Monograph Details
|
|
Pain & Pyrexia
> Nonnarcotic analgesics
|
|
TEGRETOL |
| Manufacturer |
|
Novartis Pharmaceuticals Corp |
| Legal Classification |
|
Rx
|
| Pharmacological Class |
|
Dibenzazepine. |
| Generic Name |
|
Carbamazepine 100mg+, 200mg; scored tabs; +chewable. |
| Also |
• TEGRETOL-XR
• TEGRETOL SUSPENSION
|
| Indications |
|
Trigeminal or glossopharyngeal neuralgia. |
| Children |
|
Not applicable. |
| Adults |
|
Initially 100mg twice daily with food, gradually increasing in increments of 100mg twice daily as needed. Maintenance: usually 400–800mg daily; range 200mg–1.2g daily. Taper dosage or discontinue if possible at 3 month intervals. |
| Contraindications |
|
History of bone marrow depression. Sensitivity to tricyclic antidepressants. During or within 14 days of MAOIs. |
| Precautions |
|
Evaluate for presence of HLA-B*1502 allele (esp. in Asians), if present carbamazepine should not be used; increased risk of severe dermatological reactions. History of cardiac, hepatic, renal, or hematopoietic dysfunction, or adverse hematologic reaction to other drugs. Do baseline CBCs then periodically; discontinue if significant bone marrow depression occurs. Monitor lipid profile, ophthalmic, hepatic, and renal function. Glaucoma. Activation of latent psychosis. Suicidal tendencies (monitor). Use minimum effective dose and change dose gradually. Avoid abrupt cessation. Convert tabs to susp with same quantity of mg/day in smaller, more frequent doses; convert tabs to XR on mg/mg basis. Elderly. Labor & delivery. Pregnancy (Cat.D). Nursing mothers. |
| Interactions |
|
Possible hyperpyretic crisis, seizures and death with MAOIs. Increased plasma levels with CYP3A4 inhibitors (eg, cimetidine, propoxyphene, isoniazid, macrolides, calcium channel blockers, loratadine, fluoxetine, ketoconazole, itraconazole, valproate). Decreased plasma levels with CYP3A4 inducers (eg, phenobarbital, phenytoin, rifampin, theophylline). May increase levels of clomipramine, phenytoin, primidone. May decrease levels of phenytoin, warfarin, doxycycline, theophylline, haloperidol, acetaminophen, alprazolam, clozapine, oral contraceptives, anticonvulsants, others metabolized by CYP3A4. May increase lithium toxicity. May alter thyroid function with other anticonvulsants. Do not give susp formulation simultaneously with other liquid drugs or diluents. May interfere with some pregnancy tests, thyroid function tests. Others (see literature). |
| Adverse Reactions |
|
Drowsiness, dizziness, GI upset, heart failure, edema, hyper- or hypotension, arrhythmias, liver and urinary disorders, dyspnea, lens opacities, arthralgia, fever, hyponatremia; rarely: rash (may be serious, eg, Stevens-Johnson syndrome, toxic epidermal necrolysis), aplastic anemia, agranulocytosis, bone marrow depression; others (see literature). |
| How Supplied |
Tabs 100mg—100 Tabs 200mg—100, 1000 XR tabs—100 Susp—450mL |
| Additional Resources |
|
• Related Prescribing Note |
|
|
|
|