Has your doctor prescribed you a medicine called Carbamazepine to control your seizures (epilepsy) or to help with your sometimes unbearable nerve pain? You may be a little scared or curious about this medicine. That's normal. So today, let's talk about what this medicine is, how it works, and what you need to be careful about when using it.
Simply put, Carbamazepine is a drug that calms down overactive nerves in our body's nervous system and brings their function back to normal. This is how the onset of fits is controlled and nerve-related pain is reduced. This drug is very popular in Sri Lanka under the brand name Tegretol.
Things you need to tell your doctor before starting this medication
Although carbamazepine is a very useful drug, it is not suitable for everyone. Therefore, it is very important that your doctor tells you your complete health history before prescribing this medication. Especially if you have any of the conditions listed below.
- Having Asian ancestry: This may seem a bit strange, but some people with Asian genes are at risk of severe skin reactions to this medication. So it's important to tell your doctor about your ancestry.
- Bone marrow disease:
- Glaucoma condition: (Glaucoma)
- Heart disease or irregular heartbeat:
- Kidney disease:
- Liver diseases:
- Decreased blood cell count: For example, a decrease in white blood cells, platelets, or red blood cells.
- The disease called Porphyria:
- Mental illnesses: (Psychotic disorders)
- Suicidal thoughts, plans, or attempts: Tell us if this has happened to you or someone in your family before.
- Allergies to other medications: Especially if you are allergic to medications such as carbamazepine, tricyclic antidepressants, phenytoin, phenobarbital, or to other foods or dyes.
- If you are trying to get pregnant or are pregnant:
- If the baby is breastfed:
Sharing this information with your doctor is very important for your safety. So don't hide anything, tell everything clearly.
How should I use the medicine?
This is a chewable tablet. You can chew it or swallow it whole with water . Take the medicine exactly as your doctor has prescribed. It is best to take this medicine with food . This will help reduce stomach upset.
Most importantly: If you are taking this medicine to control a fit, never stop taking it suddenly without your doctor's advice . Doing so increases the risk of the fit coming back, possibly worse than before.
What to do if you overdose?
If you suddenly think you have taken too much of this medicine, do not panic. Immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital as soon as possible.
What if I forget to take my medicine?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at once to make up for a forgotten dose.
Other things that can interact with carbamazepine
This medicine may interact with some other medicines, foods, and drinks. Therefore, you should tell your doctor about all the medicines you are taking (including vitamins and traditional medicines).
| Do not take Carbamazepine with these! | |
|---|---|
| Some medications for HIV/AIDS (given with cobicistat) | Delavirdine |
| MAOIs (a type of medication for depression) | Nefazodone, Oxcarbazepine |
| These may change the effects of Carbamazepine (tell your doctor ). | |
| Acetaminophen (Paracetamol) | Some antibiotics (such as Clarithromycin, Erythromycin) |
| Types of hormones, including birth control pills | Grapefruit juice |
| Medicines for fungal infections (such as Fluconazole, Ketoconazole) | Medication for high blood pressure |
| Medication for mental health problems | Warfarin (a medicine that reduces blood clotting) |
| Other medications given for fit | Theophylline (a medicine for asthma) |
*This is not a complete list. So please inform your doctor about everything you are taking.*
Be aware of these things when taking medication.
You need to take a little extra care of your body while taking this medicine.
- Drowsiness and dizziness: You may experience drowsiness, dizziness, lightheadedness, or blurred vision. Therefore , do not drive or operate machinery until your body adjusts to this medication. If you are elderly, do not stand or sit up suddenly, as dizziness can cause you to fall.
- Alcohol: Drinking alcohol can increase drowsiness and dizziness. Therefore, avoid alcohol completely while taking this medication.
- Severe skin reactions: This is very important. Some people may have severe skin reactions a few weeks after starting this medicine. If you develop a red rash with symptoms such as fever or chills, which then blisters and peels off, or if you develop a red rash with swollen lymph nodes on the face, lips, neck, or armpits, see a doctor immediately.
- Birth control pills: If you are using birth control pills, taking carbamazepine may reduce their effectiveness . Therefore, talk to your doctor about using another form of birth control.
- Sunlight: This medication may make your skin more sensitive to sunlight. So if you are going to be in the sun, wear clothing that covers your skin and use sunscreen.
- Mental health: This medication may slightly increase the risk of suicidal thoughts or actions. So be very careful about your mental state and emotions. If you feel depressed, sad, or have thoughts of suicide, tell your doctor right away.
- Vitamin deficiencies: Long-term use of this medication may cause low levels of vitamin D and folic acid. So talk to your doctor about a nutritious diet and taking vitamin supplements if necessary.
Side effects of the medicine
Like any medicine, Carbamazepine can have side effects. Some of these are dangerous, while others are common.
| Side effects that should be reported to your doctor immediately | |
|---|---|
| Allergy | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Blood-related problems | Unusual fatigue, dizziness, headache, difficulty breathing, easy bleeding or bruising (Aplastic anemia). |
| Liver damage | Pain in the upper right side of the stomach, loss of appetite, yellowing of the skin or eyes, and dark urine. |
| Severe skin reactions | Redness, blistering, peeling skin (even inside the mouth). |
| Other | Changes in vision, irregular heartbeat, fever, swelling of lumps in the neck or armpits, worsening mental status. |
| Side effects that usually do not require medical attention (but tell your doctor if they persist) | |
| Dizziness | Drowsiness |
| Loss of balance in the body | Nausea or vomiting |
Take-Home Message
- Before starting carbamazepine, tell your doctor about all your health information and other medications you are taking.
- If you are taking medication for a fit, do not stop taking the medication suddenly without your doctor's advice.
- If you experience severe allergic symptoms such as fever, skin rash, blisters, and facial swelling, seek medical advice immediately.
- Avoid driving or performing tasks that require alertness as this medicine may cause drowsiness and dizziness. Avoid drinking alcohol completely.
- If you experience any changes in your mental state, sadness, frustration, or thoughts of death, tell your doctor immediately.
- Store the medicine in a dry, cool place out of the reach of children.
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