; liver function tests should be performed.

Potential Side Effects

Common: Dizziness, drowsiness, nausea, vomiting.
Serious: Severe skin reactions, blood disorders, liver dysfunction, and pancreatitis.

Drug Interactions

Enzyme Inducer: Tegretol induces liver enzymes, affecting the metabolism of other drugs (e.g., anticoagulants, oral contraceptives, other antiepileptics).
Avoid Combination: With MAOIs, as it can lead to severe reactions.

Patient Monitoring and Counselling

Regular Monitoring: Blood counts, liver function, and drug levels.
Patient Counselling: Importance of adherence, recognition of side effects, and avoiding abrupt discontinuation.

Conclusion

Tegretol is a versatile medication for managing epilepsy, neuropathic pain, and bipolar disorder. Its use requires careful patient selection, regular monitoring, and patient education to mitigate risks and manage side effects effectively.