WARNING

Tegretol-XR (extended-release carbamazepine) is a medication primarily used to treat epilepsy and bipolar disorder. While it can be effective in managing these conditions, there are several potential risks associated with its use:

• Allergic Reactions: Some individuals may experience allergic reactions to Tegretol-XR, which can range from mild skin rashes to severe reactions like Stevens-Johnson syndrome or toxic epidermal necrolysis, which are life-threatening conditions.
• Blood Disorders: Tegretol-XR may cause blood disorders such as agranulocytosis (a severe decrease in white blood cells), aplastic anemia (a decrease in all types of blood cells), or thrombocytopenia (a decrease in platelets), which can increase the risk of infections, bleeding, and bruising.
• Liver Problems: Liver toxicity is a potential risk with Tegretol-XR, which may manifest as elevated liver enzymes, hepatitis, or liver failure. Regular monitoring of liver function is typically recommended during treatment.
• Neurological Effects: Some individuals may experience neurological side effects such as dizziness, drowsiness, blurred vision, or headaches. In rare cases, Tegretol-XR may worsen seizure frequency or cause new types of seizures.
• Psychiatric Effects: Tegretol-XR may exacerbate symptoms of depression, anxiety, or other psychiatric disorders in some individuals. It can also increase the risk of suicidal thoughts or behaviors, particularly in younger patients.
• Interactions: Tegretol-XR can interact with various medications, including birth control pills, anticoagulants, antidepressants, and antipsychotics, which may lead to reduced effectiveness of either Tegretol-XR or the interacting medication.
• Hyponatremia: Tegretol-XR may cause low sodium levels in the blood, known as hyponatremia, which can lead to symptoms such as nausea, headache, confusion, seizures, and coma, particularly in elderly patients.
• Teratogenicity: Tegretol-XR can increase the risk of birth defects when taken during pregnancy, particularly neural tube defects and developmental delays. It’s crucial for women of childbearing age to discuss the risks and benefits of Tegretol-XR with their healthcare provider before conception and during pregnancy.

It’s important for individuals prescribed Tegretol-XR to be closely monitored by their healthcare provider for any signs of adverse effects or complications. Any concerns or unusual symptoms should be promptly reported to a medical professional.

Why is this medication prescribed?

Tegretol-XR, the extended-release formulation of carbamazepine, is prescribed for several medical conditions, primarily:

• Epilepsy: Tegretol-XR is commonly used to treat various types of epilepsy, including partial seizures, generalized tonic-clonic seizures, and mixed seizure patterns.
• Bipolar Disorder: It is also prescribed as a mood stabilizer for managing episodes of mania and preventing the recurrence of both manic and depressive episodes in individuals with bipolar disorder.
• Trigeminal Neuralgia: Tegretol-XR may be used to alleviate the intense facial pain associated with trigeminal neuralgia, a chronic pain condition affecting the trigeminal nerve in the face.
• Neuropathic Pain: In some cases, Tegretol-XR is prescribed off-label to relieve neuropathic pain, including diabetic neuropathy and postherpetic neuralgia.

How should this medicine be used?

Tegretol-XR (extended-release carbamazepine) should be used exactly as prescribed by a healthcare professional. Here are general guidelines for its use:

• Dosage: Take Tegretol-XR exactly as directed by your doctor. The dosage prescribed will depend on your medical condition, age, weight, and response to treatment. Do not adjust the dosage without consulting your doctor.
• Administration: Tegretol-XR is typically taken orally, usually once or twice daily. It can be taken with or without food. The extended-release tablets should be swallowed whole and not chewed, crushed, or broken.
• Consistency: Take Tegretol-XR at the same times each day to maintain a consistent level of the medication in your bloodstream.
• Avoid Skipping Doses: If you miss a dose, take it as soon as you remember. However, if it’s close to the time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
• Do Not Stop Abruptly: Do not stop taking Tegretol-XR suddenly without consulting your doctor, even if you feel better. Suddenly discontinuing the medication can lead to withdrawal symptoms or a recurrence of seizures or mood episodes.
• Regular Monitoring: Your doctor may periodically monitor your blood levels of carbamazepine and may perform blood tests to check your liver function and blood cell counts. Follow up with your doctor as advised.
• Precautions: Be cautious about potential interactions with other medications, including over-the-counter drugs, supplements, and herbal products. Inform your doctor about all medications and supplements you are taking.
• Side Effects: Be aware of potential side effects of Tegretol-XR, including dizziness, drowsiness, blurred vision, nausea, vomiting, and skin rash. If you experience any severe or persistent side effects, contact your doctor.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of Tegretol-XR with your doctor. The medication may pose risks to the fetus or infant, and alternative treatments may be considered.

Always follow your doctor’s instructions carefully and ask any questions you may have about the use of Tegretol-XR. If you have concerns or experience any unusual symptoms while taking the medication, contact your healthcare provider for guidance.

Other uses for this medicine

Tegretol-XR may also be prescribed off-label for other conditions. These may include:

• Alcohol Withdrawal: Tegretol-XR may be used to help manage symptoms of alcohol withdrawal, such as seizures or tremors.
• Schizophrenia: In some cases, Tegretol-XR may be used as an adjunctive treatment for schizophrenia, particularly for controlling symptoms such as aggression or agitation.
• Attention Deficit Hyperactivity Disorder (ADHD): Tegretol-XR may be used off-label as an adjunctive treatment for ADHD, especially in individuals who do not respond well to stimulant medications or who have comorbid mood disorders.

What special precautions should I follow?

Regarding special precautions for Tegretol-XR, here are some important points to consider:

• Liver Function: Tegretol-XR can affect liver function, so regular monitoring of liver enzymes is usually recommended, especially during the first few months of treatment.
• Blood Disorders: Tegretol-XR can suppress bone marrow function, leading to blood disorders such as agranulocytosis, aplastic anemia, and thrombocytopenia. Regular blood cell counts should be performed to monitor for these potential complications.
• Hyponatremia: Tegretol-XR may cause low sodium levels in the blood, particularly in elderly patients. Symptoms of hyponatremia include nausea, headache, confusion, seizures, and coma. Sodium levels should be monitored regularly, especially during the first few months of treatment.
• Drug Interactions: Tegretol-XR can interact with many medications, including other anticonvulsants, antidepressants, antipsychotics, oral contraceptives, and blood thinners. These interactions can affect the effectiveness of Tegretol-XR or other medications and may increase the risk of side effects.
• Pregnancy and Breastfeeding: Tegretol-XR can harm the fetus if taken during pregnancy, particularly in the first trimester. It may also pass into breast milk and affect a nursing infant. Women of childbearing age should use effective contraception while taking Tegretol-XR and discuss the risks and benefits of the medication with their healthcare provider.
• Suicidal Thoughts: Tegretol-XR may increase the risk of suicidal thoughts or behaviors, particularly in younger patients. Close monitoring for changes in mood or behavior is essential, especially when starting or changing the dosage of Tegretol-XR.
• Allergic Reactions: Some individuals may experience allergic reactions to Tegretol-XR, ranging from mild skin rashes to severe reactions like Stevens-Johnson syndrome or toxic epidermal necrolysis. If you develop a rash or other signs of an allergic reaction, seek medical attention immediately.

It’s crucial to discuss any concerns or questions about Tegretol-XR with your healthcare provider. They can provide personalized advice based on your medical history and current condition.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Tegretol-XR. However, maintaining a balanced diet and staying hydrated can contribute to overall health and may help mitigate some potential side effects.

What should I do if I forget a dose?

• If you forget to take a dose of Tegretol-XR, take it as soon as you remember, unless it is almost time for your next scheduled dose.
• If it is close to the time for your next dose, skip the missed dose and continue with your regular dosing schedule.
• Do not double the dose to make up for a missed one, as this can increase the risk of side effects or overdose.
• If you are unsure about what to do, or if you have missed multiple doses, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Tegretol-XR (extended-release carbamazepine) can cause various side effects, ranging from mild to severe. Not everyone will experience these side effects, and their severity can vary from person to person. Some common side effects of Tegretol-XR include:

• Dizziness: Feeling lightheaded or unsteady, which can increase the risk of falls, especially when standing up quickly.
• Drowsiness: Feeling excessively sleepy or fatigued, affecting daily activities and concentration.
• Blurred Vision: Difficulty focusing or seeing clearly, which may impair driving or operating machinery.
• Nausea and Vomiting: Feeling sick to the stomach and possibly vomiting, which can affect appetite and overall well-being.
• Headache: Mild to moderate headaches may occur, although these typically improve over time.
• Dry Mouth: Reduced saliva production, leading to a dry sensation in the mouth and throat.
• Constipation: Difficulty passing stools or infrequent bowel movements.
• Weight Changes: Some individuals may experience weight gain or weight loss while taking Tegretol-XR.
• Skin Reactions: Rash or skin irritation may occur, ranging from mild to severe. Severe reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis are rare but serious and require immediate medical attention.
• Mood Changes: Tegretol-XR may affect mood, leading to symptoms such as irritability, agitation, or depression.
• Memory and Cognitive Changes: Some people may experience memory problems, difficulty concentrating, or confusion.
• Reduced Coordination: Impaired coordination or balance, making tasks like walking or driving more challenging.
• Tremors: Involuntary shaking or trembling of the hands or other parts of the body.
• Changes in Blood Sugar Levels: Tegretol-XR may affect blood sugar levels, potentially leading to hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar).
• Hormonal Changes: Tegretol-XR may affect hormone levels, leading to menstrual irregularities or changes in libido.
• Liver Problems: In rare cases, Tegretol-XR can cause liver toxicity, leading to elevated liver enzymes or liver damage. Symptoms may include abdominal pain, jaundice (yellowing of the skin or eyes), or dark urine.

It’s essential to report any new or worsening symptoms to your healthcare provider, especially if they are severe or persistent. Your doctor can help manage side effects and adjust your treatment regimen if necessary. Additionally, seek immediate medical attention if you experience signs of a severe allergic reaction or any other serious side effects while taking Tegretol-XR.

What should I know about storage and disposal of this medication?

Here’s what you should know about the storage and disposal of Tegretol-XR:

Storage:

• Store Tegretol-XR at room temperature, away from moisture and heat.
• Keep the medication in its original packaging or container to protect it from light.
• Do not store Tegretol-XR in the bathroom, as moisture and humidity can affect its stability.
• Keep Tegretol-XR out of reach of children and pets, as it can be harmful if accidentally ingested.

Disposal:

• Dispose of any unused or expired Tegretol-XR tablets properly according to local regulations.
• Do not flush Tegretol-XR down the toilet or pour it down the drain unless instructed to do so by your healthcare provider or pharmacist.
• If you have unused Tegretol-XR tablets, consult with your pharmacist or local waste disposal facility on how to safely dispose of them.

In case of emergency/overdose

• In case of an overdose of Tegretol-XR, seek emergency medical attention immediately by calling your local poison control center or emergency services.
• Symptoms of overdose may include severe dizziness, drowsiness, blurred vision, loss of consciousness, seizures, irregular heartbeat, difficulty breathing, or coma.
• If possible, provide the emergency responders with information about the medication ingested, the dosage, and the time of ingestion.

What other information should I know?

• Inform all healthcare providers involved in your care, including doctors, dentists, and pharmacists, that you are taking Tegretol-XR.
• Attend all scheduled medical appointments for monitoring and evaluation of your condition and response to treatment.
• Avoid alcohol while taking Tegretol-XR, as it may increase the risk of side effects and adverse reactions.
• Be cautious when engaging in activities that require alertness and coordination, such as driving or operating machinery, as Tegretol-XR may cause dizziness, drowsiness, or blurred vision.
• Carry a medical identification card or wear a bracelet indicating that you are taking Tegretol-XR in case of emergencies.

It’s essential to follow these guidelines for the safe and effective use of Tegretol-XR. If you have any questions or concerns about storage, disposal, emergencies, or other aspects of your medication, consult with your healthcare provider or pharmacist for personalized advice and recommendations.