Carbamazepine is used on its own or together with other medicines to treat epilepsy (fits or seizures).
It also helps to relieve pain in trigeminal neuralgia (a painful nerve condition that affects the face).
This medicine is also used to prevent the occurrence of a mood disturbance called bipolar disorder.
Carbamazepine may be used to treat other conditions as decided by your doctor.
Take Carbamazepine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Ask your doctor or pharmacist about whether you should take this medicine with or without food. Different preparations of Carbamazepine may be taken differently.
Try to take it at the same time each day.
This medicine is available as a conventional or chewable tablet, extended-release tablet or capsule, or as an oral suspension.
If you are taking the conventional or chewable tablet, take it together with food or immediately after meals.
If you have been given the oral suspension, shake the bottle well before you take it to ensure that the liquid is evenly mixed. You may take it with food or immediately after meals. Use the measuring spoon or cup provided to measure your dose. Do not mix the suspension with other liquid medicines.
If you are taking the extended-release type of tablet or capsule (usually labelled as “CR”, “XR” or “ER”), swallow it whole with a glass of water. The tablet may be taken with meals while the capsule may be taken with or without food. Do not chew or crush the tablet or capsule.
The extended-release capsule, if necessary, may be opened and the contents are sprinkled over a teaspoon of applesauce or similar foods. Do not chew or crush the capsule contents.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition.
Carbamazepine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Carbamazepine is not a cure and you may need to take it long-term to keep your seizures under control. Do not stop taking this medicine unless instructed by your doctor as stopping it suddenly may worsen your condition.
Take 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.
If you often forget to take your medicine, let your doctor and pharmacist know.
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 take this medicine with medicines used to treat depression known as a monoamine oxidase inhibitor (MAOI), nefazodone (medicine for depression), and certain medicine for HIV infection. Please see the section “Can I take this with other medicines?” below for more information.
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
- constipation
Let your doctor know if you are pregnant or planning to have a baby soon. Carbamazepine may cause harm to your unborn child.
It is important that you do not get pregnant while taking this medicine. You must use proven birth control methods during Carbamazepine therapy and for at least 2 weeks after stopping the treatment. Birth control medicines containing hormones may not be effective. You may wish to discuss other reliable methods of birth control with your doctor.
Inform your doctor if you are breastfeeding.
Be sure to check with your doctor or pharmacist before giving Carbamazepine to a child or the elderly. Children and elderly people may be more sensitive to the side effects.
Do not switch between the different types of tablets, capsules or suspension unless advised by your doctor.
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 and
HLA-A*31:01, 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. thyroid function or pregnancy tests), inform your doctor that you are taking 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, and skin itching.
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
- irregular or abnormal heartbeat, feeling lightheaded, fainting
- 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 take 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.
Do not take this medicine with the following medicines:
- nefazodone (medicine to treat depression)
- delavirdine (medicine for HIV infection) unless instructed by your doctor
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 light and moisture.
Medicines must not be used past the expiry date.
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