Adult Dosing
Seizure disorder
Immediate release
- Start 200 mg PO bid, increase 200 mg/day qwk
- Usual range: 800-1200 mg/day PO divided bid-qid
- Max: 1600 mg/day
Extended release
- Start 200 mg PO bid, increase 200 mg/day qwk
- Usual range: 800-1200 mg/day PO divided bid
- Max: 1600 mg/day
Trigeminal neuralgia
Immediate release
- Start 100 mg PO bid, increase 200 mg/day using increments of 100 mg q12 hours only as needed to achieve freedom from pain
- Max: 1200 mg/day
Extended release
- Start 200 mg PO qd, increase 200 mg/day q12 hours only as needed to achieve freedom from pain
- Max: 1200 mg/day
Bipolar disorder (Equetro only)
- Start 200 mg PO bid, increase 200 mg/day to achieve optimal clinical response
- Max: 1600 mg/day
Pediatric Dosing
Seizure disorder
Immediate release
- Child < 6 yrs
- Start 10-20 mg/kg/day PO divided bid-tid; may increase dose qwk
- Usual range: 20-30 mg/kg/day PO divided bid-qid
- Max: 35 mg/kg/day
- Child 6-12 yrs
- Start 100 mg PO bid, increase 100 mg/day qwk
- Usual range: 400-800 mg/day PO divided bid-qid
- Max: 1000 mg/day
- Child 12-15 yrs
- Start 200 mg PO bid, increase 200 mg/day qwk
- Usual range: 800-1200 mg/day PO divided bid-qid
- Max: 1000 mg/day
- Child > 15 yrs
- Start 200 mg PO bid, increase 200 mg/day qwk
- Usual range: 800-1200 mg/day PO divided bid-qid
- Max: 1200 mg/day
Extended release
- Child < 6 yrs
- Start 10-20 mg/kg/day PO divided bid-tid; may increase dose qwk
- Usual range: 20-30 mg/kg/day PO divided bid-qid
- Max: 35 mg/kg/day
- Child 6-12 yrs
- Start 100 mg PO bid, increase 100 mg/day qwk
- Usual range: 400-800 mg/day PO divided bid
- Max: 1000 mg/day
- Child 12-15 yrs
- Start 200 mg PO bid, increase 200 mg/day qwk
- Usual range: 800-1200 mg/day PO divided bid
- Max: 1000 mg/day
- Child > 15 yrs
- Start 200 mg PO bid, increase 200 mg/day qwk
- Usual range: 800-1200 mg/day PO divided bid
- Max: 1200 mg/day
Note:
- The safety and effectiveness of Equetro in pediatric and adolescent patients have not been established
[Outline]
- Prescribers should be thoroughly familiar with complete prescribing information before use, particularly regarding use with other drugs, especially those which accentuate toxicity potential
- Eosinophilia and Systemic Symptoms (DRESS), also known as multiorgan hypersensitivity, may occur with therapy. Some of these events have been fatal or life-threatening
- Avoid use of carbamazepine in patients with a history of hepatic porphyria (eg, variegate porphyria, acute intermittent porphyria, porphyria cutanea tarda). Acute attacks have been reported in patients administered carbamazepine
- Antiepileptic drugs, including carbamazepine, increase the risk of suicidal thoughts or behavior. Monitor patients for emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior
- Carbamazepine has mild anticholinergic activity. Closely observe patients with increased IOP during therapy
- Carbamazepine can cause fetal harm when administered to a pregnant woman
- Carbamazepine may cause dizziness/drowsiness. Advise patients not to engage in activities requiring mental alertness viz driving, operating machinery
- Do not discontinue abruptly. Abrupt discontinuation in patients with seizure disorder may precipitate status epilepticus
- Monitor carbamazepine serum levels to evaluate therapeutic response, compliance, and possible toxicity. Therapeutic levels: 4-12 mcg/mL; toxic levels: >12 mcg/mL
- Monitor CBC, platelet, reticulocytes, iron at baseline
- Monitor LFTs, urinalysis, BUN, ophthalmological exams at baseline, then periodically
- Risk of hypersensitivity reactions including SJS/TEN, maculopapular eruptions, and drug reaction with eosinophilia and systemic symptoms in patients of Asian ancestry (genetic screening recommended) is increasing due to the presence of HLAA*3101, an inherited allelic variants of the HLA-A in patients using the therapy
- Rare instances of vanishing bile duct syndrome have been reported with therapy
Cautions: Use cautiously in
- CYP 3A4 inhibitors inhibit metabolism and can increase plasma carbamazepine levels
- CYP 3A4 inducers can increase metabolism and can decrease plasma carbamazepine levels
- Hepatic impairment
- Renal impairment
- Increased IOP
- Cardiac disease
- Cardiac conduction disturbances
- Hypersensitivity to other anticonvulsants
- Hx of blood dyscrasias
- Hx of depression
- Pregnancy
- SLE
- Elderly patients with prostatic hyperplasia
- Asian patients
Pregnancy Category:D
Breastfeeding: Excreted in breast milk in relatively high levels. Monitor the infant for adverse reactions viz jaundice, drowsiness, especially in younger, exclusively breastfed infants and when combinations of anticonvulsant or psychotropic drugs are used. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 19 May 2010)
US Trade Name(s)
- Carbatrol
- Epitol
- Equetro
- Tegretol
- Tegretol XR
- Teril
US Availability
carbamazepine (generic)
- TABS: 100, 200, 300, 400 mg
- CHEW TABS: 100, 200 mg
- ETABS: 100, 200, 300 mg
- SUSP: 100 mg/5 mL
- ECAPS: 100, 200, 300 mg
Carbatrol
Epitol
- TABS: 200 mg
- CHEW TABS: 100 mg
Equetro
Tegretol
- TABS: 200 mg
- CHEW TABS: 100 mg
- SUSP: 100 mg/5 mL
Tegretol XR
Teril
Canadian Trade Name(s)
Canadian Availability
carbamazepine (generic)
- TABS: 100 mg
- CHEW TABS: 100, 200 mg
- ETABS: 200, 400 mg
Mazepine
Tegretol
- TABS: 200 mg
- CHEW TABS: 100, 200 mg
- ETABS: 200, 400 mg
- SUSP: 100mg/5 mL
UK Trade Name(s)
- Carbagen SR
- Tegretol
- Tegretol Retard
UK Availability
carbamazepine (generic)
Carbagen SR, Tegretol Retard
Tegretol
- TABS: 100, 200, 400 mg
- CHEW TABS: 100, 200 mg
- SUSP: 100 mg/5 mL (300 mL)
Australian Trade Name(s)
Australian Availability
carbamazepine (generic)
Tegretol
- TABS: 100, 200 mg
- ETABS: 200, 400 mg
- SUSP: 100 mg/5 mL (300 mL)
Teril
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- CarBAMazepine 300 MG CP12 [Bottle] (NOSTRUM LABORATORIES)
30 mg = $52.99
90 mg = $145.96 - TEGretol 100 MG CHEW [Bottle] (NOVARTIS)
60 mg = $45.99
180 mg = $115.97 - TEGretol XR 400 MG TB12 [Bottle] (NOVARTIS)
30 mg = $77.99
90 mg = $216.97 - Carbatrol 300 MG CP12 [Bottle] (SHIRE US INC.)
60 mg = $115.99
180 mg = $342.98 - CarBAMazepine 200 MG CP12 [Bottle] (NOSTRUM LABORATORIES)
30 mg = $52.99
90 mg = $145.96 - CarBAMazepine 400 MG TB12 [Bottle] (TARO)
100 mg = $175.99
300 mg = $499.95 - TEGretol XR 200 MG TB12 [Bottle] (NOVARTIS)
30 mg = $42.99
90 mg = $107.97 - TEGretol XR 100 MG TB12 [Bottle] (NOVARTIS)
30 mg = $30.99
90 mg = $64.97 - Equetro 200 MG CP12 [Bottle] (VALIDUS PHARMACEUTICALS)
60 mg = $117.99
180 mg = $330.96 - CarBAMazepine 200 MG TB12 [Bottle] (TARO)
100 mg = $86.65
300 mg = $259.96 - CarBAMazepine 200 MG TABS [Bottle] (TARO)
90 mg = $14.99
270 mg = $35.97 - CarBAMazepine 100 MG/5ML SUSP [Bottle] (TARO)
450 5ml = $67.95
1350 5ml = $178.71 - CarBAMazepine 100 MG CP12 [Bottle] (NOSTRUM LABORATORIES)
30 mg = $52.99
90 mg = $145.96 - Carbatrol 200 MG CP12 [Bottle] (SHIRE US INC.)
60 mg = $118.99
120 mg = $225.96 - TEGretol 100 MG/5ML SUSP [Bottle] (NOVARTIS)
450 5ml = $81.99
1350 5ml = $226.97 - Equetro 300 MG CP12 [Bottle] (VALIDUS PHARMACEUTICALS)
60 mg = $148.75
180 mg = $427.87 - Carbatrol 100 MG CP12 [Bottle] (SHIRE US INC.)
30 mg = $65.99
90 mg = $177.97 - CarBAMazepine 100 MG CHEW [Bottle] (TARO)
60 mg = $14.99
120 mg = $19.97 - TEGretol 200 MG TABS [Bottle] (NOVARTIS)
30 mg = $43.99
90 mg = $109.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
