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CarbamazepineAka: Tegretol

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  1. Indication
    1. Simple Partial Seizures
    2. Complex Partial Seizures
    3. Generalized Tonic Clonic Seizures
    4. Trigeminal Neuralgia
    5. Bipolar Disorder
      1. Frequently reserved for use as a second agent
    6. Resistant Schizophrenia
    7. Restless Leg Syndrome
    8. Psychosis in Dementia
    9. Post-Traumatic Stress Disorder
  2. Contraindications
    1. MAO inhibitor use within last 14 days
    2. Bone Marrow depression
    3. Pregnancy
  3. Precautions
    1. Do not use in Asian patients unless they are negative for HLA-B1502
      1. Risk of Steven's Johnson: 5% if HLA-B1502 positive
      2. FDA has issued a black box warning
      3. Man (2007) Epilepsia 48(5):1015
  4. Adverse Effects: Dose related
    1. Gradual tolerance to side effects
    2. Lethargy
    3. Nausea and Vomiting
    4. Tremor
    5. Ataxia
    6. Diplopia
  5. Adverse Effects: Other
    1. Morbilliform rash
    2. Leukopenia
    3. Agranulocytosis
    4. Aplastic Anemia
    5. Cardiac conduction abnormality (increases A-V delay)
    6. Hyponatremia (SIADH risk in elderly)
    7. Liver failure
    8. Osteoporosis
    9. Serum Sickness
    10. Stevens-Johnson Syndrome
  6. Drug Interactions (Numerous)
    1. Substrate of Cytochrome P450 2C8/9
    2. Substrate of Cytochrome P450 3A4
    3. Induces Cytochrome P450 1A2
    4. Induces Cytochrome P450 2B6
    5. Induces Cytochrome P450 2C8/9
    6. Induces Cytochrome P450 2C19
    7. Induces Cytochrome P450 3A4
  7. Dose: General
    1. Titrate dose to serum concentration and effect
    2. Target serum concentration: 4-12 mcg/ml
      1. Observe closely for concentration 8 mcg/ml or higher
    3. Toxic serum concentration: >15 mcg/ml
  8. Dose: Adults
    1. Seizure Disorder
      1. Initial: 200 mg PO bid
      2. Increase by 200 mg/day increments weekly
      3. Target: 800-1200 mg/day divided tid - qid
    2. Trigeminal Neuralgia
      1. Initial: 100 mg PO bid
      2. Increase by 100 mg/day increments weekly
      3. Target: 400-800 mg/day divided bid
  9. Dose: Elderly
    1. Initial: 100 mg PO bid
    2. Increase by 100 mg/day increments weekly
    3. Target: 400-1000 mg/day divided tid - qid
  10. Monitoring: Periodic labs
    1. Complete Blood Count with Platelet Count
    2. Serum Iron
    3. Liver Function Test
    4. Urinalysis
    5. Serum Sodium
    6. Blood Urea Nitrogen
    7. Thyroid Stimulating Hormone
    8. Serum carbamazepine level

Carbamazepine (C0006949)

Definition (MSH)An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of PHENYTOIN; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar.
Definition (CSP)anticonvulsant and antineuralgic used in the treatment of pain associated with trigeminal neuralgia and in epilepsy manifested by tonic-clonic and partial seizures.
Definition (PDQ)A tricyclic compound chemically related to tricyclic antidepressants (TCA) with anticonvulsant and analgesic properties. Carbamazepine exerts its anticonvulsant activity by reducing polysynaptic responses and blocking post-tetanic potentiation. Its analgesic activity is not understood; however, carbamazepine is commonly used to treat pain associated with trigeminal neuralgia. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42418&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42418&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C341" NCI Thesaurus)
Definition (NCI)A tricyclic compound chemically related to tricyclic antidepressants (TCA) with anticonvulsant and analgesic properties. Carbamazepine exerts its anticonvulsant activity by reducing polysynaptic responses and blocking post-tetanic potentiation. Its analgesic activity is not understood; however, carbamazepine is commonly used to treat pain associated with trigeminal neuralgia.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishCarbamazepine, CARBAMAZEPINE PREPARATION, Carbamazepine product
Spanishcarbamacepina, carbamazepina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Tegretol (C0700087)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishTegretol
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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