Brand Name

Tegretol {Novartis)

Generic Name

carbamazepine, pronounced kar ba MAZ e peen

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Drug Guide

The information contained in the following drug guide is intended as an educational resource only. This guide is not exhaustive and does not contain all available information about this drug.This guide is not intended as medical advice for individual conditions or treatment.

The information provided in this guide does not replace the need for the advice and services of medical professionals or the need for medical examination. Always talk to your physician or pharmacist before taking any prescription medication or over the counter drugs (including any supplements) or before making any changes to your treatment. Only your doctor, nurse or pharmacist can provide you with safe and effective advice regarding your drug treatment.

The use of the information in this guide is at your sole risk. This information is provided "AS IS" with no warranties to accuracy or timeliness.

**All trademarks and registered trademarks are the property of their respective owners.

What is Tegretol?

Tegretol is a medication used to stop seizures. It classified as an anticonvulsant. It works in the brain by decreasing nerve impulses that cause seizures. Tegretol also helps to treat nerve pain caused from conditions such as trigeminal neuralgia and diabetic neuropathy. Tegretol may be used in certain cases to treat bipolar disorder.

Tegretol may also be used for purposes not described in this medication guide.

Key Facts About Tegretol

Taking Tegretol may cause you to have thoughts about suicide, or mood changes like anxiety, depression, or hyperactivity (mental or physical). You should tell your doctor immediately if you have any of these conditions, or if your seizures worsen.

You should not stop taking Tegretol for seizures or epilepsy without talking to your doctor, even if you think you are better. Stopping this medication suddenly may cause you to have increased seizures. Tell your doctor if you want to stop taking Tegretol and he or she will gradually taper you off of this medication

If you have used an MAO inhibitor like furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days you should not take Tegretol.

You should have a medical ID card or wear a medical ID bracelet to let others know that you are taking Tegretol. Be sure to let any doctor or dentist know that you are taking Tegretol.

If you are of Asian ancestry you may be at a higher risk of developing a serious, but rare, skin reaction to Tegretol. Your doctor may suggest that you have a blood test before you start taking Tegretol to determine your potential risk of having this skin reaction. You should seek emergency medical attention if you have a fever, sore throat, headache and skin pain, which is followed by a red or purple skin rash that spreads and causes blistering and peeling.

Pregnancy/Breastfeeding: Tegretol has the potential to harm an unborn baby; talk to your doctor about the risks of using this medication versus the risk of seizure if you are pregnant or thinking of becoming pregnant. Tegretol can pass into breast milk, so you should not breast-feed while taking Tegretol. Having a seizure may cause harm to both you and your baby. Tell your doctor immediately if you are pregnant or think you may be pregnant. Do not suddenly stop taking this medication. It is important for you to have control of your seizures, and any risks posed by using Tegretol may be outweighed by the benefits of not having seizures. Your doctor will advise you of what you should do.

Before You Take Tegretol

If you are allergic to carbamazepine, or the antidepressants amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor) you should not take Tegretol.

You should not take Tegretol if you have used an MAO inhibitor like furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days

If you have a history of bone marrow suppression you should tell your doctor before taking Tegretol.

If you are currently taking nefazodone you should not take Tegretol.

If you a heart disease, high blood pressure, high cholesterol, high triglycerides, liver disease or kidney disease you should tell your doctor before taking Tegretol.

If you have a condition called porphyria, which is a genetic enzyme disorder that causes symptoms affecting the skin or nervous system you should tell your doctor before beginning treatment with Tegretol.

If you have glaucoma, a thyroid disorder or a history of mental illness or psychosis you should tell your doctor before taking Tegretol.

Be sure that you keep your regular appointments with your doctor while you are taking Tegretol, and tell your family to be alert to any behavior changes you may have. If you have any concerns about your history of depression or mood disorders talk to your doctor before starting treatment with Tegretol.

If you have thoughts of suicide you should tell your doctor immediately. You may experience new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.

Tegretol may affect blood cells that help your body to fight infections. This can make it easier for you to get sick from being around others who are ill, or to bleed more easily. You should be aware of these factors while you are being treated with Tegretol.

Tegretol can make you more sensitive to the sun. Be certain to wear appropriate clothing and SPF when going outdoors to avoid a sunburn.

Be aware that Tegretol may cause your reaction time to be impaired. Take care to have someone with you when you are driving or doing anything that requires you to be alert when you first start taking Tegretol, until you know how you will react to this medication.

You should not drink alcohol while you are taking Tegretol. If you use alcohol daily it can increase your risk of seizures.

Tegretol may interfere with other medications, including oral contraceptive medications. Be sure to take proper precautions to prevent unplanned pregnancy while using Tegretol.

Tegretol Drug Interactions

You should inform your doctor if you are taking any of the following:

• acetaminophen (Tylenol)
• acetazolamide (Diamox)
• alprazolam (Xanax)
• anticoagulants like warfarin (Coumadin)
• antidepressants like amitriptyline (Elavil), bupropion (Wellbutrin, Zyban), buspirone (BuSpar), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), fluoxetine (Prozac, Sarafem) and fluvoxamine (Luvox)
• antifungals like itraconazole (Sporanox) and ketoconazole (Nizoral)
• cimetidine (Tagamet)
• cisplatin (Platinol)
• clarithromycin (Biaxin)
• clonazepam (Klonopin)
• clozapine (Clozaril)
• cyclosporine (Neoral, Sandimmune)
• dalfopristin and quinupristin (Synercid)
• danazol (Danocrine)
• delavirdine (Rescriptor)
• diltiazem (Cardizem, Dilacor, Tiazac)
• doxorubicin (Adriamycin, Rubex)
• doxycycline (Vibramycin)
• erythromycin (E.E.S., E-Mycin, Erythrocin)
• felodipine (Plendil)
• haloperidol (Haldol)
• HIV protease inhibitors atazanavir (Reyataz), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Fortovase, Invirase)
• isoniazid (INH, Nydrazid)
• levothyroxine (Levoxyl, Synthroid)
• lithium (Lithobid)
• loratadine (Claritin)
• lorazepam (Ativan)
• malaria medications chloroquine (Aralen) and mefloquine (Lariam)
• seizure medications like ethosuximide (Zarontin), felbamate (Felbatol), lamotrigine (Lamictal), methsuximide (Celontin), oxcarbazepine (Trileptal), phenobarbital (Luminal, Solfoton), phenytoin (Dilantin), primidone (Mysoline), tiagabine (Gabitril),topiramate (Topamax), and valproic acid (Depakene, Depakote)
• theophylline (Theobid, Theo-Dur)
• tramadol (Ultram)
• tranquilizers
• verapamil (Calan, Covera, Isoptin, Verelan)
• zileuton (Zyflo)

Other drugs you take that are not listed may interact with Tegretol. You should tell your doctor about all of the medications you use. This includes prescription drugs, vitamins, supplements and herbal products, and over the counter medications. You should not begin taking a new medication without telling your doctor first.

Directions for Taking Tegretol

You should take Tegretol exactly your doctor has told you to. It is important that you do not take Tegretol in larger or smaller amounts, or for longer or shorter than recommended. Follow the directions on your prescription label and follow any dose changes carefully if your doctor instructs you to change your dose.

You can take Tegretol with or without food.

You should discuss your use of grapefruit products with your doctor. Grapefruit and grapefruit juice may interact with Tegretol and lead to potentially dangerous effects.

Do not break, chew or crush the Tegretol extended release capsule. You must swallow it whole. If you break the capsule you may cause too much of the medicine to be released at one time. Do not use the capsule if it has changed in color. Tell your pharmacist if your capsule has a different color and you will get a new prescription.

If you are taking liquid Tegretol you must use a special dose-measuring spoon or cup. Do not use a not a regular table spoon. Ask your pharmacist for a dose-measuring device. Be sure to shake the liquid Tegretol well before using it.

Tegretol liquid medication and capsules should be stored at room temperature, and away from both moisture and heat.

Your family or other caregivers should also be alert to changes in your mood or symptoms. You will need to maintain regular visits with your doctor while you are taking Tegretol.

You may have thoughts about suicide while taking Tegretol. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.

Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking Tegretol. Follow your doctor’s instructions about taking Tegretol while you are pregnant.

You may not experience symptom relief for up to 4 weeks while taking Tegretol. Keep taking this medication as your doctor has directed, and let him or her know if your seizures do not improve by the fourth week of treatment, or if they get worse

If you miss a dose of Tegretol you should attempt to take the missed dose as soon as you remember. However, if it is almost time for your next scheduled dose, or if your next dose of controlled release or extended release formulations is less than 12 hours away you should skip the dose you missed.

Tegretol Side Effects

If you experience any of the following adverse effects you should stop taking Tegretol and

seek emergency medical help

immediately:

• allergic reaction like breathing difficulties, hives, and swelling of your face, lips, throat or tongue
• behavior changes, including aggression and restlessness, depression and anxiety, thoughts of hurting yourself or others or suicidal urges.

Contact your physician if you experience the following.

• chest pain, irregular heart rhythm, pounding or slow or rapid heart rate.
•  confusion or memory loss
•  easy bleeding or bruising
•  flu like symptoms and body aches paleness, with rapid heart rate, faint feeling and trouble concentrating, fever and chills, muscle pain or weakness
•  jaundice or yellowing of your skin urine which is extremely dark
•  urinating less than usual or not at all
•  hallucinations, suicidal thoughts or thoughts of harming yourself, vision difficulties
•  increased seizure activity
•  restless movement in your eyes, tongue jaw or neck
•  shortness of breath
•  sore throat, with mouth sores or ulcers
•  skin rash, along with a fever, sore throat, swelling in your face or tongue, burning in your eyes and skin pain; followed by a red or purple skin rash which spreads to areas like your face or upper body and causes blistering and peeling
•  swelling with rapid weight gain
•  tremors
•  upper stomach pain

Less serious side effects of Tegretol for adults and children may include:

•  constipation
•  diarrhea
•  dizziness
•  drowsiness
•  dry mouth
•  headache
•  nausea
•  swollen tongue
•  unsteady feeling
•  vomiting

It should be noted that this is not a complete list of possible side effects of Tegretol. You should contact your physician for a complete list and medical advice regarding these effects.

Tegretol Description and Dosing

Tegretol is available in Chewable Tablets of 100 mg. These are red-speckled and pink in color.

Tegretol Tablets of 200 mg are also available, and they are pink.

A Suspension of 100 mg/5 mL of Tegretol is also available.

Typical dosages of Tegretol vary based on each individual patient. Your doctor will tell you what the appropriate dose of Tegretol is for you.

You should not attempt to alter or change your dose of Tegretol without your physician’s consent.

If you suspect that you have overdosed with Tegretol you should seek emergency help immediately.

Ingredients in Tegretol

The main ingredient in Tegretol is carbamazepine, Additional, inactive ingredients include: Colloidal silicon dioxide, D&C Red No. 30 Aluminum Lake (chewable tablets only), FD&C Red No. 40 (200-mg tablets only), flavoring (chewable tablets only), gelatin, glycerin, magnesium stearate, sodium starch glycolate (chewable tablets only), starch, stearic acid, and sucrose (chewable tablets only). The suspension also includes the following inactive ingredients: Citric acid, FD&C Yellow No. 6, flavoring, polymer, potassium sorbate, propylene glycol, purified water, sorbitol, sucrose, and xanthan gum.

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The information contained in this drug guide is intended as an educational resource only. This guide is not exhaustive and does not contain all available information about this drug.This guide is not intended as medical advice for individual conditions or treatment.

The information provided in this guide does not replace the need for the advice and services of medical professionals or the need for medical examination. Always talk to your physician or pharmacist before taking any prescription medication or over the counter drugs (including any supplements) or before making any changes to your treatment. Only your doctor, nurse or pharmacist can provide you with safe and effective advice regarding your drug treatment.

The use of the information in this guide is at your sole risk. This information is provided "AS IS" with no warranties to accuracy or timeliness.

**All trademarks and registered trademarks are the property of their respective owners.