Tegretol - Instructions For Use, Price, Reviews, Analogues, Tablets

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Tegretol

Tegretol: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation
10. 10. In case of impaired renal function
11. 11. For violations of liver function
12. 12. Use in the elderly
13. 13. Drug interactions
14. 14. Analogs
15. 15. Terms and conditions of storage
16. 16. Terms of dispensing from pharmacies
17. 17. Reviews
18. 18. Price in pharmacies

Latin name: Tegretol

ATX code: N03AF01

Active ingredient: carbamazepine (carbamazepine)

Producer: Novartis Pharma (Switzerland)

Description and photo update: 2019-26-08

Prices in pharmacies: from 294 rubles.

Buy

Tegretol is a drug with antiepileptic action, which also has psychotropic and neurotropic effects.

Release form and composition

Dosage forms of release:

• syrup: white, viscous, has a caramel smell (in dark glass bottles of 100 ml, 1 bottle in a cardboard box, complete with a dosing spoon);
• tablets: flat, white, beveled; 200 mg each - round, marking on one side - CG, on the other - G / K, risk on one side; 400 mg - rod-shaped, marking on one side - LR / LR, on the other - CG / CG, on both sides of the risk (10 pcs. in blisters, 3 or 5 blisters in a cardboard box).

The cardboard box also contains instructions for the use of Tegretol.

Composition of 5 ml syrup:

• active substance: carbamazepine - 100 mg;
• auxiliary components: macrogol stearate - 100 mg, caramel flavor - 50 mg, hydroxyethyl cellulose (hyetellose) - 500 mg, sodium saccharinate - 40 mg, liquid sorbitol - 25,000 mg, propylene glycol - 2.5 mg, RC 581 avicel (microcrystalline cellulose + carmellose sodium) - 1000 mg, methylparaben (methyl parahydroxybenzoate) - 120 mg, sorbic acid - 100 mg, propylparaben (propyl parahydroxybenzoate) - 30 mg, purified water - in sufficient quantity.

Composition of 1 tablet:

• active substance: carbamazepine - 200 or 400 mg;
• auxiliary components (200/400 mg): magnesium stearate - 3/6 mg, sodium carmellose - 10/20 mg, microcrystalline cellulose - 65/130 mg, colloidal silicon dioxide - 2/4 mg.

Pharmacological properties

Pharmacodynamics

Tegretol is one of the antiepileptic drugs, it is a dibenzodiazepine derivative. In addition to antiepileptic action, the drug also has psychotropic and neurotropic properties.

As an antiepileptic agent, the use of carbamazepine is effective in the treatment of focal (partial) simple / complex epileptic seizures that occur with / without secondary generalization, generalized tonic-clonic epileptic seizures, as well as with a combination of these types of seizures.

During clinical trials, it was found that with Tegretol monotherapy in patients with epilepsy (especially in the case of use in pediatric practice), the psychotropic effect of carbamazepine is noted, which, in particular, manifests itself in a positive effect on the symptoms of depression and anxiety, as well as in reducing aggressiveness and irritability. … According to a number of studies, the effect of Tegretol on psychomotor performance and cognitive function is dose-dependent and is of questionable or negative nature. Other studies have noted a positive effect of carbamazepine on attention, memorization and learning.

Tegretol, as a neurotropic agent, is effective in a number of neurological diseases. In particular, it helps prevent pain attacks in idiopathic / secondary trigeminal neuralgia. In addition, the use of carbamazepine is justified in order to alleviate neurogenic pain in a variety of conditions, including tabes, post-traumatic paresthesias and postherpetic neuralgia. In patients with alcohol withdrawal syndrome, carbamazepine helps to increase the seizure threshold (in this condition, it is usually reduced) and to reduce the severity of clinical manifestations of the syndrome (in the form of excitability, tremor, gait disturbances). Thanks to Tegretol therapy, in patients with diabetes insipidus of central genesis, there is a decrease in urine output and a feeling of thirst.

As a psychotropic agent, the use of Tegretol is effective in patients with affective disorders, namely in the treatment of acute manic conditions, for the maintenance therapy of bipolar affective (manic-depressive) disorders (as monotherapy or in combination with lithium preparations, antidepressants or neuroleptic drugs), in the treatment schizoaffective and manic psychosis (where it is used simultaneously with neuroleptics), acute polymorphic schizophrenia (rapid cycling episodes).

The mechanism of action of Tegretol is based on the blockade of voltage-dependent sodium channels, due to which the membranes of overexcited neurons are stabilized, the occurrence of serial neuronal discharges is inhibited and the synaptic conduction of impulses is reduced.

The anticonvulsant effect of carbamazepine is mainly due to the stabilization of neuronal membranes and a decrease in the release of glutamate, a decrease in the activity of the excitatory neurotransmitter amino acid glutamate, since glutamate is the main mediator, there is no data on the role of aspartate.

Tegretol increases the reduced seizure threshold of the central nervous system, thereby reducing the likelihood of an epileptic seizure. The increased conductivity of potassium, as well as the modulation of calcium channels, which is activated by the high potential of the membrane, can contribute to the anticonvulsant effect of the drug. Carbamazepine eliminates epileptic personality changes and, as a result, increases the communication skills of patients and contributes to their social rehabilitation.

Tegretol can be prescribed as the main therapeutic agent or used in combination with other drugs with an anticonvulsant effect.

Pharmacokinetics

After oral administration, carbamazepine is absorbed almost completely, although rather slowly. C _max (maximum concentration of the substance) after a single dose of a regular tablet is reached in 12 hours. After the use of various dosage forms of Tegretol for oral administration, clinically significant differences in the degree of absorption of the active substance are not observed. After a single oral intake of 400 mg of carbamazepine, the average C _{max of the} active substance unchanged is approximately 0.004 5 mg / ml.

After a single / repeated oral administration of retard tablets, the time to reach C _max is within 24 hours, its value is 25% less than when taking a conventional tablet. Daily fluctuations in the plasma concentration of carbamazepine when taking retard tablets are less pronounced, while there is no significant decrease in the minimum value of C _ss (equilibrium concentration of the substance). When taking Tegretol in the form of retard tablets 2 times a day, fluctuations in the concentration of the active ingredient in the plasma are insignificant. The bioavailability of carbamazepine with retard tablets is approximately 15% lower than that of other dosage forms of the drug.

Food intake does not significantly affect the degree and rate of absorption of carbamazepine, no matter what dosage form of Tegretol is used.

Plasma C _{ss of} carbamazepine are achieved in the range of 1–2 weeks. The value of this indicator is determined by the individual characteristics of metabolism (autoinduction of liver enzyme systems with carbamazepine, heteroinduction with other simultaneously used drugs), as well as the patient's condition, dose of Tegretol and duration of therapy. There are significant interindividual differences in the C _ss index in the therapeutic range: in most cases, these values vary from 0.004 to 0.012 mg / ml (17-50 μmol / l). The concentrations of the pharmacologically active metabolite (carbamazepine-10,11-epoxide) are approximately 30% of the concentration of the substance.

The level of binding of carbamazepine to blood plasma proteins is 70–80%. The concentration in the cerebrospinal fluid and saliva of the unchanged substance is proportional to the proportion of carbamazepine not associated with proteins (from 20 to 30%). The concentration of the substance in breast milk is in the range of 25-60% of its plasma level.

Carbamazepine crosses the placental barrier. If the absorption of the substance is considered complete, the apparent V _d (volume of distribution) is from 0.8 to 1.9 l / kg.

The metabolism of carbamazepine occurs in the liver, mainly through the epoxy pathway, with the formation of the main metabolites - 10,11-transdiol derivative and its conjugate with glucuronic acid. The main isoenzyme that provides the biotransformation of carbamazepine to carbamazepine-10,11-epoxide is CYP3A4. As a result of these metabolic reactions, the formation of a low-activity metabolite 9-hydroxy-methyl-10-carbamoylacridane also occurs.

T _1/2 (half-life) of unchanged carbamazepine after a single dose of Tegretol orally averages about 36 hours, and after repeated doses - from 16 to 24 hours (associated with autoinduction of the liver monooxygenase system, the value of the indicator depends on the duration of therapy). In the case of combined treatment with the use of drugs that induce the same liver enzyme system (in particular, with phenytoin, phenobarbital), T _{1/2 of the} substance averages 9-10 hours.

After a single oral administration of 400 mg of carbamazepine, 72 and 28% of the dose taken are excreted in urine and feces, respectively. Approximately 2% of the dose is excreted in the urine as an unchanged substance, approximately 1% as a pharmacologically active 10,11-epoxy metabolite, about 30% as final metabolites formed by the epoxy metabolism.

Children may need to use higher doses of Tegretol per kg of body weight compared to adults, which is associated with faster elimination of the substance.

Indications for use

• epilepsy: generalized tonic-clonic epileptic seizures, simple or complex partial epileptic seizures (with / without loss of consciousness) with / without secondary generalization, mixed forms of epileptic seizures; in the treatment of myoclonus epilepsy and absences, Tegretol is usually not prescribed (the drug is ineffective);
• alcohol withdrawal syndrome;
• maintenance therapy of bipolar affective disorders and acute manic states (prevention of exacerbations or weakening of the clinical manifestations of exacerbations);
• idiopathic glossopharyngeal neuralgia;
• neuralgia / idiopathic trigeminal neuralgia with multiple sclerosis (atypical / typical).

Contraindications

Absolute:

• atrioventricular block;
• burdened history of inhibition of bone marrow hematopoiesis;
• hepatic porphyrias, including tardive cutaneous, acute intermittent and variegated porphyrias;
• intolerance to fructose (for syrup, since sorbitol is part of the drug);
• combined use with monoamine oxidase inhibitors (structurally similar to tricyclic antidepressants);
• individual intolerance to the components of the drug, as well as hypersensitivity to chemically similar drugs to carbamazepine (for example, tricyclic antidepressants).

Relative (the use of Tegretol requires caution in the presence of the following diseases / conditions):

• aggravated history of heart disease (including decompensated chronic heart failure), kidney / liver disease (including renal / hepatic failure), adverse hematological reactions to other drugs, or the presence of data on the cancellation of previous therapy with Tegretol (prescribing the drug is possible after a thorough assessment of the ratio between the expected benefit of therapy and the likely risk, with the provision of regular monitoring of the patient's condition);
• dilutional hyponatremia, hypothyroidism;
• mixed forms of epileptic seizures, including atypical / typical absence, given the possible increase in seizures;
• increased intraocular pressure and prostatic hyperplasia, given the weak M-anticholinergic activity of carbamazepine;
• pregnancy and lactation;
• old age (it is necessary to take into account the likelihood of drug interactions and the different pharmacokinetics of drugs with antiepileptic action).

It should be borne in mind that the syrup contains parahydroxybenzoate, which can lead to allergic reactions (including those delayed in time).

If it is necessary to use Tegretol in pregnant women, as well as if pregnancy was diagnosed during the period of therapy, or when planning a pregnancy, it is necessary to carefully assess the expected benefits and possible risks, especially in the first trimester of pregnancy.

In women of childbearing period, with sufficient clinical efficacy, Tegretol in the minimum effective dose is recommended to be used as monotherapy, which reduces the incidence of congenital fetal anomalies in comparison with combined antiepileptic treatment, especially simultaneously with valproate.

You should not interrupt effective antiepileptic therapy during pregnancy (the progression of the disease can negatively affect the patient and the fetus). Before and during pregnancy, it is recommended to additionally take folic acid, in the last weeks of pregnancy - vitamin K ₁.

Before prescribing Tegretol, nursing women need to compare the expected benefit with the possible risk; during the period of therapy, it is necessary to monitor the condition of the newborn for the timely diagnosis of adverse reactions.

Women of childbearing age should take into account the decrease in the effectiveness of oral contraceptives used in combination with Tegretol.

Tegretol, instructions for use: method and dosage

Tegretol is taken orally. The tablets are taken with a little water. The drug can be taken regardless of food intake.

It is possible to use Tegretol as monotherapy or in combination with other drugs.

It is advisable to take syrup (5 ml - 1 scoop - 100 mg) if it is difficult to swallow or in cases where careful selection of the dose is necessary. When using the syrup, a greater maximum concentration is achieved than when the dose is taken in Tegretol tablet form. In order to avoid the development of adverse reactions, it is recommended to start treatment with small doses, after which they are gradually increased. Shake the syrup bottle before use.

If the patient is transferred from taking tablets to the dosage form of a syrup, the daily dose is not changed, however, it is recommended to reduce the size of a single dose and increase the frequency of Tegretol administration.

Elderly patients need to be very careful when choosing a dosage regimen.

Epilepsy

Tegretol, if possible, should be taken as monotherapy.

At the beginning of the course, a small daily dose is prescribed, which is then slowly increased.

In order to select the optimal dose, it is recommended to determine the plasma concentration of the active substance in the blood (usually 0.004–0.012 mg / ml).

The initial dose of Tegretol for adults and children from 16 years old is 100-200 mg 1-2 times a day, the average optimal dose is 2-3 times a day, 400 mg. Sometimes an increase in the daily dose to 1600-2000 mg is required.

Trigeminal neuralgia

The initial daily adult dose of Tegretol is 200-400 mg, for elderly patients - 200 mg (100 mg 2 times a day). It is gradually increased until the pain disappears, the average dose is 3-4 times a day, 200 mg. The maximum allowable daily dose is 1200 mg. Then the optimal maintenance dose of Tegretol is prescribed.

If the pain syndrome passes, therapy is gradually canceled until the next painful attack occurs.

Alcohol withdrawal syndrome

The average daily dose of Tegretol is 200 mg 3 times a day. In severe cases, the first few days increase it (for example, up to 3 times a day, 400 mg).

Possible combined use with drugs with sedative and hypnotic effects (for example, with chlordiazepoxide, clomethiazole). After resolution of the acute phase, therapy is continued with Tegretol as monotherapy.

Acute Manic Conditions and Supportive Treatment for Bipolar (Affective) Disorders

The average daily dose of Tegretol is from 400 to 600 mg (2-3 divided doses). When treating an acute manic state, the dose is increased quite quickly. With maintenance therapy for bipolar disorder, each subsequent dose increase should be small (to ensure optimal tolerance).

Termination of therapy

Abrupt cessation of taking Tegretol can lead to the development of epileptic seizures, therefore, treatment should be canceled gradually over 6 months or longer.

If it is necessary to quickly cancel treatment in patients with epilepsy, the transition to another drug with an antiepileptic effect should be carried out under the cover of the drug shown in these cases.

The use of Tegretol in children

The main indication for the use of Tegretol in children is epilepsy.

Recommended starting daily doses:

• up to 4 years: from 20 to 60 mg, every other day the dose can be increased by 20-60 mg;
• from 4 years: 100 mg, then the dose can be increased by 100 mg per week.

Maintenance doses are established at the rate of 10-20 mg / kg per day, divided into several doses:

• up to 1 year: 100-200 mg (1-2 doses of syrup);
• 1–5 years: 200–400 mg (1–2 doses of syrup in 2 divided doses);
• 6-10 years: 400-600 mg (2 doses of syrup in 2-3 doses);
• 11-15 years: 600-1000 mg (2-3 doses of syrup in 3 divided doses; when using 1000 mg, you need to increase the dose of syrup by 5 ml);
• from 15 years: from 800 to 1200 (in more rare cases) mg.

Maximum daily doses of Tegretol:

• up to 6 years: 35 mg / kg;
• 6-15 years: 1000 mg;
• from 15 years: 1200 mg.

Since the required amount of reliable information is not available for taking Tegretol for other indications in children, it is recommended to select the drug regimen in accordance with the weight and age of the child, without going beyond the above dosages.

Side effects

Some types of disorders, for example, from the nervous and digestive systems, as well as allergic skin reactions, are observed very often or often, especially at the beginning of Tegretol use, when excessively high initial doses of the drug are prescribed and when used in elderly patients.

Dose-related side effects in most cases disappear within a few days (on their own or after a short dose reduction).

Possible side reactions of Tegretol (> 10% - very common;> 1% and 0.1% and 0.01% and <0.1% - rarely; <0.01%, taking into account individual reports - very rare):

• immune system: rarely - delayed-type multiple organ hypersensitivity with skin rashes, fever, lymphadenopathy, eosinophilia, vasculitis, signs resembling lymphoma, leukopenia, arthralgia, altered liver function and hepatosplenomegaly, destruction of their intrahepatic bile ducts; very rarely - angioedema, anaphylactic reaction, hypogammaglobulinemia (in cases of the development of the above hypersensitivity reactions, therapy is canceled);
• endocrine system: often - weight gain, edema, fluid retention, hyponatremia and decreased blood osmolarity; very rarely - gynecomastia, galactorrhea;
• respiratory system: very rarely - hypersensitivity reactions in the form of fever, shortness of breath, pneumonitis or pneumonia;
• cardiovascular system: rarely - intracardiac conduction disorders, decrease / increase in blood pressure; very rarely - bradycardia, thrombophlebitis, collapse, thromboembolism, arrhythmias, AV block with fainting, exacerbation of ischemic heart disease, chronic heart failure;
• digestive system: very often - nausea, vomiting; often - dry mouth; infrequently - constipation, diarrhea; rarely - abdominal pain; very rarely - stomatitis, glossitis, pancreatitis;
• nervous system: very often - ataxia, dizziness, drowsiness; often - diplopia, headache; infrequently - abnormal involuntary movements, nystagmus; rarely - oculomotor disorders, dyskinesia, speech disorders, choreoathetosis, paresthesia, paresis, peripheral neuropathy; very rarely - neuroleptic malignant syndrome, dysgeusia, aseptic meningitis with peripheral eosinophilia and myoclonus;
• psyche: rarely - auditory / visual hallucinations, depression, agitation, aggression, anxiety, disorientation; very rarely - activation of psychosis;
• skin and subcutaneous tissues: very often - urticaria, allergic dermatitis; infrequently - exfoliative dermatitis; rarely - itching, systemic lupus erythematosus; very rarely - Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, erythema nodosum, photosensitivity reactions, alopecia, skin pigmentation disorders, acne, purpura, sweating, hirsutism;
• blood and lymphatic system: very often - leukopenia; often - eosinophilia, thrombocytopenia; rarely - leukocytosis, lymphadenopathy; very rarely - hemolytic anemia, agranulocytosis, aplastic anemia, reticulocytosis, megaloblastic anemia, anemia, pancytopenia, true erythrocytic aplasia;
• kidneys and urinary tract: very rarely - frequent urination, tubulointerstitial nephritis, renal failure, sexual dysfunction / erectile dysfunction, renal dysfunction, urinary retention, spermatogenesis disturbances;
• liver and biliary tract: rarely - hepatitis of parenchymal, cholestatic or mixed type, destruction of intrahepatic bile ducts, jaundice; very rarely - liver failure, granulomatous liver damage;
• metabolism and nutrition: rarely - folic acid deficiency, decreased appetite; very rarely - acute / mild porphyria;
• connective and musculoskeletal tissue: rarely - muscle weakness; very rarely - disorders of bone metabolism, arthralgia, muscle spasms, myalgia;
• organ of vision: often - violation of accommodation; very rarely - conjunctivitis, lens opacity;
• labyrinth disorders and the organ of hearing: very rarely - hearing disorders;
• instrumental / laboratory data: very often - increased activity of gamma-glutamyltransferase; often - increased activity of blood alkaline phosphatase; infrequently - an increase in transaminase activity; very rarely - an increase in intraocular pressure, cholesterol and triglyceride concentrations, changes in thyroid function indicators, an increase in serum prolactin concentration in the blood;
• general disorders: very often - fatigue.

Adverse reactions based on the results of post-marketing use of Tegretol (with an unknown frequency):

• instrumental / laboratory data: decrease in bone density;
• immune system: drug rash with systemic manifestations and eosinophilia;
• lymphatic system and blood: bone marrow failure;
• parasitic and infectious diseases: reactivation of the herpes simplex virus type 6;
• subcutaneous tissues and skin: acute generalized exanthematous pustulosis, onychomadesis, lichenoid keratosis;
• nervous system: memory impairment, sedation;
• connective and musculoskeletal tissue: fractures;
• gastrointestinal tract: colitis.

Overdose

The main symptoms are:

• cardiovascular system: arterial hypotension, tachycardia; sometimes - syncope, cardiac arrest, hypertension, conduction disturbances with expansion of the QRS complex;
• respiratory system: pulmonary edema, respiratory depression;
• urinary system: fluid or urinary retention, anuria / oliguria, dilution hyponatremia, which is due to the effect of carbamazepine, similar to the effect of antidiuretic hormone;
• digestive system: delayed passage of food from the stomach, vomiting, decreased motility of the colon;
• central nervous system: suppression of the functions of the central nervous system, seizures, myoclonus, mydriasis, hypothermia, psychomotor disorders, agitation, disorientation, drowsiness, hallucinations, coma, slurred speech, blurred vision, dysarthria, nystagmus, dyskinesia, ataxia, hyper- and hyporeflexia at the beginning and later, respectively);
• laboratory parameters: hyponatremia, hyperglycemia, metabolic acidosis, increased muscle fraction of creatinine phosphokinase are possible.

Therapy: measures are selected based on the clinical condition of the patient; hospitalization is indicated. It is necessary to determine the plasma concentration of carbamazepine in order to confirm and assess the degree of poisoning.

Shows the evacuation of the contents of the stomach, gastric lavage, intake of activated carbon. With late evacuation of gastric contents, delayed absorption and re-emergence of symptoms of intoxication during the recovery period are possible. Symptomatic supportive treatment is used in the intensive care unit, including careful correction of electrolyte disorders, monitoring of heart function. The specific antidote for Tegretol is unknown.

Special recommendations:

• cardiac arrhythmias: therapy is selected individually;
• arterial hypotension: intravenous administration of dobutamine / dopamine;
• hyponatremia (water intoxication): restriction of fluid intake (necessary to prevent cerebral edema);
• convulsions: use of anticonvulsants.

It is recommended to carry out hemosorption using carbon sorbents. There is information about the ineffectiveness of forced diuresis, peritoneal dialysis and hemodialysis.

The likelihood of a re-increase in overdose symptoms on the second and third days from the moment of its onset should be foreseen, which is associated with slow absorption of carbamazepine.

special instructions

Tegretol should only be taken under medical supervision.

With mixed forms of epileptic seizures, therapy is carried out with caution; in cases of increased seizures, treatment is canceled.

During the treatment period, a persistent / transient decrease in the number of leukocytes or platelets may develop (as a rule, these disorders are not precursors of the onset of agranulocytosis or aplastic anemia). Before the appointment of Tegretol, as well as periodically during the course, it is necessary to conduct clinical blood tests with counting the number of platelets and, possibly, reticulocytes, as well as determine the serum iron concentration in the blood. If signs of significant bone marrow suppression are detected, the course is interrupted.

If symptoms appear that may suggest the development of severe dermatological reactions, for example, Lyell and Stevens-Johnson syndromes, Tegretol is canceled, an alternative therapy is selected, and, if necessary, the patient is hospitalized.

In cases of hypersensitivity to Tegretol, various reactions may occur, including a drug rash with systemic manifestations and eosinophilia, delayed multiple organ manifestations of hypersensitivity with the development of eosinophilia, arthralgia, lymphadenopathy, fever, vasculitis, rash, pseudolymphoma, leukopenia, changes in liver function syndrome, and destruction of the bile ducts with a decrease in their number (violations can occur in any combination). In addition, damage to other internal organs can be observed, including the lungs, kidneys, pancreas, myocardium, and colon. In such situations, the drug is immediately discontinued.

Careful monitoring of symptoms of suicidal behavior and intentions is required.

Before the appointment of Tegretol and periodically during the period of the therapeutic course, a study of the function of the liver and kidneys should be carried out.

Influence on the ability to drive vehicles and complex mechanisms

When driving and performing work with mechanisms, it is necessary to exercise caution (due to the disease itself and possible adverse reactions of Tegretol, especially at the beginning of treatment and during periods of dose selection).

Application during pregnancy and lactation

Tegretol is prescribed with caution during pregnancy / lactation.

With impaired renal function

With a burdened history of kidney disease, before prescribing Tegretol, the ratio of the expected effect of therapy with the possible risk should be assessed. When prescribing the drug, a regular and careful analysis of the patient's condition should be provided.

For violations of liver function

Before the appointment of Tegretol, as well as during the course of therapy, a study of hepatic function should be carried out, especially in patients with a history of liver disease. If during the period of use of the drug there is an increase in the existing violations, or active diseases of this organ appear, Tegretol is immediately canceled.

Use in the elderly

Elderly patients are prescribed Tegretol with caution. In patients of this category, the recommended initial dose is 100 mg 2 times a day.

Drug interactions

The combined use of Tegretol with monoamine oxidase inhibitors is contraindicated (the recommended interval between the use of these drugs is at least 14 days).

With the simultaneous use of Tegretol with some drugs / substances, the following effects may develop (combinations that should be taken into account):

• isoniazid: increased toxicity;
• levetiracetam: in some cases, increased toxicity of carbamazepine;
• lithium, metoclopramide, antipsychotics: an increase in the incidence of unwanted neurological reactions;
• non-depolarizing muscle relaxants: antagonism of action (dose adjustment may be required; monitoring of the patient's condition is required);
• some drugs with diuretic action: the development of hyponatremia, proceeding with clinical manifestations;
• hormonal contraceptives: a decrease in their effectiveness, the appearance of bleeding between periods;
• alcohol: a decrease in its tolerance (it is recommended to refuse it during the therapy period).

Taking Tegretol can lead to a false-positive result in determining the concentration of perphenazine, carried out by high performance liquid chromatography, as well as tricyclic antidepressants, determined by the method of polarization fluorescence immunoassay.

It should be borne in mind that some drugs / substances may affect the plasma concentration of carbamazepine in the blood (dose adjustment may be required).

Analogs

The analogues of Tegretol are: Karbasan retard, Tegretol CR, Finlepsin, Zeptol, Storilat, Karbapin, Stazepin, Mazepin, Aktinerval, Apo-Carbamazepin, Epial, Zagretol.

Terms and conditions of storage

Store in a dark and dry place at temperatures up to 30 ° C. Keep out of the reach of children.

Shelf life:

• syrup - 3 years;
• tablets - 5 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Tegretol

Reviews about Tegretol are mostly positive. Patients note that they successfully replace their more expensive counterparts. In some cases, the therapeutic effect is insufficient. Side effects are infrequent, with dizziness and drowsiness being the most common.

Price for Tegretol in pharmacies

The approximate price for Tegretol (50 tablets 200 mg each) is 349-399 rubles.

Tegretol: prices in online pharmacies

Drug name Price Pharmacy

Tegretol CR tablets of prolonged action 400mg 30 pcs. 294 r Buy

Tegretol CR 200 mg film-coated tablets of prolonged action 50 pcs. RUB 312 Buy

Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!