Has your doctor prescribed you a medicine called Carbamazepine for seizures or unexplained nerve pain? Maybe someone in your family is using this medicine. If so, it is very important to know everything about this medicine and use it safely. Today, we will talk simply and friendly about this medicine, what it does, what you need to be careful about when using it, and what the side effects are.
What exactly is this medicine called Carbamazepine?
Simply put, it is mainly used to control and prevent epilepsy, or as we commonly call it, fits . In addition, this medicine is also prescribed for some severe nerve pain conditions, for example, Trigeminal Neuralgia.
This medicine works by calming the overactive nerves in our body and brain. When these nerves are calmed, the onset of fits and nerve pain are controlled. You can find this medicine under various brand names in Sri Lanka such as Tegretol and Epitol.
Things you need to tell your doctor before starting medication
Carbamazepine is a medication that should be used with extreme caution. Therefore, it is essential that your doctor knows your complete medical history before prescribing it. Be sure to tell your doctor if you have any of the conditions listed below.
| The situation that affects you | Why should you inform? |
|---|---|
| You are of Asian Ancestry | There is a risk of severe skin allergies to Carbamazepine due to certain genetic markers common to Asians. Therefore, it is very important to inform your doctor about this. |
| Bone marrow disease | Since this medicine can affect blood production, it should be reported if you already have a bone marrow disease. |
| Glaucoma condition | This medicine can affect eye pressure. |
| Heart disease or heart rhythm irregularities | This is very important because carbamazepine can affect the heart rate. |
| Kidney or liver disease | Because these organs are involved in the process of removing drugs from the body, the doctor should be aware of their function. |
| Low blood counts | If you have low white blood cells, red blood cells, or platelets, this medicine may make it worse. |
| Mental illness, suicidal thoughts | Because this medication can sometimes affect mental status, it is essential to inform about existing conditions. |
| Allergies to other medicines, foods or substances | Tell your doctor if you are allergic to other medications, especially tricyclic antidepressants, phenytoin, and phenobarbital. |
| Being pregnant, trying to get pregnant, or breastfeeding | This medicine can affect the baby in the womb and can also pass to the baby through breast milk. |
How should I use the medicine?
- Take the dose prescribed by the doctor at the right time.
- Swallow the medicine with a glass of water.
- It is best to take the medicine with or after a meal to avoid stomach upset.
- Most importantly: Never stop taking this medication suddenly without your doctor's advice. Doing so can make the seizure worse and make it harder to control. If you do stop taking the medication, do so under your doctor's supervision, gradually reducing the dose.
What if I take too much medicine?
If you think you have taken too much medicine, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
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 (e.g., within a few hours), skip the missed dose and take your next dose at the scheduled time. Do not take a double dose for any reason.
Other medications that may interact with this medicine
Carbamazepine can interact with many other medications, so it is important to tell your doctor about all the medications you are taking (including vitamins, herbal remedies, and nutritional supplements).
| Drug category | Examples |
|---|---|
| Medications that should never be taken with Carbamazepine | |
| MAOI-type antidepressants | Marplan, Nardil, Parnate |
| Some medications for HIV/AIDS | Like Delavirdine |
| Other | Nefazodone, Oxcarbazepine |
| Other things that can cause problems with carbamazepine | |
| Medications for other fits | Phenobarbital, such as Phenytoin |
| Some antibiotics | Clarithromycin, Erythromycin |
| Hormones, including birth control pills | The effectiveness of birth control pills may be reduced. |
| Antifungals | Ketoconazole, Fluconazole |
| Painkillers | Acetaminophen (Paracetamol), Tramadol |
| Anticoagulant | Warfarin |
| Food | Grapefruit juice |
Things to be especially careful about when taking medication
Be careful of dangerous skin reactions!
This is the most important warning you need to know about Carbamazepine. Some people taking this medicine, especially those of Asian descent, may develop serious skin reactions that can be life-threatening . These can occur weeks or months after starting the medicine. Be very careful of these symptoms:
- Red skin rash with flu-like or cold-like symptoms.
- These red/purple lesions may later turn into blisters or the skin may peel off.
- Sores inside the mouth.
- Swelling of the face, lips, and lymph nodes in the neck or armpits.
If you notice any of these symptoms, stop taking the medicine immediately and see a doctor or go to a hospital immediately . Do not ignore this.
Special attention to mental health
A small number of people who use this medicine may have increased thoughts of suicide or depression. So be aware of your feelings and behavior while taking this medicine. If you feel that you are becoming increasingly sad or have thoughts of losing your mind, tell your doctor or a family member right away.
Other important points
- Drowsiness and dizziness: This medicine may make you feel sleepy, dizzy, and have blurred vision. Therefore, avoid driving or operating machinery until you know how this medicine affects you. Drinking alcohol can make this drowsiness worse.
- Birth control pills: If you are a woman using birth control pills, they may be less effective when you take carbamazepine. Therefore, talk to your doctor about using an additional form of birth control .
- Sun sensitivity: Your skin may be more sensitive to sunlight while taking this medication. Therefore, wear clothing that covers your skin and use sunscreen when going out in the sun.
What side effects might I experience?
Like any medicine, Carbamazepine can have side effects. Some are dangerous, some are common.
| Side effect | Description |
|---|---|
| If you have these symptoms, seek medical advice immediately . | |
| Severe allergy | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. |
| Severe skin diseases | Skin redness, blistering, peeling (as described above in the article). |
| Symptoms of liver damage | Pain in the upper right side of the abdomen, loss of appetite, dark yellow/brown urine, yellowing of the eyes and skin, and extreme fatigue. |
| Symptoms of aplastic anemia | Feeling unusually tired, pale, getting frequent infections (fever, sore throat), increased bleeding or bruising. |
| Changes in heart rate | Rapid heartbeat, chest pain, dizziness. |
| These are usually not dangerous, but tell your doctor if they persist. | |
| Drowsiness, dizziness | These will decrease as the body gets used to the medication. |
| Loss of body balance | It may feel like walking. |
| Nausea, vomiting | This can be reduced by taking the medicine with food. |
Take-Home Message
- Carbamazepine is a medication that should be taken exactly as prescribed by the doctor, in the correct dosage, and at the correct time. Never stop taking it suddenly.
- Before starting the medication, tell your doctor about all other illnesses you have and all medications you are taking .
- If you experience symptoms such as fever, skin rash, blisters, or mouth sores while taking the medication, see a doctor immediately.
- If you notice a change in your mental state , increased sadness, or thoughts of being bored with life, report it immediately.
- Avoid driving as the medicine may make you drowsy. Do not drink alcohol.
- If you are taking birth control pills , talk to your doctor about an additional method of birth control.
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