Carbamazepine

Summary

Carbamazepine is a drug most commonly used to treat trigeminal neuralgia, but is also prescribed for treating seizures and bipolar disorder. Severe side effects of carbamazepine include agranulocytosis, which presents as a rapid fall in neutrophil counts that puts the patient at risk for developing life-threatening infections. Carbamazepine can also cause a severe rash known as Stevens-Johnson Syndrome, so any signs of a rash should be reported immediately.

Key Points

• Carbamazepine (Tegretol)
  • Mechanism
    • Drug class: Anticonvulsants
      • Blocks sodium channels, stabilizing the rapid firing that occurs during seizure activity
  • Clinical Uses
    • Trigeminal Neuralgia
      • Severe facial pain involving the trigeminal nerve (cranial nerve V)
      • Also used for other neuropathic pain syndromes
    • Seizures
      • Tonic-clonic and partial seizures
    • Bipolar Disorder
  • Side Effects and Adverse Reactions
    • Agranulocytosis
      • Black box warning
      • Low white blood cell count
      • Increased risk of infection
      • Report signs of fever or sore throat
      • Patient will require monthly CBC monitoring
    • Steven-Johnson’s Syndrome
      • Black box warning
      • Report signs of rash
    • Food-drug interactions may cause carbamazepine toxicity
      • Avoid grapefruit juice
      • Avoid benzodiazepines