Tegretol
carbamazepin \ المادة الفعالة
مضاد للتشنجات
tegretol 200 mg ( 20 tab ) >>> 11 L.E
tegretol CR 200 mg ( 20 tab ) >>> 16 L.E
tegretol CR 400 mg ( 10 tab ) >>> 12 L.E
tegretol 100 mg / 5 ml ( syrup ) >>> 8 L.E
Class of drug: Anticonvulsant, analgesic.
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Mechanism of action:
Anticonvulsant action: blocks polysynpatic transmission by inhibiting influx of sodium ions across thecell membrane.
Analgesic action: blocks polysynpatic transmission within the CNS. Also has anticholinergic, antidiuretic, antiarrythmic, muscle relaxant properties.
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Indications/dosage/route: Oral only.
• Epilepsy: tonic–clonic, partial seizures with complex symptoms (psychomotor or temporal lobe seizures)
Ð Adults, children >12 years: Initial: 200 mg b.i.d.; increase dose weekly by 200 mg/d maximum. Maintenance: 800–1200 mg/d.
Maximum: 1600 mg/d.
Ð Children 6–12 years: Initial: 100 mg b.i.d.; increase dose
weekly by 100 mg/d. Maintenance: 400–800 mg/d. Maximum:
1000 mg/d.
• Trigeminal neuralgia (unlabeled use)
Ð Adults: Initial: 100 mg b.i.d. Maintenance: 200 mg–1.2 g/d.
Maximum: 1.2 g/d.
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Adjustment of dosage
• Kidney disease: creatinine clearance <10 mL/min: 75% of standard dose.
• Liver disease: None.
• Elderly: Reduce dose and monitor carefully.
• Pediatric: Safety and efficacy have not been established in children<6 years.
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Food: Should be taken with food to prevent GI upset.
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Pregnancy: Category C. Should be continued during pregnancy if favorable benefits versus risk.
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Lactation: Present in breast milk. Considered compatible by American Academy of Pediatrics. Should be continued during lactation if favorable benefits versus risk.
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Contraindications: Bone marrow depression, use of MAO inhibitor within 14 days, cross-sensitivity with tricyclic antidepressants, hypersensitivity to carbamazepine.
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Warnings/precautions
• Use with caution in patient with the following conditions: mixed type seizures, liver and cardiac disease.
• Carbamazepine should be discontinued if WBC is <3000 and neutrophils <=1500.
• Abrupt withdrawal may precipitate seizures.
• Aplastic anemia and agranulocytosis are significant risks in using carbamazepine.
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Advice to patient
• To minimize possible photosensitivity reaction, apply adequate sunscreen and use proper covering when exposed to strong sunlight.
• If you are receiving an oral contraceptive, use an alternative method of birth control.
• Avoid alcohol and other CNS depressants such as opiate analgesics and sedatives (eg, diazepam) when taking this drug.
• Avoid driving and other activities requiring mental alertness or that are potentially dangerous until response to drug is known.
• Notify dentist or treating physician prior to surgery if taking this medication.
• Do not stop taking this drug without consulting treating physician.
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Adverse reactions
• Common: drowsiness, dizziness, ataxia, confusion, nausea, vomiting, rash, blurred vision, nystagmus.
• Serious: worsening of seizures, bone marrow depression (including aplastic anemia), hepatitis, Stevens–Johnson syndrome, toxic
epidermal necrolysis, CHF, heart block, arrhythmia.
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Clinically important drug interactions
• Drugs that increase effects/toxicity of carbamazepine: isoniazid, cimetidine, diltiazem, verapamil, erythromycin, propoxyphene,
danazol.
• Drugs that decrease effects/toxicity of carbamazepine: phenobarbital, phenytoin, primidone, theophylline.
• Carbamazepine increases effects/toxicity of following: primidone, clomipramine, lithium, phenytoin.
• Carbamazepine decreases effects/toxicity of following: phenytoin,
warfarin, doxycycline, theophylline, alprazolam, rifampin,
cisplatin, oral contraceptives, cyclosporine, clonazepam, valproic acid.
مواضيع مشابهة
الأقسام: أدوية هامة
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