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Carbamazepine
Diagnosis & Treatment > Seizure Medications > Carbamazepine > Introduction to carbamazepine
 

Introduction to carbamazepine

Carbamazepine (CAR-buh-MAZ-uh-peen) is the generic name of a widely used antiepileptic drug (AED). Brand names for carbamazepine in the United States include Tegretol and Carbatrol. In other countries, brand names include Carbagen SR, Mazepine, Tegrital, Teril, and Timonil.

Using generic medications rather than brand-name drugs is often suggested as a way to save money. Sometimes the savings are large, but with other products the price differences are pretty small. It's worth investigating before deciding whether the savings are worth any possible problems.

People who switch from brand-name Tegretol to generic carbamazepine possibly risk having more seizures or side effects during the changeover, because the body does not absorb the different types in the same way. Switching from one company's generic phenytoin to another company's may have similar risks. So can switching from generic carbamazepine to Tegretol.

All these risks are not fully known. For some people the effects of changing from one type to another are very small. Some use generic carbamazepine successfully by always using the same company's product. Then the dosage can be adjusted to achieve the best results.

What's important is that both the doctor and the patient should know what the pharmacy is dispensing and have control over what type of medication is used.

Forms
Various companies make and sell carbamazepine under different names, including Epitol and Atretol. It is generally available in three forms:

  • 200-mg tablets: to be swallowed whole, not chewed
  • 100-mg chewable tablets: to be either swallowed whole or chewed
  • Suspension (100 mg/5 mL)

How to take and store carbamazepine
Most doctors recommend taking carbamazepine with food to avoid an upset stomach, but it can also be taken on an empty stomach. Consistency is important, to avoid variations in absorption.

Remind patients using the suspension to shake the bottle just before measuring. Advise them not to mix carbamazepine suspension with any other liquid or take it at the same time as another liquid medication. (A precipitate may be produced when carbamazepine suspension is mixed with some other liquids.)

Store all types of carbamazepine at controlled room temperature (below 86°F, 30°C). Protect the suspension from light.

Missed doses
Missed doses of carbamazepine are common because many people need to take it three or four times per day. Advise patients to take a forgotten dose immediately unless it is almost time for the next dose. In that case, they should either skip the forgotten dose (rather than taking a double dose) or make it up with the next 2 or 3 doses.

Patients who often forget doses may benefit from using a special pillbox or watch with an alarm. Switching to a twice-a-day extended-release form (in the U.S., Tegretol-XR or Carbatrol) may also be helpful.