Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Carbamazepine.
Anemia: Carbamazepine may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia), such as shortness of breath, feeling unusually tired or pale skin, contact your doctor as soon as possible.
Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.
Birth control: Carbamazepine, like other anticonvulsants, may reduce the effectiveness of birth control pills. Women taking carbamazepine should use an alternative, non-hormonal birth control method such as condoms. If you become pregnant while taking Carbamazepine, contact your doctor immediately.
Bleeding: Carbamazepine may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.
Bone strength: Long term use of antiepileptics has been associated with a risk of weakened or brittle bones. If you have Osteoporosis, are at risk for developing osteoporosis, or have a history of disease affecting your bones, discuss with your doctor how Carbamazepine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Carbamazepine, and whether any special monitoring is needed.
Cancer: Some studies indicate a possible risk of developing cancer with long term use of carbamazepine. Discuss the potential benefits and possible risks of taking Carbamazepine with your doctor.
Depression: Carbamazepine has been known to cause mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how Carbamazepine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Carbamazepine, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking Carbamazepine, contact your doctor as soon as possible.
Drowsiness/reduced alertness: Carbamazepine may cause dizziness and drowsiness. People taking carbamazepine should avoid operating hazardous machinery (including cars) until they are certain that the medication does not affect their mental alertness, judgment, or physical coordination.
Heart disease: If you have Coronary Artery Disease, organic heart disease, or Congestive Heart Failure, discuss with your doctor how Carbamazepine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Carbamazepine, and whether any special monitoring is needed.
Hypersensitivity syndrome: A Anaphylaxis (severe allergic reaction) called hypersensitivity syndrome has occurred for some people with the use of carbamazepine. This reaction involves a number of organs in the body and may be fatal if not treated quickly. Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.
Glaucoma: Carbamazepine may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how Carbamazepine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Carbamazepine, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking Carbamazepine.
Periodic eye examinations are recommended for people who take Carbamazepine.
Infection: Carbamazepine can reduce the number of cells that fight infection in the body (white blood cells). If you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness, contact your doctor. Let your doctor know if you are experiencing more frequent infections than normal. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.
Kidney function: If you have Kidney Disease or decreased kidney function, discuss with your doctor how Carbamazepine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Carbamazepine, and whether any special monitoring is needed.
Liver function: Carbamazepine can cause decreased liver function and may cause liver failure. If you have liver problems, discuss with your doctor how Carbamazepine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Carbamazepine, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Carbamazepine.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Lupus: In rare cases, carbamazepine can cause lupus. If you experience symptoms such as fever, facial rash or joint pain, or your lupus symptoms worsen while taking Carbamazepine, contact your doctor.
Neuroleptic malignant syndrome (NMS): Carbamazepine, like other medications used to treat some psychiatric illnesses, can cause a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS). If you notice the symptoms of NMS such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, or fainting, get immediate medical attention.
Psychiatric issues: Carbamazepine may activate certain mental disorders or cause confusion and agitation for seniors. When used to treat bipolar disorder, some people have experienced worsening of their symptoms of depression, feeling unlike themselves, or they may want to hurt themselves or others. People should be closely monitored by their doctor for emotional and behavioural changes.
Skin reactions: Although uncommon, carbamazepine has been linked to serious skin reactions. If you experience symptoms of a serious skin reaction (such as skin rash; redness of the skin; skin peeling; or blisters on the lips, eyes, or mouth) with fever, chills, headache, cough, or body aches, contact your physician immediately.
Stopping the medication: Suddenly stopping carbamazepine can cause seizures. Before stopping Carbamazepine, discuss with your doctor how you should gradually reduce the dose.
Suicidal thoughts and behaviour: Some people taking anti-seizure medications may have suicidal thoughts or behaviour. If this happens to you or you notice this in a family member who is taking Carbamazepine, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking Carbamazepine.
Low Thyroid hormones: Carbamazepine can cause thyroid hormones to be removed from the body more quickly than usual. This is most noticeable if you take thyroid replacement therapy. If you have an underactive thyroid, discuss with your doctor how Carbamazepine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Carbamazepine, and whether any special monitoring is needed. Your doctor may want to test your thyroid function with blood tests when you first start taking carbamazepine.
Pregnancy: Women with Epilepsy who are pregnant or intend to become pregnant need special care. The potential benefits of carbamazepine must be weighed against its risks, particularly during the first 3 months of pregnancy. If needed to prevent major seizures, do not stop taking the medication. Usually, women with epilepsy who are pregnant should be treated with only one medication to prevent seizures.
Additional folic acid supplementation may be advisable for women taking carbamazepine, as Carbamazepine may contribute to a lack of folic acid in the body. Talk to your doctor about the benefits and risks of using carbamazepine during pregnancy.
Breast-feeding: Carbamazepine passes into breast milk. If you are a breast-feeding mother and are taking carbamazepine, it may affect your baby. If a mother taking carbamazepine breast-feeds her infant, the infant must be observed for possible side effects (e.g., drowsiness or skin rash). The benefits of breast-feeding should be weighed against the possible risks to the infant. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using carbamazepine to treat trigeminal neuralgia or psychiatric disorders in children have not been established. The use of Carbamazepine for these conditions in this age group is not recommended.
Seniors: People over the age of 65 years may require lower doses of Carbamazepine.
