Carbamazepine, Tegretol, Carbatrol, Tegretol XR

Introduction

Written by Patricia Weiser, PharmD
Medically reviewed by Amber Watson, PharmD
Updated on August 9, 2023

Carbamazepine (kar ba MAZ e peen) is a generic medication prescribed for certain seizures due to epilepsy. It’s also used to treat a type of nerve pain. Carbamazepine belongs to a group of drugs called anticonvulsants.

Specifically, the Food and Drug Administration (FDA) has approved carbamazepine to treat:

• focal onset seizures,* generalized tonic-clonic seizures, and mixed seizure patterns in adults and some children with epilepsy
• trigeminal neuralgia (a nerve disorder that causes severe pain in the face) in adults

This article doesn’t provide coupons for all forms of carbamazepine. To find coupons for carbamazepine extended-release oral tablet,† see this article.

* Focal onset seizures are also known as partial seizures.
† With extended release, the drug releases slowly into your body over time.

Boxed warnings

Carbamazepine has boxed warnings about the risks of serious skin reactions and serious low blood cell levels. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

For details, see the “Interactions and warnings for carbamazepine” section.

Side effects of carbamazepine

Carbamazepine may cause mild or serious side effects. More common mild side effects of carbamazepine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about carbamazepine’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for carbamazepine listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of carbamazepine are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about carbamazepine’s side effects based on the form, refer to the prescribing information for carbamazepine listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Mild side effects of carbamazepine oral tablet and extended-release* oral tablet include:

• dizziness
• drowsiness
• nausea
• vomiting
• mild allergic reaction†

* With extended release, the drug releases slowly into your body over time.
† For details about this side effect, see the “Interactions and warnings for carbamazepine” section.

Serious side effects

Serious side effects of carbamazepine are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about carbamazepine’s side effects based on the form, refer to the prescribing information for carbamazepine listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, carbamazepine’s serious side effects include:

• problems with balance and walking
• heart and blood vessel problems such as heart failure
• increased liver enzymes, which may be a sign of liver problems
• inflammation of the pancreas
• low sodium levels in the blood
• visual hallucinations (seeing things that aren’t real)
• depression
• suicidal thoughts or behaviors
• boxed warnings:* risks of serious skin reaction and serious low blood cell levels
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for carbamazepine” section.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Uses of carbamazepine

The Food and Drug Administration (FDA) approves prescription drugs such as carbamazepine for certain conditions. Approved uses for carbamazepine are described below.

Use for seizures

Doctors may prescribe carbamazepine for certain types of seizures due to epilepsy. It’s used for this purpose in adults and some children.* It’s usually prescribed as a long-term treatment.

Specifically, the FDA has approved carbamazepine to treat:

• focal onset seizures
• generalized tonic-clonic seizures
• mixed seizure patterns

A focal onset seizure starts in one area or side of your brain. It’s also known as a partial seizure. Symptoms you may experience can include:

• muscle twitches on one side of your body
• unusual head or eye movements
• sweating
• nausea

A generalized tonic-clonic seizure affects both sides of your brain. You may experience episodes of stiffness and jerking motions involving your whole body. Other symptoms include:

• loss of consciousness
• drooling
• falling
• involuntary movements or sounds

With mixed seizure patterns, you may experience multiple seizure types, including both focal onset and generalized seizures.

Carbamazepine may be prescribed alone or together with other anticonvulsant drugs.

Doctors may not prescribe carbamazepine in certain situations, such as for absence seizures. An absence seizure affects both sides of your brain and typically causes brief episodes of staring into space.

* The drug’s prescribing information doesn’t specify the lower age limit for carbamazepine treatment in children. However, it has recommended dosages for children younger or older than age 6 years. For more information about this, talk with your child’s doctor. You can also refer to the prescribing information for carbamazepine listed in the “Resources” section.

Use for trigeminal neuralgia

Doctors may prescribe carbamazepine for treating trigeminal neuralgia. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

With trigeminal neuralgia, you have sudden, short episodes of pain. Some people describe the pain as feeling like electric shocks. The pain generally involves one side of the face. Touching or moving your face may cause an episode.

Doctors will not prescribe carbamazepine for relief of minor aches or pains.

Common questions about carbamazepine

Below you’ll find answers to a few commonly asked questions about carbamazepine.

What is carbamazepine’s mechanism of action? How does the drug work?

The exact way carbamazepine works isn’t fully known. Seizures are thought to occur when there are too many electrical signals passing between nerves in your brain. Electrical signals between nerves also play a role in how you perceive pain.

It’s thought that carbamazepine works by reducing electrical signals in your nervous system. (Your nervous system includes your brain and nerves.) This action may help prevent epileptic seizures and ease pain due to trigeminal neuralgia (a type of nerve pain). (Keep in mind that carbamazepine is prescribed for certain epileptic seizures and trigeminal neuralgia.)

Carbamazepine starts working soon after your first dose. But it may take several weeks before you notice a decrease in your symptoms. This is because your doctor will prescribe a low dose of carbamazepine to start. Then they’ll increase your dose over several weeks until they reach the amount that’s effective for your condition.

If you’d like to know more about how carbamazepine works, talk with your doctor or pharmacist.

Are there brand names available for carbamazepine?

Yes, several brand-name versions of carbamazepine are available. These include:

• Carbatrol and Equetro, which come as an extended-release* oral capsule
• Epitol, which comes as an oral tablet and chewable tablet
• Tegretol, which comes as an oral tablet and oral suspension (a type of liquid mixture)
• Tegretol XR, which comes as an extended-release oral tablet
• Teril, which comes as an oral suspension

Carbamazepine is a generic medication. A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less than brand-name drugs.

* With extended release, the drug releases slowly into your body over time.

Is carbamazepine similar to Xanax?

Not really. Carbamazepine and alprazolam (Xanax) are both prescription drugs, but they differ in several ways.

Carbamazepine is approved by the Food and Drug Administration (FDA) for certain seizures due to epilepsy. It’s also approved for trigeminal neuralgia (a type of nerve pain). (For details, see the “Uses of carbamazepine” section.) In contrast, Xanax is FDA-approved to treat certain anxiety disorders.

Carbamazepine belongs to a group of drugs called anticonvulsants. Xanax belongs to a group of drugs called benzodiazepines. Some benzodiazepines are prescribed to stop seizures in certain situations, but Xanax isn’t one of them.

Xanax is also a controlled substance, but carbamazepine is not. A controlled substance is a drug the government regulates due to the risk of dependence or misuse.

If you’d like to know more about carbamazepine or Xanax, talk with your doctor or pharmacist.

Interactions and warnings for carbamazepine

Below, you’ll find information about carbamazepine’s possible interactions and warnings.

Interactions of carbamazepine

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take carbamazepine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for carbamazepine” section below.

Warnings for carbamazepine

Some people should not take carbamazepine, and others should take it cautiously.

Boxed warnings

Carbamazepine has boxed warnings about the risks of serious skin reaction and serious low blood cell levels. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

To learn more about these warnings, read below. You can also talk with your doctor or pharmacist.

Risk of serious skin reaction. Taking carbamazepine may cause serious skin reactions, such as toxic epidermal necrolysis and Stevens-Johnson syndrome. These side effects were not seen in studies* of carbamazepine. Reports of these conditions occurred after the drug became available.

Symptoms may include painful and discolored skin rash, blisters and peeling, and body aches.

People with a certain genetic factor may have an increased risk of serious skin reactions with carbamazepine. This factor is more common in people of Asian descent. Before prescribing carbamazepine, your doctor may give you a blood test to check for this factor. If you have it, your doctor will likely prescribe a drug other than carbamazepine for your condition.

If you have questions about this, talk with your doctor before starting carbamazepine. If you experience symptoms of a skin reaction while taking the drug, tell your doctor. They’ll likely recommend stopping carbamazepine treatment.

* For details about carbamazepine’s studies, see its prescribing information in the “Resources” section.

Risk of serious low blood cell levels. Carbamazepine treatment may cause conditions that lower the number of certain blood cells your body makes. These conditions may include aplastic anemia (low red blood cell count) and agranulocytosis (low white blood cell count). This side effect was rarely reported in studies* of carbamazepine.

Symptoms vary but may include sore throat, fever, frequent infections, bruising easily, discolored spots on your skin, nosebleeds, and low energy.

If you have concerns about low blood cell levels, tell your doctor. They’ll likely recommend having blood tests throughout carbamazepine treatment to monitor your blood cell levels. If they become too low, your doctor may pause or stop carbamazepine treatment.

* For details about carbamazepine’s studies, see its prescribing information in the “Resources” section below.

Other warnings

Carbamazepine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether carbamazepine is a safe option for you. These warnings may differ based on the form of carbamazepine you take.

Ask your doctor about specific warnings for carbamazepine, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Carbamazepine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to carbamazepine or any of its ingredients, your doctor will likely not prescribe carbamazepine. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to carbamazepine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of carbamazepine

You should not take more carbamazepine than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much carbamazepine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and carbamazepine

Information about carbamazepine and pregnancy and breastfeeding is described below.

Carbamazepine and pregnancy

There are risks to taking carbamazepine during pregnancy. But there are also risks with having untreated epilepsy while pregnant. (Keep in mind that carbamazepine is prescribed to treat certain seizures caused by epilepsy.)

If you’re planning a pregnancy or can become pregnant, talk with your doctor about epilepsy treatment options during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether or not you should take carbamazepine during pregnancy.

If you take carbamazepine at any point during pregnancy, your doctor may encourage you to participate in a pregnancy registry. It collects information about the use of medications during pregnancy. For more details, contact the North American Antiepileptic Drug Pregnancy Registry at 888-233-2334 or visit the website.

Carbamazepine and breastfeeding

Carbamazepine should not be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child.

What to ask your doctor

Let your doctor know if you have questions about carbamazepine or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Does my genetic background increase my risk of side effects with carbamazepine?
• How does carbamazepine compare to other treatment options for my condition?
• Can I continue to take my other medications while taking carbamazepine?

Resources

• Carbamazepine- carbamazepine capsule, extended release. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/02e15f6d-5c39-4766-a4c6-17c0d8b11b14/spl-doc
• Carbamazepine- carbamazepine suspension. (2020). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/e006049f-1c0c-4544-969e-0344d1b8c5ba/spl-doc
• Carbamazepine- carbamazepine tablet. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/1dd3d934-efee-4fdb-ae6f-f47b61831a2e/spl-doc
• Carbamazepine- carbamazepine tablet, chewable. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/fcf330cc-c295-45f3-9c1c-b1799b883cb5/spl-doc
• Carbamazepine- carbamazepine tablet, extended release. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/3207764f-0663-477e-ad1f-f5fb43b6bbf3/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Xanax (alprazolam) tablets, for oral use, CIV. (2023). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/018276s059lbl.pdf

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.