Epilepsy – Carbamazepine/Tegratol

What is carbamazepine?

Carbamazepine is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and nerve pain, such as trigeminal neuralgia and diabetic neuropathy.

Carbamazepine is also used to treat bipolar disorder.

Carbamazepine may also be used for purposes not listed in this medication guide.

Important Information

You should not take carbamazepine if you have a history of bone marrow suppression, if you are allergic to it, or take an antidepressant such as amitriptyline, desipramine, doxepin, imipramine, or nortriptyline.

TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE. Some drugs can raise or lower your blood levels of carbamazepine, which may cause side effects or make this medicine less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

Carbamazepine may cause serious blood problems or a life-threatening skin rash or allergic reaction. Call your doctor if you have a fever, unusual weakness, bleeding, bruising, or a skin rash that causes blistering and peeling.

Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Do not stop taking this medicine without asking your doctor first, even if you feel fine.

If you are pregnant, do not start or stop taking carbamazepine without your doctor’s advice.

Before taking this medicine

You should not take carbamazepine if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptylinedesipraminedoxepinimipramine, or nortriptyline.

Do not use carbamazepine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidoneisocarboxazidlinezolidphenelzinerasagilineselegiline, and tranylcypromine.

Carbamazepine may cause severe or life-threatening skin rash, and especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk.

Tell your doctor if you have ever had:

You may have thoughts about suicide while taking carbamazepine. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking seizure medication during pregnancy without your doctor’s advice. Carbamazepine may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. The benefit of preventing seizures may outweigh any risks to the baby.

Tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of this medicine on the baby.

Carbamazepine can make birth control pills or implants less effective. Use a barrier form of birth control (such as a condom or diaphragm with spermicideto prevent pregnancy.

You should not breastfeed while you are using carbamazepine.

How should I take carbamazepine?

Take carbamazepine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Take with food.

Swallow the extended-release tablet or capsule whole and do not crush, chew, or break it. Tell your doctor if you cannot swallow a pill whole.

The chewable tablet must be chewed before you swallow it.

Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures.

You will need frequent medical tests.

Store at room temperature away from moisture, heat, and light.

Do not stop using carbamazepine suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe drowsiness, weak or shallow breathing, and loss of consciousness.

What to avoid

Drinking alcohol with this medicine can cause side effects, and can also increase your risk of seizures.

Grapefruit may interact with carbamazepine and lead to unwanted side effects. Avoid the use of grapefruit products.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Carbamazepine could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Carbamazepine side effects

Get emergency medical help if you have signs of an allergic reaction to carbamazepine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (feversore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, depression, anxietyinsomnia, or if you feel agitated, hostile, restless, irritable, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • a skin rash, no matter how mild;
  • loss of appetite, right-sided upper stomach pain, dark urine;
  • slow, fast, or pounding heartbeats;
  • anemia or other blood problems – fever, chills, sore throat, mouth sores, bleeding gums, nosebleeds, pale skin, easy bruising, unusual tiredness, feeling light-headed or short of breath; or
  • low levels of sodium in the body – headache, confusion, severe weakness, feeling unsteady, increased seizures.

Common carbamazepine side effects may include:

  • dizziness, loss of coordination, problems with walking;
  • nausea, vomiting; or
  • drowsiness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.Carbamazepine side effects (more detail)

What other drugs will affect carbamazepine?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Using carbamazepine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with carbamazepine, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

COVID-19 vaccine

Photo by Artem Podrez on Pexels.com

Who can get the COVID-19 vaccine

The NHS is currently offering the COVID-19 vaccine to people most at risk from coronavirus.

In England, the vaccine is being offered in some hospitals and pharmacies, at local vaccination centres run by GPs and at larger vaccination centres. More centres are opening all the time.

It’s being given to:

  • people aged 80 and over
  • some people aged 70 and over
  • some people who are clinically extremely vulnerable
  • people who live or work in care homes
  • health and social care workers

The order in which people will be offered the vaccine is based on advice from the Joint Committee on Vaccination and Immunisation (JCVI).

Wait to be contacted

The NHS will let you know when it’s your turn to have the vaccine. It’s important not to contact the NHS for a vaccination before then.

Letters are being sent out every week – you might not get your letter straight away.

Advice if you’re of childbearing age, pregnant or breastfeeding

There’s no evidence the COVID-19 vaccine is unsafe if you’re pregnant. But more evidence is needed before you can routinely be offered it.

The JCVI has updated its advice to recommend you may be able to have the vaccine if you’re pregnant and:

  • at high risk of getting coronavirus because of where you work
  • have a health condition that means you’re at high risk of serious complications of coronavirus

You can have the COVID-19 vaccine if you’re breastfeeding.

Speak to a healthcare professional before you have the vaccination. They will discuss the benefits and risks with you.

You do not need to avoid pregnancy after vaccination. The vaccine cannot give you or your baby COVID-19.

How the COVID-19 vaccine is given

The COVID-19 vaccine is given as an injection into your upper arm.

It’s given as 2 doses. You will have the 2nd dose 3 to 12 weeks after having the 1st dose.

How to get the COVID-19 vaccine

If you’ve been sent a letter you can book your vaccination appointments online.

How safe is the COVID-19 vaccine?

The vaccines approved for use in the UK have met strict standards of safety, quality and effectiveness set out by the independent Medicines and Healthcare products Regulatory Agency (MHRA).

Any coronavirus vaccine that is approved must go through all the clinical trials and safety checks all other licensed medicines go through. The MHRA follows international standards of safety.

Other vaccines are being developed. They will only be available on the NHS once they have been thoroughly tested to make sure they are safe and effective.

So far, millions of people have been given a COVID-19 vaccine and reports of serious side effects, such as allergic reactions, have been very rare. No long-term complications have been reported.

How effective is the COVID-19 vaccine?

The 1st dose of the COVID-19 vaccine should give you good protection from coronavirus. But you need to have the 2 doses of the vaccine to give you longer lasting protection.

There is a chance you might still get or spread coronavirus even if you have the vaccine.

This means it is important to:

  • continue to follow social distancing guidance
  • if you can, wear something that covers your nose and mouth in places where it’s hard to stay away from other people

COVID-19 vaccine side effects

Most side effects of the COVID-19 vaccine are mild and should not last longer than a week, such as:

  • a sore arm where the needle went in
  • feeling tired
  • a headache
  • feeling achy
  • feeling or being sick

You can take painkillers, such as paracetamol, if you need to.

If you have a high temperature you may have coronavirus or another infection.

If your symptoms get worse or you are worried, call 111.

Allergic reactions

Tell healthcare staff before you are vaccinated if you’ve ever had a serious allergic reaction.

You should not have the COVID-19 vaccine if you have ever had a serious allergic reaction (including anaphylaxis) to:

  • a previous dose of the same vaccine
  • any of the ingredients in the vaccine

Serious allergic reactions are rare. If you do have a reaction to the vaccine, it usually happens in minutes. Staff giving the vaccine are trained to deal with allergic reactions and treat them immediately.