Carbamazepine

Tegretol, Tegretol XR, Carbatrol, Epitol, Equetro

Antiepileptic • Sodium channel blocker

Premium

NTICNS DepressantHepatotoxic

Half-life

25-65 hours initially, then 12-17 hours (auto-induction)

Protein Binding

76%

Metabolized By

CYP3A4

External

Drugs.com

Boxed warning

Stevens-Johnson syndrome/TEN (HLA-B*1502 screening in Asians)
Aplastic anemia/Agranulocytosis

Clinical alerts

Boxed warning

2 boxed warnings

Narrow therapeutic index

Small dose changes can cause toxicity or loss of effect

Hepatotoxic

Monitor liver function

Anticholinergic

Adds to anticholinergic burden, particularly in older patients

CNS depressant

Additive sedation with other CNS depressants and alcohol

Mechanism of action

Stabilizes neuronal membranes by blocking voltage-sensitive sodium channels

Recorded indications

From the drug index — may include conditions studied rather than approved indications

·Epilepsy — focal and generalised tonic-clonic seizures
·Trigeminal neuralgia
·Bipolar disorder — manic episodes
·Glossopharyngeal neuralgia

Monitoring

Therapeutic range: 4–12 mg/L

Interactions

2 curated · 1 major or contraindicated · select a row for management

Interacting drug	Severity	Effect
rivaroxaban	major	Inadequate anticoagulation; stroke risk in AF patients
rifampicin	moderate	Reduced carbamazepine levels; increased seizure risk.

Common adverse effects

Dizziness
Drowsiness
Ataxia
Nausea
Diplopia
Hyponatremia

Food, alcohol & herbal

Food

Take with food to reduce GI upset

Alcohol · major

Additive CNS depression

Herbal

St. John's Wort (major) — Additive enzyme induction

Pharmacokinetics

Published parameters · PMID:7572096

Half-life: 25-65 hours initially, then 12-17 hours (auto-induction)
Protein binding: 76%
Metabolised by: CYP3A4
Induces: CYP3A4, CYP2C9, CYP2C19, CYP1A2, UGT
Clearance: 5 L/h; adult epilepsy patients (autoinduced)
Volume of distribution: 80 L
Bioavailability: 75%
Renally eliminated: 2%
Model: 1-compartment

Pregnancy & lactation

Not recorded for Carbamazepine. Absence here means this database does not hold a category — not that the drug is safe in pregnancy or breastfeeding.

Sources

Assembled from: drug index, curated drug database, curated interaction pairs, published PK literature.

Not a substitute for clinical judgement

Carbamazepine

Tegretol, Tegretol XR, Carbatrol, Epitol, Equetro

Antiepileptic • Sodium channel blocker

Premium

NTICNS DepressantHepatotoxic

Half-life

25-65 hours initially, then 12-17 hours (auto-induction)

Protein Binding

76%

Metabolized By

CYP3A4

External

Drugs.com

Boxed warning

Stevens-Johnson syndrome/TEN (HLA-B*1502 screening in Asians)
Aplastic anemia/Agranulocytosis

Clinical alerts

Boxed warning

2 boxed warnings

Narrow therapeutic index

Small dose changes can cause toxicity or loss of effect

Hepatotoxic

Monitor liver function

Anticholinergic

Adds to anticholinergic burden, particularly in older patients

CNS depressant

Additive sedation with other CNS depressants and alcohol

Mechanism of action

Stabilizes neuronal membranes by blocking voltage-sensitive sodium channels

Recorded indications

From the drug index — may include conditions studied rather than approved indications

·Epilepsy — focal and generalised tonic-clonic seizures
·Trigeminal neuralgia
·Bipolar disorder — manic episodes
·Glossopharyngeal neuralgia

Monitoring

Therapeutic range: 4–12 mg/L

Interactions

2 curated · 1 major or contraindicated · select a row for management

Interacting drug	Severity	Effect
rivaroxaban	major	Inadequate anticoagulation; stroke risk in AF patients
rifampicin	moderate	Reduced carbamazepine levels; increased seizure risk.

Common adverse effects

Dizziness
Drowsiness
Ataxia
Nausea
Diplopia
Hyponatremia

Food, alcohol & herbal

Food

Take with food to reduce GI upset

Alcohol · major

Additive CNS depression

Herbal

St. John's Wort (major) — Additive enzyme induction

Pharmacokinetics

Published parameters · PMID:7572096

Half-life: 25-65 hours initially, then 12-17 hours (auto-induction)
Protein binding: 76%
Metabolised by: CYP3A4
Induces: CYP3A4, CYP2C9, CYP2C19, CYP1A2, UGT
Clearance: 5 L/h; adult epilepsy patients (autoinduced)
Volume of distribution: 80 L
Bioavailability: 75%
Renally eliminated: 2%
Model: 1-compartment

Pregnancy & lactation

Not recorded for Carbamazepine. Absence here means this database does not hold a category — not that the drug is safe in pregnancy or breastfeeding.

Sources

Assembled from: drug index, curated drug database, curated interaction pairs, published PK literature.

Not a substitute for clinical judgement

Carbamazepine Drug Profile | PharmaGraphX