Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Toxicological Effects
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Induces
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Carbamazepin, Deleptin, Neurotop, Tegretol; Belgium: Tegretol; Bulgaria: Carbamazepin, Finlepsin, Neurotop, Stazepine, Tegretol; Cyprus: Storilat, Syntopine, Taver, Tegretol; Czech Republic: Biston, Neurotop, Tegretol CR, Timonil; Denmark: Karbamazepin, Tegretol, Trimonil; Estonia: Carbalex, Carbamazepine, Finlepsin, Tegretol CR, Timonil; Finland: Neurotol, Tegretol; France: Carbamazepine, Tegretol; Germany: Carba-CT, Carbabeta, Carbadura, Carbaflux, Carbagamma, Carbamazepin, Finlepsin, Sirtal, Tegretal, Tegretol, Teril, Timonil; Greece: Tegretol; Hungary: Neurotop, Stazepine, Tegretol, Timonil; Ireland: Gericarb, Tegretol; Italy: Carbamazepina, Tegretol; Latvia: Carbalex, Finlepsin, Tegretol CR; Lithuania: Carbatol, Carbalex, Carbamazepin, Finlepsin, Tegretol CR; Luxembourg: Tegretol; Malta: Tegretol; Netherlands: Carbamazepine, Tegretol; Poland: Amizepin, Espa-Lepsin, Finlepsin, Neurotop, Tegretol, Timonil; Portugal: Carbamazepina, Tegretol; Romania: Carbamazepin, Carbamazepina, Carbavim, Carbepsil, Finlepsin, Neurotop, Taver, Tegretol, Timonil; Slovakia: Biston, Neurotop, Tegretol, Timonil; Slovenia: Tegretol; Spain: Carbamazepina, Tegretol; Sweden: Hermolepsin, Tegretol, Timonil; UK: Tegretol.

North America

Canada: Carbamazepine, Mapezine, Tegretol; USA: Carbamazepine, Carbatrol, Epitol, Equetro, Tegretol, Teril.

Latin America

Argentina: Actinerval, Carbagramon, Carbamat, Carbamazepina, Conformal, Elebe, Tegretol; Brazil: Carbamazepina, Carmazin, Convulsan-Carbamazepina, Tegretard, Tegretol, Tegrex; Mexico: Bioneuril, Carbacef, Carbalan, Carbamazepina, Carbasal, Carbaval, Carbazina, Carpin, Cinazel, Clostedal, Neugeron, Sepibest, Tegretol, Ultrepyl, Zepiken.


Japan: Carbamazepine, Lexin, Tegretol, Telesmin.

Drug combinations


Carbamazepine: C~15~H~12~N~2~O. Mw: 236.27. 5H-Dibenz[b,f]azepine-5-carboxamide. CAS-298-46-4 (1965).

Pharmacologic Category

Anticonvulsants, Miscellaneous. Antimanic Agents. (ATC-Code: N03AF01).

Mechanism of action

The anticonvulsant activity of carbamazepine, like phenytoin, principally involves limitation of seizure propagation by reduction of post-tetanic potentiation of synaptic transmission. Carbamazepine has only slight analgesic properties. Carbamazepine appears to provide relief of pain in trigeminal neuralgia by reducing synaptic transmission within the trigeminal nucleus. The drug has also demonstrated sedative, anticholinergic, antidepressant, muscle relaxant, antiarrhythmic, antidiuretic, and neuromuscular transmission-inhibitory actions. May depress activity in the nucleus ventralis of the thalamus or decrease synaptic transmission or decrease summation of temporal stimulation leading to neural discharge by limiting influx of sodium ions across cell membrane or other unknown mechanism. May decrease the turnover of γ-aminobutyric acid (GABA). Stimulates the release of ADH and potentiates its action in promoting reabsorption of water. Chemically related to tricyclic antidepressants.

Therapeutic use

Partial seizures with complex symptomatology. Generalized tonic-clonic seizures (grand mal). Mixed seizure patterns. Trigeminal/glossopharyngeal/diabetic neuralgia. Acute manic and mixed episodes associated with bipolar I disorder. Epileptic seizures.

Pregnancy and lactiation implications

Crosses the placenta. Risk of fetus malformations. Anticonvulsants should not be discontinued in pregnant women in whom the drugs are administered to prevent major seizures because of the strong possibility of precipitating status epilepticus with attendant hypoxia and threat to life. Not recommended during lactation.

Unlabeled use

Resistant schizophrenia. Ethanol withdrawal. Restless leg syndrome. Post-traumatic stress disorders. Bipolar disorders and other affective disorders. Psychotic behavior associated with dementia. Management of aggression (e.g. uncontrolled rage outbursts) and/or loss of control (dyscontrol) in patients with or without an underlying seizure disorder. Pain and control of paroxysmal symptoms of multiple sclerosis, paroxysmal kinesigenic choreoathetosis, Klüver-Bucy syndrome, post-hypoxic action myoclonus, acute idiopathic polyneuritis (Landry-Guillain-Barré syndrome). Pain of post-traumatic paresthesia. Pain of diabetic neuropathy. Hemifacial spasm and dystonia (children). Neurohypophyseal diabetes insipidus.


Hypersensitivity to carbamazepine, tricyclic antidepressants, or any component of the formulation. Bone marrow depression. With or within 14 days of MAO inhibitor use. Concurrent use of nefazodone.

Warnings and precautions

A spectrum of hematologic effects has been reported with use (e.g. agranulocytosis, aplastic anemia, leukopenia, neutropenia, pancytopenia, thrombocytopenia, and anemias: higher risk if previous history of adverse hematologic reaction to any drug). May cause CNS depression (potential additive effects with alcohol). May exacerbate certain seizure types in children with mixed seizure disorders. Not effective in absence, myoclonic, or akinetic seizures (carbamazepine may increase the frequency of these seizures). The smallest effective dose is suggested for use in bipolar disorder to reduce the risk of overdose/suicide. Because of the relationship of carbamazepine to other tricyclic compounds, the possibility of activation of a latent psychosis or, in geriatric patients, confusion or agitation should be kept in mind. Severe reactions, including toxic epidermal necrolysis and Stevens-Johnson syndromes, may result in fatalities (Asian descents should be screened for the variant HLA-B*1502 allele prior to initiating therapy). Potentially serious, fatal multiorgan hypersensitivity reactions reported (associated with lymphatic, hepatic, renal, and/or hematologic organ systems). Has mild anticholinergic activity (caution in sensitivity to anticholinergic effects, such as urinary retention, increased intraocular pressure, constipation). May cause conduction abnormalities (caution if underlying ECG abnormalities, pre-existing cardiac damage, or risk for conduction abnormalities). Use with caution in hepatic impairment or history of hepatic porphyria (risk of hepatic failure). Use with caution in renal impairment. Anticonvulsants should not be discontinued abruptly because of the possibility of increasing seizure frequency. May interact with some pregnancy tests. May produce increased BUN, AST, ALT, ammonia, bilirubin, alkaline phosphatase. May produce decreased calcium, T~3~, T~4~, sodium. May cause false-positive urine immunoassay for tricyclic antidepressants. Bacterial and mammalian mutagenicity studies using carbamazepine have shown no evidence of mutagenicity. Carbamazepine has produced dose-related increases in the incidence of hepatocellular tumors in female rats and benign interstitial cell adenomas in male rats.



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