A potentially fatal allergic reaction known as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis can be brought on by carbamazepine (TEN). The skin and internal organs may suffer serious harm as a result of these allergic reactions. Those of Asian ancestry who have a genetic (inherited) risk factor are most at risk for SJS or TEN. Before giving carbamazepine to an Asian patient, your doctor would typically perform a test to see whether you have the genetic risk factor. Your doctor may recommend carbamazepine if you do not have this genetic risk factor, but there is still a small chance that you will develop SJS or TEN. If you experience a painful rash, hives, blistering or peeling of the skin, easy bruising, mouth sores, or a fever while taking carbamazepine, call your doctor right once. Typically, Stevens-Johnson syndrome or toxic epidermal necrolysis happens in the first few months of carbamazepine therapy.

Your body may manufacture fewer blood cells if you use carbamazepine. Rarely, a drop in blood cell count might result in serious or even life-threatening health issues. If you have ever experienced bone marrow depression (a decrease in the amount of blood cells) or any other blood abnormalities, especially if they were brought on by a different medicine, let your doctor know. You could be advised by your doctor not to take carbamazepine. Call your doctor right away if you have any of the following symptoms: Shortness of breath; weariness; unusual bleeding or bruises, such as excessive menstrual flow; nose bleeds; bleeding gums; or tiny red or purple dots or spots on the skin. Sore throat, fever, chills, or other infection symptoms that come and go or do not go away.

Keep all of your appointments with your physician and the lab. To monitor your body’s reaction to carbamazepine, your doctor will order specific lab tests both before and after your therapy.

The manufacturer’s patient information sheet (Medication Guide) will be sent to you by your doctor or pharmacist when you start taking carbamazepine and at each time your prescription is renewed. If you have any questions, carefully read the material and contact your doctor or pharmacist. To obtain the Medication Guide, you can also go to the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs) or the manufacturer’s website.

People who have epilepsy can use carbamazepine either by alone or in conjunction with other drugs to manage specific types of seizures. Trigeminal neuralgia can also be treated with it (a condition that causes facial nerve pain). Patients with bipolar I disorder can also use carbamazepine extended-release capsules (Equetro brand only) to treat periods of mania (frenzied, unusually aroused or irritable mood) or mixed episodes (manic-depressive symptoms occurring concurrently) (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). The drug carbamazepine belongs to the anticonvulsant drug class. It affects the brain’s aberrant electrical activity by lowering it.

The oral dosage forms of carbamazepine include tablets, chewable tablets, extended-release (long-acting) tablets, extended-release capsules, and suspensions (liquids). It is typical to take the standard pill, chewable tablet, and suspension two to four times per day with meals. Tegretol XR, an extended-release pill, is typically taken twice day with meals. It is typical to take the extended-release capsule (Carbatrol, Equetro) twice daily, with or without food. Take your carbamazepine at roughly the same times each day to help yourself remember to take it. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the medication’s directions precisely. Never take it in larger or less amounts or more frequently than directed by your doctor.

Do not split, chew, or crush the extended-release pills; instead, swallow them whole. The beads inside the extended-release capsules can be opened and sprinkled over food, like a teaspoon of applesauce or another comparable meal. The extended-release capsules and the beads inside of them should not be crushed or chewed.

Before each use, thoroughly shake the suspension to combine the medication.

Starting with a modest dose of carbamazepine, your doctor will progressively raise it.

Your problem won’t be cured with carbamazepine, but it might help you manage it. Before you experience all of carbamazepine’s advantages, it could take a few weeks or longer. Even if you feel good, keep taking carbamazepine. Even if you encounter adverse effects including strange behavioural or emotional changes, never discontinue taking carbamazepine without consulting your doctor first. Your seizures can get worse if you have a seizure disorder and abruptly stop using carbamazepine. Your dose will likely be gradually reduced by your doctor.

Moreover, carbamazepine is occasionally used to treat chorea, a disease that affects children, as well as mental diseases, melancholy, posttraumatic stress disorder, drug and alcohol withdrawal, restless legs syndrome, and diabetes insipidus. Discuss the potential dangers of using this medicine for your illness with your doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before taking carbamazepine,

• Inform your doctor and pharmacist if you experience any of the following side effects from taking carbamazepine, amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor, Zonalon), imipramine (Tofranil), or nortriptyline: rash, wheezing, hives, difficulty swallowing or breathing, swelling of your face, eyes (Pamelor), phenobarbital, phenytoin (Dilantin, Phenytek), primidone (Mysoline), oxcarbazepine (Trileptal), protriptyline, any other drugs, or any of the components in carbamazepine preparations. For a list of the ingredients, consult the Medication Guide or speak with your pharmacist.
• Carbamazepine should not be taken with certain drugs. When starting carbamazepine, make sure your doctor and pharmacist are aware of any medications you are taking or plan to take. Consult your doctor before beginning, stopping, or changing any medications while using carbamazepine.
• Inform your doctor if you are currently using an MAO inhibitor, such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Emsam, Zelapar), or tranylcypromine (Parnate), or if you have just discontinued taking one. Most likely, your doctor will advise against taking carbamazepine. You should wait at least 14 days after stopping carbamazepine before starting an MAO inhibitor.
• Inform your doctor and pharmacist about any additional prescription drugs, vitamins, and dietary supplements you are now taking or intend to take. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• A number of over-the-counter medicines and herbal remedies, including acetaminophen (Tylenol), cimetidine (Tagamet), ibuprofen (Advil, Motrin), loratadine (Claritin), and omeprazole, may interact with carbamazepine (Prilosec OTC, Zegerid OTC). When beginning to take carbamazepine, be careful to let your doctor and pharmacist know if you are taking these medications. While taking carbamazepine, avoid starting any of these drugs without first consulting your doctor.
• Do not take carbamazepine suspension along with any other liquid drugs that you are taking.
• Inform your doctor if you have or have had had heart, kidney, thyroid, or liver problems as well as glaucoma, a condition in which increasing pressure in the eye can cause a gradual loss of vision.
• You should be aware that hormonal contraceptives may not work as well when taking carbamazepine (birth control pills, patches, rings, injections, implants, or intrauterine devices). Contraception should be used when using carbamazepine. If you experience unexpected vaginal bleeding while taking carbamazepine or believe you could be pregnant, let your doctor know right away.
• Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant. The foetus could suffer from carbamazepine. Call your doctor right away if you conceive while taking carbamazepine.
• Inform your doctor or dentist that you are taking carbamazepine if you are having surgery, including dental surgery.
• It’s important to be aware that carbamazepine can cause drowsiness. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
• Keep in mind that drinking alcohol can worsen the drowsiness brought on by this drug.
• You should be aware that while taking carbamazepine for the treatment of epilepsy, mental illness, or other illnesses, your mental health may alter in unexpected ways and you may become suicidal (thinking about injuring or killing oneself, preparing to do so, or trying to do so). One in 500 adults and children aged 5 years and older who were treated with anticonvulsants like carbamazepine for a variety of diseases during clinical studies developed suicidal thoughts while on the medication. Some of these individuals started exhibiting suicidal thoughts and actions as little as one week after beginning the medicine.If you take an anticonvulsant drug like carbamazepine, there is a chance that your mental state may change, but there is also a chance that your condition will not be addressed and that your mental state will alter. Whether the hazards of using an anticonvulsant drug outweigh the dangers of not using it will be decided by you and your doctor. Any of the following symptoms should prompt you, your family, or your carer to call your doctor immediately away: mania (frenzied, abnormally excited mood); talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; giving away prized possessions; or any other unusual changes in behaviour or mood. panic attacks, agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling or staying asleep; aggressive, angry, or violent behaviour. Make sure your family or carer is aware of any symptoms that could be significant so they can contact the doctor on your behalf if you are unable to call for help.
• You should be aware that the oral solution is sweetened with sorbitol if you have fructose intolerance, a condition in which the body lacks the protein required to break down fructose, a fruit sugar contained in some sweeteners like sorbitol. If you have a fructose intolerance, let your doctor know.

If you plan to consume grapefruit or grapefruit juice while taking this medication, consult your doctor.

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

There may be negative effects from carbamazepine. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Dizziness
• Thinking strangely
• Having trouble speaking
• Body part shaking that is uncontrollable
• Constipation
• Mouth ache

Certain adverse effects can be very harmful. Call your doctor right away if you have any of the following symptoms or any of those mentioned in the IMPORTANT WARNING or SPECIAL PRECAUTION sections:

• Confusion
• Rash
• A hammering, rapid, or irregular pulse
• Eyes or skin that have a yellow tint
• Dark faeces
• Your right side of your stomach is hurting.
• Reduced appetite
• Nausea
• Vomiting
• Vision alterations
• Fatigue
• Swelling of your tongue, lips, face, eyes, or eyelids
• Breathing or swallowing challenges
• Headache, new or more frequent seizures, memory loss, disorientation, weakness, or unsteadiness
• Severe rash with at least one of the following symptoms: fever, aches in your muscles or joints, red or watery eyes, blisters or skin that is starting to peel off, mouth sores, or swelling of your face or neck

Further negative effects of carbamazepine are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from light, excessive heat, and moisture at room temperature (not in the bathroom).

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose signs could include the following:

• Unconsciousness
• Seizures
• Restlessness
• Muscle jerking
• Unusual motions
• Region of your body that you are unable to control shakes
• Unsteadiness
• Drowsiness
• Dizziness
• Vision alterations
• Abnormal or sluggish breathing
• Hammering or fast heartbeat
• Nausea
• Vomiting
• Having trouble urinating

Inform the lab staff and your doctor that you are taking carbamazepine prior to any laboratory test.

Home pregnancy tests may not yield accurate results when taken with carbamazepine. If you suspect that you might be pregnant while taking carbamazepine, discuss it with your doctor. Never attempt a pregnancy test at home.

After being swallowed, the extended-release pill does not dissolve in the stomach. The medication is gradually released as it moves through your digestive system. The coating from the tablet may show up in your faeces.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.