Has your doctor prescribed you a medicine called Carbamazepine for epilepsy or some nerve pain? If so, it is very important to be fully informed about this medicine. Because, like any medicine, to get the most out of it, you need to use it correctly. Let's talk about this simply and honestly today.
Simply put, what is Carbamazepine?
This is mainly a medicine that calms the nerves in our body. Imagine, electrical signals travel through the nerves in our brain and body. In a condition like a seizure, these signals become uncontrolled and overactive. Carbamazepine calms those overactive nerves and controls the abnormal electrical activity. This controls the occurrence of seizures. This medicine also helps in controlling severe pain (nerve pain) caused by some nerves. You can get this medicine in Sri Lanka under brand names like `Tegretol-XR`.
Things you need to tell your doctor before taking medicine
This is very important. Before your doctor prescribes this medicine, he or she should know your complete health history. Be sure to tell your doctor if you have any of the following conditions:
| Situation you need to report | Description |
|---|---|
| Pre-existing medical conditions | Conditions such as bone marrow disease, glaucoma, heart disease or irregular heartbeat, kidney disease, liver disease, and porphyria. |
| Blood problems | Conditions such as a decrease in the number of white blood cells, platelets, or red blood cells in the blood. |
| Mental health | Psychotic disorders or suicidal thoughts, plans, or attempts (in yourself or a family member) |
| Asian origin | If you are of Asian descent, it is important to tell your doctor about it, as you are at risk of developing some severe skin allergies. |
| Allergies | If you are allergic to other medications such as carbamazepine, tricyclic antidepressants, phenytoin, phenobarbital, or to foods or preservatives. |
| Pregnancy and breastfeeding | If you are pregnant, trying to get pregnant, or breastfeeding, be sure to say so. |
How exactly do I use this medicine?
In this case, the most important thing is to follow your doctor's instructions exactly.
- Swallow this pill whole with a glass of water.
- Do not break, crush, or chew the tablet. Since these are extended-release tablets, doing so can cause the medicine to be absorbed into the body too quickly and cause side effects.
- Inspect the tablets. Do not use if there are any broken or chipped tablets.
- It is usually best to take this medicine with a meal . This can help reduce side effects such as stomach upset.
- Take the prescribed dose as prescribed by your doctor. Do not increase or decrease the dose as you feel like it, or take it more often than prescribed.
- Most importantly: Do not stop taking this medication suddenly without your doctor's advice. Doing so may increase the risk of seizures.
Sometimes you may see the tablet coating come out with your stool. Don't worry about it. This is normal. The active ingredient in the medicine has been absorbed into your body.
What to do if you miss a dose of medication?
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.
What if I take too much medicine?
If you think you have taken too much medicine, go to an Emergency Department (ETU) immediately or call the National Poisons Information Centre at the Colombo National Hospital . Do not take this lightly.
Other things that may interact with this medicine
Carbamazepine can interact with other medications, foods, and beverages, so it is important to tell your doctor about all the medications you are taking (including vitamins and herbal remedies).
Do not take these with carbamazepine:
- Some medications for HIV or AIDS (those given with cobicistat)
- Delavirdine
- MAOI antidepressants (e.g. Carbex, Eldepryl, Marplan, Nardil, Parnate)
- Nefazodone
- Oxcarbazepine
These can also react:
This list is very long, so talk to your doctor about any new medication you take.
- Acetaminophen
- Some antibiotics (such as clarithromycin, erythromycin)
- Birth control pills (This medication may reduce the effectiveness of birth control pills. Therefore, talk to your doctor about another method of birth control.)
- Grapefruit juice
- Medications for mental illness such as Lithium
- Blood pressure medication
- Antifungals (such as fluconazole, ketoconazole)
- Types of steroids
- Blood thinners such as Warfarin
This is not a complete list. So tell your doctor about all the medications you take, if you smoke, or if you drink alcohol .
Things to be especially careful about when taking medication
- Serious skin reactions: This is very important. Some people may have serious skin reactions a few weeks or months after starting this medicine. If you develop a red rash with symptoms like fever or chills, if the rash turns purple, blisters, or starts to peel, or if you notice swelling of the face, lips, or a lump in the neck or armpits , see a doctor right away.
- Drowsiness and dizziness: This medicine may make you feel sleepy, dizzy, or have blurred vision. So , do not drive or operate machinery until you know how this medicine affects you. Be careful when getting up from a sitting position or sitting down suddenly, especially if you are an elderly person. Drinking alcohol can make this drowsiness worse.
- Watch for mood swings: Although rare, this medication may increase the risk of suicidal thoughts or actions. If you lose your sense of joy, your mood becomes worse, or you feel like you are going to die, tell your doctor or a family member right away. Don't keep it a secret.
- Sun sensitivity: Your skin may be more sensitive to the sun while taking this medication. So if you are going to be in the sun, wear clothing that covers your skin and use sunscreen.
Side effects that may occur due to medication
| Classification of side effects | |
|---|---|
| If you experience these symptoms, tell your doctor immediately. | |
| Severe allergy | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Aplastic anemia | Unusual tiredness, weakness, dizziness, difficulty breathing, easy bleeding or bruising. |
| Liver damage | Pain in the upper right side of the stomach, loss of appetite, nausea, light-colored stools, dark yellow or brown urine, and yellowing of the skin or eyes. |
| Low sodium levels | Muscle weakness, fatigue, dizziness, headache, memory loss. |
| Other serious symptoms | Vision changes, fast or irregular heartbeat, fever, chills, sore throat, red, blistering, or peeling skin, including inside the mouth. |
| These are usually not serious, but if they persist, tell your doctor. | |
| Minor side effects | Dizziness, drowsiness, loss of balance, nausea, vomiting. |
Take-Home Message
- Do not break, crush, or chew the carbamazepine tablet. Swallow it whole.
- Do not stop taking the medication suddenly without your doctor's advice. This can increase the risk of seizures.
- If your fever is accompanied by red, blistering skin lesions, it could be a sign of a serious condition. Tell a doctor immediately.
- If you feel hopeless, depressed, or have suicidal thoughts, be sure to tell your doctor or someone you trust.
- Tell your doctor about all other medications you are taking, even vitamins. Avoid drinking grapefruit juice.
- This medication may cause drowsiness, so be very careful when performing tasks that require attention, such as driving.
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