Clinical pharmacology of Carbatrol
Carbamazepine is metabolized and eliminated by the liver. It is metabolized by the hepatic P450 system (in particular, the 3A4 isoenzyme). Carbamazepine is ~70-80% protein-bound.
Carbamazepine induces its own metabolism (autoinduction) within the first month of treatment and also accelerates the metabolism of other hepatically metabolized drugs (see Interactions of Carbatrol with other medications). The half-life in chronic therapy (that is, after autoinduction is complete) is 10-20 hours in young adults but is shorter in children and longer in the elderly.
The main metabolite of carbamazepine is carbamazepine-10,11-epoxide. This metabolite is active and also is associated with neurotoxicity.
