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Carbamazepine
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PRECAUTIONS
CARBAMAZEPINE
CAS No 298-46-4
Before taking carbamazepine,
* tell your doctor and pharmacist if you are allergic to carbamazepine,
amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil),
desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil),
nortriptyline (Aventyl, Pamelor), other medications for seizures such as
phenobarbital (Luminal, Solfoton) or phenytoin (Dilantin), protriptyline (Vivactil),
trimipramine (Surmontil), or any other medications.
* you should know that carbamazepine is the active ingredient in several
products that have different names and may be prescribed to treat different
conditions. Check the list of brand names at the beginning of this document
carefully. All of the products listed contain carbamazepine and you should
not take more than one of them at the same time.
* do not take carbamazepine if you are taking monoamine oxidase (MAO)
inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil)
selegiline (Eldepryl); and tranylcypromine (Parnate), or have stopped taking
them within the past 2 weeks.
* tell your doctor and pharmacist what other prescription and
nonprescription medications, vitamins, nutritional supplements, and herbal
products you are taking. Be sure to mention any of the following:
acetaminophen (Tylenol); acetazolamide (Diamox); alprazolam (Xanax);
anticoagulants ('blood thinners') such as warfarin (Coumadin);
antidepressants such as amitriptyline (Elavil), bupropion (Wellbutrin, Zyban),
buspirone (BuSpar), citalopram (Celexa), clomipramine (Anafranil),
desipramine (Norpramin), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox),
mirtazapine (Remeron), nortriptyline (Pamelor); antifungals such as
itraconazole (Sporanox) and ketoconazole (Nizoral); cimetidine (Tagamet);
cisplatin (Platinol); clarithromycin (Biaxin); clonazepam (Klonopin);
clozapine (Clozaril); cyclosporine (Neoral, Sandimmune); dalfopristin and
quinupristin (Synercid); danazol (Danocrine); delavirdine (Rescriptor);
diltiazem (Cardizem, Dilacor, Tiazac); doxorubicin (Adriamycin, Rubex);
doxycycline (Vibramycin); erythromycin (E.E.S., E-Mycin, Erythrocin);
felodipine (Plendil); haloperidol (Haldol); HIV protease inhibitors
including atazanavir (Reyataz), indinavir (Crixivan), lopinavir (in Kaletra),
nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Fortovase,
Invirase); isoniazid (INH, Nydrazid); levothyroxine (Levoxyl, Synthroid);
lithium (Lithobid); loratadine (Claritin); lorazepam (Ativan); certain
medications to treat malaria such as chloroquine (Aralen) and mefloquine (Lariam);
medications for anxiety or mental illness; other medications for seizures
such as ethosuximide (Zarontin), felbamate (Felbatol), lamotrigine (Lamictal),
methsuximide (Celontin), oxcarbazepine (Trileptal), phenobarbital (Luminal,
Solfoton), phensuximide (Milontin) (not available in the United States),
phenytoin (Dilantin), primidone (Mysoline), tiagabine (Gabitril),topiramate
(Topamax), and valproic acid (Depakene, Depakote); methadone (Dolophine);
nefazodone; niacinamide (nicotinamide, Vitamin B3); propoxyphene (Darvon);
praziquantel (Biltricide); quinine; rifampin (Rifadin, Rimactane);
sedatives; sleeping pills; terfenadine (Seldane) (not available in the
United States); theophylline (Theobid, Theo-Dur); tramadol (Ultram);
tranquilizers; troleandomycin (TAO); verapamil (Calan, Covera, Isoptin,
Verelan); and zileuton (Zyflo). Many other medications may also interact
with carbamazepine, so be sure to tell your doctor about all the medications
you are taking, even those that do not appear on this list. Your doctor may
need to change the doses of your medications or monitor you carefully for
side effects.
* if you are taking any other liquid medications, do not take them at the
same time as carbamazepine liquid.
* tell your doctor what herbal products you are taking, especially St.
John's wort.
* tell your doctor if you have or have ever had glaucoma; psychosis; or
heart, kidney, thyroid, or liver disease.
* you should know that carbamazepine may decrease the effectiveness of
hormonal contraceptives (birth control pills, patches, rings, injections,
implants, or intrauterine devices). Use another form of birth control while
taking carbamazepine. Tell your doctor if you have unexpected vaginal
bleeding or think you may be pregnant while you are taking carbamazepine.
* tell your doctor if you are pregnant or plan to become pregnant.
Carbamazepine may harm the fetus. If you become pregnant while taking
carbamazepine, call your doctor immediately.
* do not breast-feed while you are taking carbamazepine.
* if you are having surgery, including dental surgery, tell the doctor or
dentist that you are taking carbamazepine.
* you should know that carbamazepine may make you drowsy. Do not drive a car
or operate machinery until you know how this medication affects you.
* remember that alcohol can add to the drowsiness caused by this medication.
* you should know that your mental health may change in unexpected ways, and
you may become suicidal (thinking about harming or killing yourself or
planning or trying to do so) while you are taking carbamazepine for the
treatment of epilepsy, mental illness, or other conditions. A small number
of adults and children 5 years of age and older who took antiepileptics such
as carbamazepine during clinical studies were found to be twice as likely to
become suicidal than people who did not take the medication. This increased
risk of suicidal behavior was seen as early as one week after starting the
medication. You, your family, or your caregiver should call your doctor
right away if you experience any of the following symptoms: anxiety,
agitation, hostility, mania (frenzied, abnormally excited mood), talking or
thinking about wanting to hurt yourself or end your life, withdrawing from
friends and family, new or worsening depression, preoccupation with death
and dying, or giving away prized possessions. Be sure that your family or
caregiver knows which symptoms may be serious so they can call the doctor if
you are unable to seek treatment on your own.
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