Carbamazepine (Tegretol)

Chemical

Iminostilbene derivative, structurally related to TCAs

Use

  1. Tx epilepsy
  2. Trigeminal neuralgia
  3. Bipolar disorder

Presentation

Tablets/supp/syrup

Dose

100 – 1600mg (divided doses)

Route

PO

Onset

?

MoA (mechanism)

  • Unknown MoA
  • Does not act like TCAs
  • Limits seizure propagation

PD

CNS – antileptic

CVS – antiarrhythmic, depressing AV conduction

GU – antidiuretic effect

PK

A

100% OBA

D

75% PPB

VD 1L/kg

M

Liver oxidation

Chronic use = induces its own metabolism

E

Unconjugated metabolites excreted in urine

Adverse Effects

  • H2O toxicity
  • Rashes
  • Renal & liver damage
  • Diplopia
  • Drowsiness
  • N&V