Valparin (Generic name: Valproic Acid)

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

• In rare cases, Valparin has caused life-threatening liver failure, especially in children younger than 2 years old. Children of this age may be at even greater risk for liver problems if they use more than one seizure medication, if they have a metabolic disorder, or if they have a brain disease causing mental impairment (such as Creutzfeldt-Jacob disease, Huntington disease, multiple sclerosis, or a brain injury or infection).
• Valparin has also caused rare cases of life-threatening pancreatitis (inflammation of the pancreas). Pancreatitis can come on suddenly and symptoms may start even after you have been taking Valparin for several years.
• Seek emergency medical attention if the person taking this medicine has nausea, vomiting, stomach pain, or loss of appetite, low fever, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). These symptoms may be early signs of liver damage. Some of these symptoms may also be early signs of pancreatitis.
• Do not use this medication without your doctor's consent if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and 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 Valparin 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.
• Swallow the capsule whole. Do not crush, chew, or break a capsule because the medicine may irritate your mouth or throat when you swallow it.
• Carry an ID card or wear a medical alert bracelet stating that you are taking Valparin, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking Valparin.
• Avoid using other drugs that make you sleepy (such as other seizure medicines, alcohol, cold medicine, pain medication, muscle relaxers, and medicine for depression or anxiety). They can add to sleepiness caused by Valparin.

What is Valparin?

• Valparin affects chemicals in the body that may be involved in causing seizures.
• Valparin is used to treat various types of seizure disorders. Valparin is sometimes used together with other seizure medications.
• Valparin may also be used for purposes other than those listed in this medication guide.

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

• In rare cases, Valparin has caused life-threatening liver failure, especially in children younger than 2 years old. Children of this age may be at even greater risk for liver problems if they use more than one seizure medication, if they have a metabolic disorder, or if they have a brain disease causing mental impairment (such as Creutzfeldt-Jacob disease, Huntington disease, multiple sclerosis, or a brain injury or infection).
• Valparin has also caused rare cases of life-threatening pancreatitis (inflammation of the pancreas). Pancreatitis can come on suddenly and symptoms may start even after you have been taking Valparin for several years. Do not take Valparin if you have liver disease or a urea cycle disorder.
• Before taking Valparin, tell your doctor if you have:
  • a bleeding or blood clotting disorder;
  • a history of head injury, brain disorder, or coma;
  • a family history of a urea cycle disorder;
  • a family history of infant deaths with unknown cause; or
  • HIV or CMV (cytomegalovirus) infection.
• If you have any of these conditions, you may not be able to use Valparin, or you may need a dosage adjustment or special tests during treatment.
• FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use Valparin without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.
• Valparin passes into breast milk and could harm a nursing infant. Do not take Valparin without telling your doctor if you are breast-feeding a baby.
• Valparin should not be given to a child younger than 2 years of age without a doctor's consent.
• Older adults may be more sensitive to sleepiness caused by this medicine.

How should I take Valparin?

• 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.
• Take each dose with a full glass of water. Drink plenty of water while you are taking this medication. Your dose may need to be changed if you do not get enough fluids each day.
• Measure the liquid form of Valparin with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
• To be sure this medication is not causing harmful effects, your liver function will need to be tested. It is important that you not miss any scheduled visits to your doctor.
• Do not stop taking the medication even if you feel better. It is important to take Valparin 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.
• Swallow the capsule whole. Do not crush, chew, or break a capsule because the medicine may irritate your mouth or throat when you swallow it.
• Carry an ID card or wear a medical alert bracelet stating that you are taking Valparin, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking Valparin.
• Store Valparin 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 Valparin overdose may include sleepiness or drowsiness, shallow breathing, weak pulse, or loss of consciousness.

What should I avoid while taking Valparin?

• Avoid drinking alcohol, which can increase some of the side effects of Valparin.
• 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 Valparin.
• Valparin 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 exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Valparin can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

What are the possible side effects of Valparin?

• Seek emergency medical attention if the person taking this medicine has nausea, vomiting, stomach pain, or loss of appetite, low fever, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). These symptoms may be early signs of liver damage. Some of these symptoms may also be early signs of pancreatitis.
• 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:
  • unexplained weakness with vomiting and confusion or fainting;
  • easy bruising or bleeding, unusual weakness;
  • fever, skin rash, swollen glands;
  • fever, chills, body aches, flu symptoms;
  • urinating less than usual;
  • blood in your urine;
  • hallucinations (seeing things that aren't there);
  • weakness, lack of coordination;
  • a red, blistering, peeling skin rash;
  • extreme drowsiness;
  • unusual bleeding or bruising; or
  • double vision or back-and-forth movements of the eyes.
• Continue using Valparin and talk with your doctor if you have any of these less serious side effects:
  • drowsiness or weakness;
  • diarrhea, constipation, upset stomach;
  • depression, anxiety, or other emotional changes;
  • changes in your menstrual periods;
  • enlarged breasts;
  • tremor (shaking);
  • hair loss;
  • weight changes;
  • a red, blistering, peeling skin rash;
  • vision changes; or
  • unusual or unpleasant taste in your mouth.
• 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 Valparin?

• Before taking Valparin, tell your doctor if you are using any of the following drugs:
  • topiramate (Topamax);
  • tolbutamide (Orinase);
  • a blood thinner such as warfarin (Coumadin);
  • aspirin or acetaminophen (Tylenol);
  • zidovudine (Retrovir);
  • clozapine (Clozaril, Fazaclo);
  • diazepam (Valium);
  • meropenem (Merrem);
  • rifampin (Rifadin, Rimactane, Rifater);
  • ethosuximide (Zarontin); or
  • another seizure medicine such as phenytoin (Dilantin), carbamazepine (Tegretol, Carbatrol), phenobarbital (Luminal, Solfoton), felbamate (Felbatol), lamotrigine (Lamictal), or clonazepam (Klonopin).
• If you are using any of these drugs, you may not be able to use Valparin, or you may need dosage adjustments or special tests during treatment.
• There may be other drugs not listed that can affect Valparin. 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.

Trileptal (Generic name: Oxcarbazepine)

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

• Serious skin reactions have been reported in both children and adults who are taking Trileptal. These skin reactions may be life-threatening. Talk to your doctor immediately if you develop a rash or any kind of skin problem.
• Do not stop taking Trileptal without first talking to your doctor, even if you feel better. It is important to continue taking Trileptal to prevent the seizures from recurring. Stopping Trileptal suddenly may result in increased seizure frequency. If the medication needs to be stopped, your doctor may need to lower the dosage gradually.
• Trileptal may decrease the effectiveness of birth control pills. Use a second method of birth control while taking Trileptal to ensure protection from unintended pregnancy.
• Do not drink alcohol while taking Trileptal. Alcohol may increase drowsiness or dizziness caused by Trileptal. Alcohol may also increase the risk of seizures.
• Trileptal may cause drowsiness, dizziness, blurred vision, or poor coordination. Do not drive, operate dangerous machinery, or perform other hazardous activities until you know how Trileptal affects you. If you experience drowsiness, dizziness, blurred vision, or poor coordination, avoid these activities.

What is Trileptal?

• Trileptal is a drug that affects the nerves and brain. It works by decreasing impulses in nerves that cause seizures.
• Trileptal is used alone and with other drugs to treat seizures.
• Trileptal may also be used for purposes other than those listed in this medication guide.

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

• Do not take Trileptal without first talking to your doctor if you have ever had an allergic reaction to carbamazepine (Tegretol, others). You may have an allergic reaction to Trileptal.
• Before taking this medication, tell your doctor if you have
  • kidney disease, or
  • liver disease.
• You may not be able to take Trileptal, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Serious skin reactions have been reported in both children and adults who are taking Trileptal. These skin reactions may be life-threatening. Talk to your doctor immediately if you develop a rash or any kind of skin problem.
• Trileptal is in the FDA category C. This means that it is not known whether Trileptal will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• Trileptal passes into breast milk and may be harmful to a nursing infant. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.
• If you are over 60 years of age, you may be more likely to experience side effects from Trileptal. Your doctor may prescribe a lower dose or special monitoring during treatment.

How should I take Trileptal?

• Take Trileptal exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Trileptal can be taken with or without food.
• Shake the suspension well before measuring a dose. To ensure that you get the correct dose, measure the suspension with a dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
• It is important to take Trileptal regularly to get the most benefit.
• Do not stop taking Trileptal without first talking to your doctor, even if you feel better. It is important to continue taking Trileptal to prevent the seizures from recurring. Stopping Trileptal suddenly may result in increased seizure frequency. If the medication needs to be stopped, your doctor may need to lower the dosage gradually.
• If treatment with Trileptal is stopped for any reason, contact your doctor before restarting the medication. A lower dose may be needed to prevent side effects from occurring.
• Your doctor may want you to have blood tests or other medical evaluations during treatment with Trileptal to monitor progress and side effects.
• Carry or wear a medical identification tag to let others know that you are taking this medicine in the case of an emergency.
• Store Trileptal at room temperature away from moisture and heat. The suspension should be used within 7 weeks of first opening the bottle.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical treatment.
• Symptoms of an Trileptal overdose are not known.

What should I avoid while taking Trileptal?

• Do not drink alcohol while taking Trileptal. Alcohol may increase drowsiness or dizziness caused by Trileptal. Alcohol may also increase the risk of seizures.
• Trileptal may cause drowsiness, dizziness, blurred vision, or poor coordination. Do not drive, operate dangerous machinery, or perform other hazardous activities until you know how Trileptal affects you. If you experience drowsiness, dizziness, blurred vision, or poor coordination, avoid these activities.

What are the possible side effects of Trileptal?

• If you experience any of the following serious side effects, seek emergency medical attention or consult your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  • symptoms of low blood sodium (nausea, general discomfort, headache, extreme drowsiness, or confusion);
  • central nervous system effects (difficulty with concentration, speech, or language; excessive sleepiness or fatigue; a loss of coordination or trouble walking);
  • double vision, nystagmus (back-and-forth movements of the eyes), blurred vision, or other visual disturbances; or
  • increasing frequency or worsening of seizures.
• Other, less serious side effects may be more likely to occur. Continue to take Trileptal and talk to your doctor if you experience
  • headache;
  • mild sleepiness or fatigue;
  • nausea, vomiting, or stomach pain;
  • tremor;
  • dizziness;
  • rash;
  • diarrhea, constipation, or decreased appetite;
  • weight gain; or
  • dry mouth.
• 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 Trileptal?

• Trileptal interacts with many of the other drugs used to treat seizures. Before taking Trileptal, tell your doctor about all other medications you are taking. You may require a dosage adjustment or special monitoring during treatment if you are taking a combination of medications to treat seizures. Continue to take all medications prescribed to treat seizures exactly as directed.
• Trileptal may decrease the effectiveness of birth control pills. Use a second method of birth control while taking Trileptal to ensure protection from unintended pregnancy.
• Trileptal may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if Trileptal is taken with any of these medications.
• Drugs other than those listed here may also interact with Trileptal or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Topamax (Generic name: Topiramate)

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

• Seek immediate medical attention if you experience blurred vision, changes in vision, or pain in or around the eyes during treatment with Topamax. These may be early signs of a serious side effect.
• Do not stop taking Topamax without first talking to your doctor, even if your symptoms have improved. It is important to continue taking Topamax to prevent seizures from recurring.
• Carry or wear a medical identification tag to let others know that you are taking Topamax in the case of an emergency.
• Use caution when driving, operating machinery, or performing other hazardous activities. Topamax may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Alcohol should be avoided while taking Topamax. Alcohol may cause increased sedation or drowsiness. It may also increase the risk of having a seizure.
• Unless otherwise directed by your doctor, drink several extra glasses of fluid each day during treatment with Topamax to minimize the risk of side effects such as kidney stone formation and metabolic acidosis (a decrease in a certain electrolyte in the body). Additional fluid may be necessary during hot weather, vigorous exercise, and illness (e.g., fever, vomiting, diarrhea).
• Decreased sweating and high body temperature have been associated with the use of Topamax. These side effects may be dangerous. Avoid becoming overheated in hot weather and during vigorous exercise, monitor sweating, and drink plenty of fluid to maintain hydration. If sweating is decreased or body temperature is elevated, contact your doctor.

What is Topamax?

• The exact way that Topamax works is unknown. However, it is believed that Topamax alters the chemical impulses in the brain that cause seizures.
• Topamax is used with other medications to control seizures. Topamax is also used to prevent migraine headaches.
• Topamax may also be used for purposes other than those listed in this medication guide.

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

• Before taking Topamax, tell your doctor if you
  • have kidney disease or a history of kidney stones;
  • have liver disease;
  • have lung or respiratory disease such as asthma, emphysema, or bronchitis; or
  • need to have surgery.
• You may not be able to take Topamax, or you may require a dosage adjustment or special monitoring during treatment
• Topamax is in the FDA pregnancy category C. This means that it is not known whether Topamax will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or if you could become pregnant during treatment.
• It is not known whether Topamax passes into breast milk. Do not take Topamax without first talking to your doctor if you are breast-feeding a baby.

How should I take Topamax?

• Take Topamax exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose of Topamax with a full glass of water.
• The tablets should be swallowed whole. Due to their bitter taste, the tablets should not be broken.
• The capsules may be swallowed whole or opened to facilitate swallowing. If the capsules are opened, the entire contents of the capsule should be sprinkled onto a small amount (teaspoon) of soft food (e.g., applesauce, custard, ice cream, oatmeal, pudding, yogurt). This drug/ food mixture should be swallowed immediately, without chewing. The mixture should not be stored for future use. If the mixture is combined in a small container, add some water to the container after the dose has been taken, and drink the water to ensure the whole dose has been taken.
• Topamax can be taken with or without food.
• It is important to take Topamax regularly to get the most benefit.
• Carry or wear a medical identification tag to let others know that you are taking this medicine in the case of an emergency.
• Do not stop taking Topamax without first talking to your doctor, even if your symptoms have improved. It is important to continue taking Topamax to prevent seizures from recurring.
• Unless otherwise directed by your doctor, drink several extra glasses of fluid each day during treatment with Topamax to minimize the risk of side effects such as kidney stone formation and metabolic acidosis (a decrease in a certain electrolyte in the body). Additional fluid may be necessary during hot weather, vigorous exercise, and illness (e.g., fever, vomiting, diarrhea).
• Your doctor may want you to have blood tests or other medical evaluations during treatment with Topamax to monitor progress and side effects.
• Store Topamax at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical treatment if an overdose is suspected.
• Symptoms of a Topamax overdose are not known but may include severe drowsiness, poor coordination, tremor, confusion, difficulty speaking, and nausea.

What should I avoid while taking Topamax?

• Use caution when driving, operating machinery, or performing other hazardous activities. Topamax may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Alcohol should be avoided while taking Topamax. Alcohol may cause increased sedation or drowsiness. It may also increase the risk of having a seizure.
• Unless otherwise directed by your doctor, drink several extra glasses of fluid each day during treatment with Topamax to minimize the risk of side effects such as kidney stone formation and metabolic acidosis (a decrease in a certain electrolyte in the body). Additional fluid may be necessary during hot weather, vigorous exercise, and illness (e.g., fever, vomiting, diarrhea).
• Ketogenic diets (high protein, very low carbohydrate diets that may induce ketosis) may increase the risk of kidney stone formation and should be avoided during treatment with Topamax.
• Decreased sweating and high body temperature have been associated with the use of Topamax. These side effects may be dangerous. Avoid becoming overheated in hot weather and during vigorous exercise, monitor sweating, and drink plenty of fluid to maintain hydration. If sweating is decreased or body temperature is elevated, contact your doctor.
• Tell your doctor and dentist that you are taking Topamax before having any type of surgery.

What are the possible side effects of Topamax?

• Seek immediate medical attention if you experience blurred vision, changes in vision, or pain in or around the eyes during treatment with Topamax. These may be early signs of a serious side effect.
• If you experience any of the following serious side effects, stop taking Topamax and seek emergency medical attention or contact your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
  • worsening of seizures;
  • metabolic acidosis (a high acidity of the blood that may be detected by blood tests). Symptoms of metabolic acidosis include increased rate of breathing, decreased appetite, and irregular heartbeats;
  • decreased sweating;
  • fever or increased body temperature; or
  • side or low back pain, or painful or difficult urination (may indicate kidney stones).
• Other, less serious side effects may be more likely to occur. Continue to take Topamax and talk to your doctor if you experience
  • dizziness, poor coordination, sluggishness, or drowsiness;
  • irregular back-and-forth movements of the eyes;
  • nausea, decreased appetite, or weight loss;
  • tremor, numbness, or tingling;
  • confusion, difficulty concentrating or decreased memory;
  • speech or language difficulties; or
  • changes in behavior, depression, nervousness, or agitation.
• 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 Topamax?

• Before taking Topamax, tell your doctor if you are taking any of the following medicines:
  • another seizure medication such as valproic acid (Depakote, Depakene), carbamazepine (Tegretol, Carbatrol, Epitol), phenytoin (Dilantin), and others;
  • a carbonic anhydrase inhibitor such as acetazolamide (Diamox), methazolamide (Neptazane), or dichlorphenamide (Daranide);
  • metformin (Glucophage, Fortamet); or
  • digoxin (Lanoxin, Lanoxicaps).
• You may not be able to take Topamax, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the drugs listed above.
• Topamax may decrease the effectiveness of certain birth control pills. Talk to your doctor about other birth control options to prevent unintended pregnancy.
• Topamax may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, pain relievers, sedative (sleep aids), anxiety medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if Topamax is taken with any of these medications.
• Drugs other than those listed here may also interact with Topamax. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

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.

Neurontin (Generic name: Gabapentin)

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

• If you are taking Neurontin for seizures, do not stop taking Neurontin even if you feel better. It is important to continue taking the medication to prevent seizures from recurring.
• Carry or wear a medical identification tag to let others know that you are taking this medicine in the case of an emergency.
• Use caution when driving, operating machinery, or performing other hazardous activities. Neurontin may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

What is Neurontin?

• Neurontin affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain. The exact way that it works is unknown.
• Neurontin is used with other drugs in the treatment of some types of seizures and for the management of postherpetic neuralgia (nerve pain caused by the herpes virus or shingles).
• Neurontin may also be used for purposes other than those listed in this medication guide.

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

• Before taking this medication, tell your doctor if you have any other medical conditions, especially kidney, liver, or heart disease. Also discuss any medicines that you take, including over-the-counter preparations.
• Neurontin is in the FDA pregnancy category C. This means that it is not known whether Neurontin will be harmful to an unborn baby. Do not take Neurontin without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• Neurontin passes into breast milk. Do not take Neurontin without first talking to your doctor if you are breast-feeding a baby.

How should I take Neurontin?

• Take Neurontin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose of Neurontin with a full glass of water.
• Neurontin can be taken with or without food.
• To ensure you get the correct dose, measure the Neurontin oral solution with a dose-measuring cup or spoon, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
• Carry or wear a medical identification tag to let others know that you are taking this medicine in the case of an emergency.
• Do not stop taking Neurontin without talking to your doctor. Suddenly stopping Neurontin may cause side effects.
• If you are taking Neurontin for seizures, do not stop taking Neurontin even if you feel better. It is important to continue taking the medication to prevent seizures from recurring.
• Store Neurontin tablets and capsules at room temperature away from moisture and heat.
• Store the Neurontin oral solution in the refrigerator.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if several hours have passed and it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of the medication to catch up.

What happens if I overdose?

• Seek emergency medical treatment.
• Symptoms of a Neurontin overdose include double vision, drowsiness, slurred speech, diarrhea, poor coordination, and difficulty breathing.

What should I avoid while taking Neurontin?

• Use caution when driving, operating machinery, or performing other hazardous activities. Neurontin may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Avoid alcohol during treatment with Neurontin. Alcohol may increase the risk of having side effects while taking Neurontin.

What are the possible side effects of Neurontin?

• If you experience any of the following serious side effects, stop taking Neurontin and seek medical attention or contact your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives).
• Other, less serious side effects may be more likely to occur. Continue to take Neurontin and talk to your doctor if you experience
  • dizziness, poor coordination, or drowsiness;
  • blurred or double vision;
  • irregular back and forth movements of the eyes;
  • nausea and vomiting; or
  • tremor.
• If children 3 to 12 years of age experience any of the following serious side effects, contact your doctor immediately
  • emotional lability (anxiety, behavior problems, crying, false sense of well-being, mental depression, reacting too quickly, too emotionally, or overreacting, rapidly changing moods);
  • hostility (aggressive behavior, suspiciousness, or distrust);
  • restlessness, hyperactivity or increase in body movements;
  • amnesia (loss of memory);
  • thought disorders (concentration problems and change in school performance).
• 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 Neurontin?

• Neurontin does not interact with other commonly used antiseizure medications.
• Antacids will decrease the amount of Neurontin that is absorbed in the stomach. Do not take Neurontin for at least 2 hours after a dose of antacid.
• Neurontin may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants.
• Drugs other than those listed here may also interact with Neurontin or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Lamictal (Generic name: Lamotrigine)

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

• In rare cases, Lamictal has been associated with severe and/ or life-threatening rashes and hypersensitivity reactions. Seek emergency medical attention or contact your doctor immediately if you develop any skin rash; fever; hives; swelling of the lips, tongue, or face; sores in the mouth or around the eyes; or swollen lymph glands.
• Seek emergency medical attention or contact your doctor immediately if you experience increasing frequency or worsening of seizures during treatment with Lamictal.
• Do not stop taking Lamictal without first talking to your doctor, even if you feel better. It is important to continue taking Lamictal to prevent symptoms from recurring. Stopping Lamictal suddenly may result in increased seizure frequency or a return of symptoms of bipolar disorder. If the medication needs to be stopped, your doctor may need to lower the dosage gradually.
• Carry or wear a medical identification tag to let others know that you are taking this medicine in the case of an emergency.
• Lamictal may cause drowsiness, dizziness, blurred vision, or poor coordination. Do not drive, operate dangerous machinery, or perform other hazardous activities until you know how Lamictal affects you. If you experience drowsiness, dizziness, blurred vision, or poor coordination, avoid these activities.

What is Lamictal?

• The exact way that Lamictal works is unknown. However, it is believed that Lamictal affects chemicals in the brain involved in seizures and in bipolar disorder.
• Lamictal is used alone or in combination with other medications in the treatment of seizures. Lamictal is also used in the treatment of bipolar disorder.
• Lamictal may also be used for purposes other than those listed in this medication guide.

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

• In rare cases, Lamictal has been associated with severe and/ or life-threatening rashes and hypersensitivity reactions. Seek emergency medical attention or contact your doctor immediately if you develop any skin rash; fever; hives; swelling of the lips, tongue, or face; sores in the mouth or around the eyes; or swollen lymph glands.
• Before taking Lamictal, tell your doctor if you have heart, liver, or kidney disease or other serious medical problems. You may not be able to take Lamictal, or you may require a dosage adjustment or special monitoring during treatment.
• Do not start or stop using birth control pills or other female hormonal products until you have consulted your doctor. Tell your doctor as soon as possible if you experience changes in your menstrual pattern (e.g., break-through bleeding) while taking Lamictal and birth control pills or other female hormonal products.
• Lamictal is in the FDA pregnancy category C. This means that it is not known whether Lamictal will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• Lamictal passes into breast milk and may affect a nursing infant. Do not take Lamictal without first talking to your doctor if you are breast-feeding a baby.

How should I take Lamictal?

• Take Lamictal exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each oral dose of Lamictal with a full glass of water.
• Swallow the regular (nonchewable) Lamictal tablets whole. The tablets may have a very bitter taste if chewed, crushed, or broken.
• The chewable, dispersible tablets can be swallowed whole, chewed, or mixed in water or diluted fruit juice. If you chew these tablets, drink a small amount of water or diluted fruit juice to aid in swallowing. To disperse these tablets, add the tablet(s) to a small amount of liquid (1 teaspoon or enough to cover the medication) in a glass or spoon. Approximately 1 minute later, when the tablet is completely dispersed, mix the solution and take the entire amount immediately.
• Lamictal can be taken with or without food.
• It is important to take Lamictal regularly to get the most benefit.
• The dose of Lamictal must be increased slowly. It may be several weeks or months before the optimal dose can be determined.
• Do not stop taking Lamictal without first talking to your doctor, even if you feel better. It is important to continue taking Lamictal to prevent symptoms from recurring. Stopping Lamictal suddenly may result in increased seizure frequency or a return of symptoms of bipolar disorder. If the medication needs to be stopped, your doctor may need to lower the dosage gradually.
• If treatment with Lamictal is stopped for any reason, contact your doctor before restarting the medication. A lower dose may be needed to prevent side effects from occurring.
• Do not take more of this medication than is prescribed by your doctor.
• Your doctor may want you to have blood tests or other medical evaluations during treatment with Lamictal to monitor progress and side effects.
• Carry or wear a medical identification tag to let others know that you are taking this medicine in the case of an emergency.
• Store this medication at room temperature away from light and moisture.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical treatment.
• Symptoms of a Lamictal overdose include dizziness, drowsiness, headache, increased seizures, and unconsciousness.

What should I avoid while taking Lamictal?

• Lamictal may cause drowsiness, dizziness, blurred vision, or poor coordination. Do not drive, operate dangerous machinery, or perform other hazardous activities until you know how Lamictal affects you. If you experience drowsiness, dizziness, blurred vision, or poor coordination, avoid these activities.

What are the possible side effects of Lamictal?

• In rare cases, Lamictal has been associated with severe and/ or life-threatening rashes and hypersensitivity reactions. Seek emergency medical attention or contact your doctor immediately if you develop any skin rash; fever; hives; swelling of the lips, tongue, or face; sores in the mouth or around the eyes; or swollen lymph glands.
• Seek emergency medical attention or contact your doctor immediately if you experience increasing frequency or worsening of seizures during treatment with Lamictal.
• Other, less serious side effects may be more likely to occur. Continue to take Lamictal and talk to your doctor if you experience
  • dizziness or drowsiness;
  • blurred or double vision;
  • nausea and vomiting;
  • headache; or
  • lack of coordination.
• 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 Lamictal?

• Lamictal interacts with many other drugs used to treat seizures. Before taking Lamictal, tell your doctor about all other medications you are taking. You may require a dosage adjustment or special monitoring during treatment if you are taking Lamictal alone or with other medications to treat seizures. Continue to take all medications prescribed to treat seizures exactly as directed.
• Birth control pills may decrease the amount of Lamictal in the body. A dosage adjustment may be necessary if birth control pills are started or stopped during treatment with Lamictal.
• Lamictal may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if Lamictal is taken with any of these medications.
• Drugs other than those listed here may also interact with Lamictal. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.