Tegretol (Generic name: Carbamazepine)

What is the most important information I should know about Tegretol?

• Do not take Tegretol if you have taken an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam) in the past 14 days.
• There are many other medicines that could cause a drug interaction if you take them together with Tegretol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.
• Do not take this medicine if you have a history of bone marrow suppression, or history of allergic reaction to an antidepressant such as amitriptyline (Elavil), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor).
• Do not use this medication without your doctor's consent if you are pregnant. It could cause harm to the unborn baby. Tegretol should not be used during pregnancy, but taking the medicine can make birth control pills less effective. Use a non-hormone method of birth control (not birth control pills) to prevent pregnancy while you are taking Tegretol. Tell your doctor if you become pregnant during treatment.
• Do not stop taking the medication even if you feel better. It is important to take Tegretol regularly to prevent seizures from recurring. Call your doctor promptly if this medicine does not seem to be working as well in preventing your seizures.
• Tegretol can lower the blood cells that help your body fight infections. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. It is important that you not miss any scheduled visits to your doctor.
• Tegretol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
• Avoid drinking alcohol, which can increase some of the side effects of Tegretol. It may also increase the risk of seizures.
• Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by Tegretol.

What is Tegretol?

• Tegretol is in a group of drugs called anticonvulsants. It works by decreasing nerve impulses that cause seizures and pain.
• Tegretol is used to treat seizures and nerve pain such as trigeminal neuralgia and diabetic neuropathy. Tegretol is also used to treat bipolar disorder.
• Tegretol may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Tegretol?

• Do not take Tegretol if you have:
  • a history of allergic reaction to a tricyclic antidepressant such as amitriptyline (Elavil), clomipramine (Anafranil), doxepin (Sinequan), desipramine (Norpramin), amoxapine (Asendin), imipramine (Tofranil), or nortriptyline (Pamelor);
  • a history of bone marrow suppression; or
  • if you have taken an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam) in the past 14 days.
• Before taking Tegretol, tell your doctor if you have:
  • a history of serious side effects from any drug;
  • liver disease;
  • heart disease or congestive heart failure;
  • lupus;
  • a history of mental illness; or
  • glaucoma.
• You may not be able to take Tegretol, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use Tegretol without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective non-hormone form of birth control (such as a condom, diaphragm, or spermicidal gel) while you are taking Tegretol.
• Tegretol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
• Older adults may be more sensitive to the side effects of this medicine.

How should I take Tegretol?

• Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication.
• Take each dose with a full glass of water.
• Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.
• You may open the extended-release capsule and sprinkle the medicine into a spoonful of pudding or applesauce to make swallowing easier. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.
• Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
• The Tegretol chewable tablet must be chewed before you swallow it.
• Tegretol can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. It is important that you not miss any scheduled visits to your doctor.
• Tegretol can cause eye changes. Your doctor may recommend having your eyes examined regularly while you are taking this medicine.
• Do not stop taking the medication even if you feel better. It is important to take Tegretol regularly to prevent seizures from recurring. Get your prescription refilled before you run out of medicine completely. Call your doctor promptly if this medicine does not seem to be working as well in preventing your seizures.
• Carry an ID card or wear a medical alert bracelet stating that you are taking Tegretol, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking Tegretol.
• Grapefruit and grapefruit juice may interact with Tegretol and cause unwanted side effects. Do not change the amount of grapefruit products in your diet without first talking to your doctor.
• It may take 4 weeks or more for you to start feeling better. Do not stop using Tegretol without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.
• Store Tegretol at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

• Seek emergency medical attention if you think you have used too much of this medicine.
• Symptoms of a Tegretol overdose may include shallow breathing, fast heartbeat, nausea, vomiting, urinating less or not at all, muscle twitches, restlessness, seizures, tremors, slurred speech, staggering walk, and feeling light-headed or fainting.

What should I avoid while taking Tegretol?

• Tegretol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
• Do not drink alcohol while taking Tegretol. Alcohol may increase drowsiness caused by Tegretol. It may also increase the risk of seizures.
• Avoid prolonged exposure to sunlight. Tegretol may increase the sensitivity of your skin to sunlight. Use a sun screen and wear protective clothing when exposure to the sun is unavoidable.
• Tegretol should not be used during pregnancy, but taking the medicine can make birth control pills less effective. Use a non-hormone method of birth control (not birth control pills) to prevent pregnancy while you are taking Tegretol.

What are the possible side effects of Tegretol?

• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Call your doctor at once if you have any of these serious side effects:
  • a red, blistering, peeling skin rash;
  • fever, sore throat, body aches, flu symptoms;
  • easy bruising or bleeding, unusual weakness;
  • white patches or sores inside your mouth or on your lips;
  • feeling short of breath, even with mild exertion;
  • swelling of your ankles or feet;
  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • urinating less than usual.
• Other, less serious side effects may be more likely to occur, such as:
  • feeling unsteady;
  • mild nausea, vomiting, diarrhea, constipation, stomach pain;
  • confusion, headache, blurred vision;
  • feeling agitated or depressed;
  • ringing in your ears;
  • dry mouth, swollen tongue; or
  • joint or muscle pain, leg cramps.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Tegretol?

• There are many other medicines that could cause a drug interaction if you take them together with Tegretol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.