Slideshows Images Quizzes
font size


Carbamazepine

Medical and Pharmacy Editor:

Brand Name: Tegretol, Equetro, Epitol, Tegretol XR, Carbamazepine Chewtabs, Carbamazepine CR, Carbatrol, Teril, Carnexiv

Generic Name: carbamazepine

Drug Class: Anticonvulsants, Other; Antimanic Agents; Bipolar Disorder Agents

What Is Carbamazepine and How Does It Work?

Carbamazepine is used to prevent and control seizures. This medication is known as an anticonvulsant or anti-epileptic drug. It is also used to relieve certain types of nerve pain (such as trigeminal neuralgia). This medication works by reducing the spread of seizure activity in the brain and restoring the normal balance of nerve activity.

Carbamazepine is available under the following different brand names: Tegretol, Equetro, Epitol, Tegretol XR, Carbamazepine Chewtabs, Carbamazepine CR, Carbatrol, Teril, and Carnexiv

Dosages of Carbamazepine:

Tablet, chewable (Epitol)

Adult and pediatric dosage

  • 100 mg

Tablet, immediate-release (Tegretol)

Adult and pediatric dosage

  • 200 mg

Tablet, extended-release (Tegretol XR)

Adult and pediatric dosage

  • 100 mg
  • 200 mg
  • 400 mg

Capsule, extended-release (Equetro, Carbatrol)

Adult and pediatric dosage

  • 100 mg
  • 200 mg
  • 300 mg

Oral suspension (Teril)

Adult and pediatric dosage

  • 100 mg/5mL

IV solution (Carnexiv)

Adult dosage only

  • 10 mg/mL (200 mg/20mL single-dose vial)

Dosage Considerations – Should be Given as Follows:

Epilepsy

Indicated for the treatment of partial seizures with complex symptomatology (psychomotor, temporal lobe), generalized tonic-clonic seizures (grand mal), and mixed seizure patterns, which include the seizure types listed here or other partial or generalized seizures

Adult Dosage

  • Maintenance dose range: 800-1,200 mg/day orally in divided doses
  • Therapeutic range: 4-12 mg/L (16.9-50.8 micromoles/L)
  • Maximum dose of 1,600 mg/day recommended (rarely, some patients have required 1.6-2.4 g/day)

Tablet (immediate-release)

  • Initial: 200 mg orally every 12 hours
  • Increase each week by 200 mg per day divided orally each 6-8 hours

Tablet/capsule (extended-release)

  • Initial: 200 mg orally every 12 hours
  • Increase each week by 200 mg/day orally dived every 12 hours

Oral suspension

  • Initial: 10 mL (200 mg) orally every 6 hours
  • Increase each week by 200 mg/day orally dived every 6-8 hours

Intravenous (IV) solution

  • Indicated as replacement therapy in adults for oral carbamazepine formulations, when oral administration is temporarily not feasible
  • Approved as temporary use (no more than 7 days) for the following seizure types:
    • partial seizures with complex symptomatology
    • generalized tonic-clonic seizures
    • mixed seizure patterns which include the above, or other partial or generalized seizures

Dose

  • The total daily dose of carbamazepine intravenously is 70% of the total daily oral dose from which patients are being changed. Equally divide the total daily dose of the intravenously in four 30-minute infusions, separated by 6 hours
  • Patients should be switched back to oral carbamazepine administration at their previous total daily oral dose and frequency of administration as soon as clinically appropriate
  • Intravenous administration has not been studied for greater than 7 days

Limitations of use

  • Not indicated for absence seizures (including atypical absence); carbamazepine has been associated with increased frequency of generalized convulsions in these patients

Pediatric dosage

Children under 6 years

  • Initial (oral suspension): 10-20 mg/kg/day orally every 6 hours
  • Initial (tablet): 10-20 mg/kg/day orally every 8-12 hours
  • Maintenance: For tablets or suspension may divide frequency into 3-4 times daily not to exceed 35 mg/kg/day

Children 6-12 years

  • Initial (oral suspension): 50 mg orally every 6 hours
  • Initial (tablet, immediate- or extended-release): 100 mg orally every 12 hours; may increase each week by 100 mg/day
  • Maintenance: 400-800 mg/day orally every 6-8 hours (immediate-release); every 12 hours (extended-release)
  • Not to exceed 1,000 mg/day

Children over 12 years

  • Initial (oral suspension): 10 mL (200 mg) orally every 6 hours
  • Initial (tablet, immediate- or extended-release tab/cap): 200 mg orally every 12 hours
  • May increase by up to 200 mg/day each week; every 12 hours (extended-release tablet); every 6-8 hours (other formulations)
  • Children 12-15 years: Dose not to exceed 1,000 mg/day
  • Children over 15 years: Dose not to exceed 1,200 mg/day

Dosage Modifications

Renal impairment

Hepatic impairment

  • Use caution; drug is metabolized primarily in the liver

Dosing Considerations

  • Important to initiate slowly by advancing dose every 5-7 days to minimize gastrointestinal upset and allow auto-induction of liver enzymes to occur (auto-induction is complete at 3-5 weeks)
  • Children under 12 years who receive over 400 mg/day may be converted to Carbatrol ER at the same dose, every 12 hours orally
  • Monitor: complete blood counts (CBC), liver function tests

Trigeminal Neuralgia

Indicated for pain associated with trigeminal neuralgia; beneficial results have also been reported in glossopharyngeal neuralgia; carbamazepine is not a simple analgesic and should not be used for the relief of trivial aches or pains

  • Maintenance dose range: 400-800 mg/day orally in divided doses; attempts to reduce or discontinue the drug should be made at least every 3 months throughout the treatment period
  • Maximum dose of 1200 mg/day recommended
Tablet (immediate-release)
  • Initial: 200 mg/day on day 1 divided every 12 hours
  • Increase by up to 200 mg/day in increments of 100 mg every 12 hours, to dose range of 400-800 mg/day divided twice daily; not to exceed 1200 mg/day
Tablet/capsule (extended-release)
  • Initial (XR tablet): 200 mg/day orally on day 1 divided every 12 hours
  • Initial (XR capsules): 200 mg orally once on the first day; may increase dose by up to 200 mg/day using increments of 100 mg every 12 hours to reach an effective/tolerated dose; not to exceed 1200 mg/day
  • Increase by up to 200 mg/day in increments of 100 mg every 12 hours, to dose range of 400-800 mg/day divided twice daily; not to exceed 1200 mg/day

Oral suspension

  • Initial: 200 mg orally on day 1 divided every 6 hours
  • Increase by up to 200 mg/day in increments of 50 mg every 6 hours, to dose range of 400-800 mg/day divided twice daily; not to exceed 1200 mg/day

Bipolar Mania

Equetro

  • Indicated for treatment of patients with acute manic or mixed episodes associated with bipolar I disorder
  • Initial: 200 mg orally every 12 hours
  • Increase by increments of 200 mg/day; not to exceed 1600 mg/day

Dosage Modifications

Renal impairment

  • Glomerular filtration rate less than 10 mL/min: Administer 75% of dose and monitor
  • Peritoneal dialysis and hemodialysis: Administer 75% of dose and monitor

Hepatic impairment

  • Use caution; drug is metabolized primarily in the liver

Restless Legs Syndrome (Off-label)

  • 100-600 mg orally at bed time for up to 5 weeks

Schizophrenia (Off-label)

  • 200-1,300 mg/day for 2.5-8 weeks

Postherpatic Neuralgia

  • 100-200 mg orally each day; may increase slowly to 1,200 mg/day
Medically Reviewed by a Doctor on 4/24/2017



Epilepsy

Find tips and treatments to control seizures.

Use Pill Finder Find it Now See Interactions

Pill Identifier on RxList

  • quick, easy,
    pill identification

Find a Local Pharmacy

  • including 24 hour, pharmacies

Interaction Checker

  • Check potential drug interactions
Search the Medical Dictionary for Health Definitions & Medical Abbreviations

Health Solutions From Our Sponsors