Carbamazepine dosage. Overdose and side effects. General characteristics. Compound

A psychotropic, antiepileptic drug is Carbamazepine. What does this medicine help with? The drug has a neurotropic, antidiuretic effect. Carbamazepine instructions for use prescribes use for alcoholism, epilepsy, neuralgia.

Release form and composition

Carbamazepine is available in tablet form. Carbamazepine tablets, what they help with alcohol withdrawal, contain 200 mg of the same name active substance. Auxiliary elements are: talc, povidone K30, colloidal silicon dioxide (Aerosil), polysorbate 80, potato starch, magnesium stearate.

pharmachologic effect

The active component of the drug is Carbamazepine, which helps with epileptic seizures and other conditions, has antidiuretic, neurotropic, antiepileptic and psychotropic effects. According to the instructions, Carbamazepine eliminates irritability, aggressiveness, depression, anxiety and the frequency of seizures in patients with epilepsy. For neuralgia this drug prevents the occurrence of paroxysmal pain. As for alcohol withdrawal syndrome, the medication for this pathology reduces tremor, increased nervous excitability, and also increases the threshold convulsive readiness.

Carbamazepine tablets are very often used as an antipsychotic and mood stabilizer in the treatment of affective disorders. At diabetes insipidus the medicine significantly reduces diuresis and thirst. In the pediatric field to achieve therapeutic action given pharmacological agent used in very high doses, which cannot be said about adult patients. This is related, according to medical specialists, with physiological features.

Medicine Carbamazepine: what helps

Indications for use include the following pathological conditions:

• Alcohol withdrawal syndrome.
• Generalized tonic-clonic seizures.
• Mild and severe attacks of epilepsy.
• Acute manic states.
• Mixed forms epileptic seizures.
• Idiopathic neuralgia of the glossopharyngeal nerve.
• Pain syndrome in diabetic neuropathy.
• Polydipsia and polyuria of neurohormonal etiology in diabetes insipidus.
• Neuralgia trigeminal nerve.

Reviews of Carbamazepine indicate that this drug is effective for bipolar affective disorders.

Contraindications

Carbamazepine instructions for use prohibit when:

• atrioventricular block;
• acute form"intermittent" porphyria;
• disorders of bone marrow circulation (leukopenia, anemia);
• intolerance to the main substance;
• hypersensitivity to tricyclic antidepressants.

In case of active alcoholism, decompensated form of CHF, adrenal insufficiency, hypothyroidism, hypopituitarism, ADH hypersecretion syndrome, dilution hyponatremia, suppression of bone marrow hematopoiesis, increased intraocular pressure, prostatic hyperplasia, pathology of the renal system, the drug is prescribed with caution, assessing possible risks.

The drug Carbamazepine: instructions for use

The drug is taken orally with a drink a small amount liquids. The tablets can be taken regardless of meals. In the treatment of epilepsy, in cases where this is possible, the drug is prescribed as monotherapy. The drug is taken with a small daily dose, which is then gradually increased to the optimal dose. If antiepileptic therapy is already being carried out, carbamazepine should be added gradually (depending on the indications, the doses of drugs used simultaneously may be adjusted).

Initial adult dose is 100-200 mg 1-2 times a day. If necessary, it is slowly increased until the optimal therapeutic effect is achieved (usually up to 400 mg 2-3 times a day). The maximum daily dose is 1600-2000 mg. Children are prescribed the following dosage regimen:

• Up to 5 years: initial daily dose - 20-60 mg, every other day the dose is gradually increased by 20-60 mg.
• From 5 years: initial daily dose - 100 mg, every week the dose is gradually increased by 100 mg.
• Maintenance dose for children - 10-20 mg/kg per day in 2-3 doses (to ensure accurate dosing in children under 5 years of age, liquid oral dosage forms drug).

For other indications, Carbamazepine is prescribed:

• Trigeminal neuralgia: on the first day - 200-400 mg per day; the dose is gradually increased until discontinuation pain syndrome, but not more than 200 mg per day (average daily dose - 400-800 mg), then reduced to the minimum effective dose.
• Pain syndrome of neurogenic origin: on the first day - 100 mg 2 times a day; until the pain subsides, the dose is increased by no more than 200 mg per day (it is possible to increase by 100 mg every 12 hours). Maintenance daily dose - 200-1200 mg (in several doses).
• Diabetic neuropathy accompanied by pain: the average dose is 200 mg 2-4 times a day. To prevent relapses of schizoaffective and affective psychoses - 600 mg per day in 3-4 doses; Diabetes insipidus: average adult dose - 200 mg 2-3 times a day. For children, Carbamazepine is prescribed in accordance with the body weight and age of the child.
• Alcohol withdrawal syndrome: average dose - 200 mg 3 times a day; at severe course during the first few days, the single dose can be increased to 400 mg. At the beginning of therapy for severe withdrawal symptoms, simultaneous use with drugs with sedative-hypnotic effects (clomethiazole, chlordiazepoxide) is recommended.
• Acute manic states and affective (bipolar) disorders: daily dose - 400-1600 mg (on average, the drug is taken 400-600 mg in 2-3 doses).
• In the acute course of the disease, the dose is increased quickly, and in the maintenance treatment of affective disorders - gradually (to improve tolerability). For elderly patients and patients with hypersensitivity, carbamazepine is usually prescribed at an initial dose of 100 mg 2 times a day.

Side effects

The use of Carbamazepine, according to patient reviews, can cause the following undesirable reactions:

• Nervous system: diplopia, dizziness, muscular dystonia, headache, asthenia, nystagmus, peripheral neuropathy, paresthesia, paresis, oculomotor disorders, tremor, fatigue, taste disturbance, drowsiness, auditory and visual hallucinations, aggressive behavior, disorientation, anxiety, mental disorders.
• CVS: decreased or increased blood pressure, congestive heart failure, thrombophlebitis, arrhythmia, intracardiac conduction disorders.
• Gastrointestinal tract: nausea, diarrhea, vomiting, disturbance taste sensations, dry mouth, abdominal pain, constipation.
• Skin reactions: itching, urticaria, systemic lupus erythematosus, erythroderma, allergic dermatitis, sweating.
• Other: aplastic anemia, weight gain, urinary retention, edema, renal failure, pneumonia, agranulocytosis, increased intraocular pressure, leukocytosis, shortness of breath, frequent urination and many others side effects.

Interaction

Metabolism of the drug is carried out using cytochrome CYP3A4. When administered simultaneously with inhibitors of this cytochrome, an increase in its concentration is observed, and, accordingly, the severity of side effects increases. Cytochrome inducers accelerate metabolic processes, reduce the level of drug concentration in the blood, reducing the severity of its therapeutic effect.

The concentration of the drug in the blood increases: Nicotinamide, Verapamil, Cimetidine, Fluvoxamine, Fluoxetine, Viloxazine, Dextropropoxyphene, Felodipine, Diltiazem, Acetazolamide, Desipramine, Danazol, Trefenadine, macrolides, azoles, Ritonavir, Propoxyphene, Isoniazid, Loratadine.

special instructions

Monotherapy for patients with epilepsy begins with small dosages with a gradual increase in the amount of the drug to achieve the desired effect. At combination therapy It is advisable to determine the concentration of carbamazepine in plasma to select optimal dosage. When the drug is abruptly discontinued, epileptic seizures are often recorded. If it is necessary to discontinue carbamazepine, they try to transfer the patient to another antiepileptic drug.

During therapy, monitoring of performance indicators is required hepatic system, blood condition. Carbamazepine has a weak anticholinergic effect, which requires constant monitoring of intraocular pressure. The drug may reduce the effectiveness oral contraceptives, which requires the use additional methods to protect against pregnancy.

Analogs and price

Carbamazepine can be replaced with the following drugs:

• Zeptol.
• Carbalex.
• Carbapin.
• Mezakar.
• Tegretol.
• Timonil.
• Finlepsin.

The price of Carbamazepine tablets in Minsk is 4-9 bel. rubles, Moscow - 76-90 rubles, Kyiv - 16-35 hryvnia, Almaty - 870 tenge.

Carbamazepine is an anticonvulsant medicinal product, which has antiepileptic, normothymic and antidepressant properties. Available in tablet form.

Pharmacological action of Carbamazepine

In accordance with the instructions for Carbamazepine, active active ingredient The medication is carbamazepine. Excipients The ingredients included in the drug are potato starch, stearic acid, and aerosil.

Carbamazepine has a pronounced neurotropic and psychotropic effect on the body.

When using Carbamazepine, the substances included in the drug have an antiepileptic effect due to their activity in relation to the causes of partial seizures simple and complex type with or without secondary generalization. The drug is effective for tonic-clonic seizures.

The medication helps stabilize active membranes nerve cells, blunts the occurrence of repeated neuronal discharges, reduces the synaptic propagation of impulses responsible for excitation. The anticonvulsant effect of Carbamazepine is due to the prevention of repeated discharges (due to blockade of sodium channels), as well as the normalization of neuronal membranes and a decrease in the release of glutamate.

The instructions for Carbamazepine indicate that the medicine helps prevent attacks of trigeminal neuralgia.

The antipsychotic property of the drug is due to the inhibition of the exchange of norepinephrine and dopamine in the brain.

When Carbamazepine is administered orally, the medicine is completely absorbed. The maximum concentration in the blood after a single dose is achieved within 24 hours. Eating does not affect the rate and degree of absorption of the drug. Carbamazepine tablets have high bioavailability. Metabolized medicinal substance in the liver with the formation of several metabolites. The period of complete elimination of the drug from the body with a single use is 72 hours, with repeated use – up to 48 hours. Carbamazepine is excreted through the kidneys.

Reviews of Carbamazepine do not indicate changes in metabolism in older people.

Indications for use of Carbamazepine

The drug is prescribed to patients who have:

• Epilepsy, accompanied by partial seizures with simple and complex symptoms, as well as primary and secondary generalized forms of seizures with tonic-clonic seizures, with the exception of absences, myoclonic and flaccid seizures;
• Idiopathic trigeminal neuralgia, including neuralgia in multiple sclerosis;
• Idiopathic glossopharyngeal neuralgia;
• Pain syndrome with diabetic polyneuropathy;
• Polydipsia and polyuria in diabetes insipidus.

• Psychotic disorders, psychoses, dysfunctions of the limbic system, panic disorders;
• Aggressive behavior caused by organic lesions brain, chorea, depression;
• Dysphoria, anxiety, tinnitus, somatization, Kluver-Bucy syndrome, senile dementia;
• Tabes dorsalis, acute idiopathic neuritis, multiple sclerosis, diabetic polyneuropathy, hemifacial spasm, Ekbom's syndrome, postherpetic neuralgia.

In reviews of Carbamazepine there are messages that note high efficiency drug for the treatment and prevention of migraine.

Directions for use and dosage

Carbamazepine tablets are intended for oral administration while eating.

For the treatment of epilepsy, adults are prescribed the drug in an initial dose of 1 tablet 1-2 times a day. Elderly people are recommended to take ½ tablet 1-2 times a day. Subsequently, the dose should be gradually increased to 2 tablets 2-3 times a day. The maximum daily dose of Carbamazepine should not exceed 6 tablets.

The daily dosage of Carbamazepine for children under 1 year old is 0.5-1 tablet per day, 1-5 years old - 1-2 tablets, 5-10 years old - 2-3 tablets, 10-15 years old - 3-5 tablets. Daily dose should be divided into 2 doses.

For the treatment of neuralgia and pain syndromes of various origins, the daily dose is 1-2 Carbamazepine tablets, divided into 2-3 doses. 2-3 days after starting to take the medicine, the dose can be increased to 2-3 tablets. Duration of therapy is 7-10 days. After improvement in the patient's condition is noted, the dose should be gradually reduced to the minimum effective. It is recommended to take a maintenance dosage for a long time.

For withdrawal symptoms, according to the instructions, Carbamazepine is prescribed to take 1 tablet 3 times a day. IN severe cases During the first three days, an increased dose of the drug is recommended - 2 tablets 3 times a day.

For the treatment of polydipsia and polyuria in diabetes insipidus, you should take the medicine 1 tablet 2-3 times a day.

Side effects of Carbamazepine

According to reviews of Carbamazepine, side effects from the body may occur when taking the medicine. Individuals may experience dry mouth, loss of appetite, nausea, headaches, vomiting, dizziness, ataxia, drowsiness, and accommodation disturbances.

Elderly patients experience agitation and confusion.

In rare cases, hyponatremia is observed, which occurs due to the antidiuretic effect of Carbamazepine.

Allergic reactions may also occur, accompanied by skin rashes and dermatitis, as well as agranulocytosis, leukopenia and thrombocytopenia, aplastic anemia, cardiac conduction disorders, proteinuria, edema, cholestatic hepatitis, interstitial nephritis, gynecomastia, lymphadenopathy.

Contraindications to the use of Carbamazepine

The drug is not prescribed to people who are hypersensitive to its components.

Contraindications are:

• atrioventricular block;
• glaucoma;
• hematological diseases;
• prostatitis;
• dysfunction of the liver, cardiac function, kidneys and sodium metabolism;
• diseases bone marrow.

Overdose

Reviews of Carbamazepine report that in case of drug overdose, there may be increased arousal, tremors, convulsions, clouding of consciousness, changes blood pressure, coma.

Additional Information

Carbamazepine therapy should be started with small doses, gradually bringing them to the required therapeutic level.

The instructions for Carbamazepine indicate that the medicine must be stored in a dark, cool place out of the reach of children. Shelf life – 36 months.

Dispensed from pharmacies with a prescription.

Anticonvulsant tablets "Carbamazepine", reviews of which we will consider today, were synthesized almost half a century ago. And although it has since been introduced into medical practice a considerable amount more modern effective drugs Having, moreover, fewer side effects, the named remedy remains very popular among doctors and patients.

In what cases is the drug "Carbamazepine" used?

The named tablets are an excellent anticonvulsant and are used:

• as the main means for different types seizures;
• at manic syndromes in acute form;
• to prevent deterioration that occurs in phases of affective disorders, as well as to alleviate the patient’s condition at the time of their exacerbation;
• with diabetic neuropathy accompanied by pain;
• to ease the well-being of patients with trigeminal neuralgia;
• as well as with alcohol withdrawal, expressed by nervousness, sleep disturbances and convulsive conditions.

In addition, according to experts who left their reviews, “Carbamazepine” is also successfully used for the treatment of psychosis, schizophrenia, in aggressive conditions, panic attacks, as well as with organic changes in brain tissue. However, it must be taken into account that the effectiveness of the drug in these cases is based only on clinical experience, since laboratory protocol studies were not carried out.

What are the benefits of Carbamazepine tablets for patients with epilepsy?

In patients with epilepsy, this drug increases the reduced seizure threshold and thereby reduces the risk of a new attack. The drug has also proven itself to be excellent for correcting personality changes (as a result of use, communication skills increase and it is easier to social rehabilitation such patients).

In adolescent patients and children, the use of the drug reduces depression, uncertainty, nervousness and aggressiveness. But at the same time, it is necessary to take into account that the effect of the drug on (state of memory, coordination of movements, attention, speech, thinking abilities, orientation, etc.) may vary depending on the dosage, and at the same time very individually!

True, some patients, leaving their reviews, mention Carbamazepine as a drug that has little effectiveness as a means to combat depression or in situations with mental problems. By the way, they also say that permanent use this tool implies mandatory observation by a doctor and periodic examinations and tests.

Mandatory rules for using the drug

Yes, we must agree that this medicine has a rather complex effect on the human body. That is why, before using it, mandatory consultation with a specialist is necessary.

When using Carbamazepine tablets, it is important to remember the rules listed below.

• Patients tolerate treatment with this drug best if they carefully follow the dosage regimen and all the recommendations of the attending physician; in other cases, the drug can cause many undesirable effects.
• Before starting treatment, as a rule, the condition of the patient’s liver is examined (especially if he is elderly or has diseases of this organ). If deterioration occurs while taking the drug, treatment should be interrupted immediately.
• Particular attention is paid to the state of intraocular pressure of patients treated with Carbamazepine tablets. Reviews from doctors prescribing this medicine indicate that its use can stimulate increased secretion intraocular fluid, which, in turn, is a risk of deterioration in the visual function of the eye.

Analogues of the drug

Carbamazepine tablets have similar drugs in action. These include "Zagretol", "Carbalepsin retard", "Carbapin", "Mazepin", "Stazepin", "Tegretol", "Finlepsin", "Carbamazepine Nycomed" and "Carbamazepine Akri". Reviews from doctors and patients about their use and effects on the body are similar to those indicated in the annotation for the drug being described.

How to use the drug

Carbamazepine tablets are taken orally before or after meals. It is permissible to take the medicine during meals, and it should be washed down with water.

For patients with epilepsy, if possible, it is undesirable to combine this drug with others.

In the first days, the use of "Carbamazepine" occurs in minimum quantity, then its dose is increased to a level at which the desired result is achieved. The same tactics are used when introducing the drug into a started treatment regimen with other drugs. Note that the amount of previously used medications is not reduced at first.

Exact dosage of the drug

• Children from four years of age are prescribed the drug in amounts from 20 mg to 60 mg per day, adding 20-60 mg every two days as necessary.
• For patients in adulthood - from 100 to 200 mg once or twice a day, increasing, if necessary, the amount to 400 mg two to three times a day (the dose should not exceed 2 g).
• When prescribed from 200 mg/day. from the beginning of treatment, gradually increasing to maximum quantity- 400-800 mg per day until the pain stops, then reduce the dose.
• Alcohol withdrawal syndrome is treated with an average dose of 200 mg 3 times a day, and in especially severe cases it is increased to 400 mg. At the beginning of treatment, the drug is combined with
• Acute manic states require an average daily dose of 400 to 1600 mg in two to three divided doses. Moreover, the dose is increased quickly.

How does a drug overdose manifest?

Possible disturbances in brain function, which are expressed in loss of orientation (so-called ataxia), lethargy, drowsiness or hyperactivity, the appearance of hallucinations, loss of consciousness and coma. Studies conducted by specialists confirm that overdose primarily affects the cardiovascular, central nervous and respiratory system body. As confirmed by the reviews left by doctors, “Carbamazepine” can be very dangerous in case of an overdose!

• An overdose also affects the functioning of the organs of vision (the patient sees a “veil” before his eyes), he experiences nystagmus (rapid arrhythmic movement eyeballs), as well as pupil dilation.
• Speech disturbances, psychomotor disorders, and myoclonus (sudden muscle twitches) are noted.
• From the outside of cardio-vascular system tachycardia, a strong decrease or increase in blood pressure, and even cardiac arrest are possible.

If an overdose is suspected, gastric lavage and administration are necessary. activated carbon. Hospitalization of patients and further symptomatic treatment are recommended.

The drug "Carbamazepine": side effects

Once again, it should be noted that the drug should be taken only under the supervision of a doctor and in the doses prescribed by him. You should not change the number of tablets you take at your own discretion, and if side effects occur, be sure to consult a specialist to clarify the treatment regimen.

Undesirable manifestations can be expressed in the form of dizziness, drowsiness, feeling constant fatigue, headache, tremor, taste disturbances, depression and aggressive behavior. Nausea, vomiting and dry mouth may occur.

In case of intolerance to the components of the drug, allergic reactions are observed.

As a result of taking this drug, manifestations of leukopenia and thrombocytopenia have also been observed, and a deficiency may occur. folic acid, edema, weight gain, fluid retention and hyponatremia (decreased concentration of sodium ions in the blood).

Who are contraindicated for Carbamazepine tablets?

The drug, despite the long list of side effects, is generally well tolerated. And the patient’s well-being often changes for the better when the dose is reduced or the regimen is changed. Numerous reviews speak about this.

"Carbamazepine" as remedy contraindicated in a small group of patients.

• These include patients with atrioventricular block (a disturbance in the transmission of nerve impulses in the cardiovascular system), as well as with depressed bone marrow hematopoiesis.
• The drug is not used for hepatic porphyria.
• During pregnancy and breastfeeding is cancelled.
• Reception prohibited of this medicine together with and within two weeks after their cancellation.

with other means

Before starting treatment, do not forget to tell your doctor what medications you are taking. this moment. Because simultaneous use of drugs such as Diltiazem, Fluoxetine, Isoniazid, Erythromycin, Nicotinamide, etc. may increase the risk of overdose.

Also should not be used during treatment. hormonal contraceptives, since the risk of uterine bleeding is high.

Alcohol enhances the inhibitory effect of the drug on the nervous system.

The doctor prescribing this medicine will tell you how to take Carbamazepine tablets, what they help with and for what diagnoses they are prescribed. The drug belongs to the class of antiepileptics. The main component is obtained from the processing of dibenzazepine. Under the influence of the drug, the conductivity of sodium channels is inhibited, and the ascension of neurotransmitters slows down. The medication is effective against cramps and pain. The drug belongs to the class of antidiuretics, mood stabilizers, and antipsychotics.

Technical information

The 200 mg of carbamazepine contained in the Carbamazepine tablets is the very ingredient that determines the activity of the drug. Also, each tablet contains additional components. To make the drug, the manufacturer used Aerosil, starch compounds, povidone and polysorbate. The preparation contains magnesium stearate. It is especially important for persons suffering from hypersensitivity or sensitivity to compounds used in the pharmaceutical industry to read the instructions in detail describing the ingredients used.

Pharmacology

To understand why Carbamazepine tablets are prescribed, you need to study the instructions for use. It also describes the rules safe use composition and explains what risks are associated with non-compliance with recommendations. The medication belongs to the antiepileptic category. It has an anti-manic effect. The drug is a mood stabilizer and helps stabilize diuresis against the background of diabetes insipidus. In case of neuralgia, the medicine is used to relieve pain. The active compound depresses sodium channels, due to which neural membranes are stabilized, serial neutron discharges are inhibited, and the ability to conduct synoptic impulses is weakened.

The active compound, as explained in the instructions for use of Carbamazepine tablets, prevents the re-generation of positive sodium potentials in neutron potentials that have already undergone depolarization. The activity of the release of nervous system mediators associated with glutamate decreases, and the threshold of readiness for seizures increases. The use of the drug can reduce the risk of an epileptic attack. The conductivity of positively charged potassium molecules improves, the operation of channels that ensure the passage of calcium from positive charge. To some extent, this determines the effectiveness of the drug against seizures.

Features of the effect

According to the instructions for using Carbamazepine tablets, under the influence of the drug, personality changes caused by epilepsy are reduced. Patients become more sociable, and the patient’s rehabilitation in society becomes easier. Allowed combined use Carbamazepine and other drugs effective against seizures. You can prescribe the drug for partial, focal attacks. It is permissible to use tablets if the attacks are simple or occur in a complex form. You can use the remedy in case of secondary generalization of the process, with a tonic-clonic variant of the course of a generalized type. You can use the tablets for any combination of the mentioned pathological conditions. At the same time, it is noted that Carbamazepine shows relatively low level effectiveness in the case of minor, myoclonic seizures, absence seizures.

Explaining why Carbamazepine tablets are prescribed in a particular case, the doctor also points to relief depressive symptoms and manifestations of anxiety, which very often bother epileptics. This effect is observed when taking the drug by both adult patients and children. The aggressiveness of patients decreases, people become less irritable. Correction of psychomotor skills and the effect on cognitive aspects is determined by the dosage of the drug. Much depends on the specifics of the case and the state of the body.

Efficiency and effectiveness: when taken correctly

Studies designed to determine how and why Carbamazepine tablets are most effective have proven that the anticonvulsant effect inherent in the drug lasts for hours in some patients, and for days in others. Autoinduction of metabolic processes can cause the effectiveness of the medication for a month. If neuralgia is established, the remedy helps prevent an attack of pain. It can be used to relieve neurogenic pain from tabes dorsalis, paresthesia due to previous trauma, and neuralgia associated with herpes. If the cause of pain is in the trigeminal nerve, pain relief is observed 8-72 hours after taking the composition. At alcohol poisoning taking the drug helps to increase the body’s threshold of readiness for seizures, which is reduced during the abstinence period. At the same time, the clinical picture of the syndrome as a whole is alleviated - tremor goes away, excessive excitability decreases, and gait stabilizes.

By identifying aspects of the action of Carbamazepine tablets, scientists have found that taking the medicine against the background of diabetes insipidus helps stabilize the fluid balance in the body. The desire to drink weakens, diuresis becomes less. As for the psychotropic effects, the anti-manic effect can be observed a week or a week and a half after the start of the course. This action is assumed to be due to oppression metabolic processes affecting the production of dopamine and norepinephrine.

Kinetic nuances

According to the instructions, which explain what Carbamazepine tablets help with, how they are used and how they are processed in the body, the absorption process is quite slow, but it is highly effective. The process does not depend on meals. After using a single dose, the maximum serum concentration is recorded after 12 hours, and the equilibrium serum concentration is established within a week or two. When processed in the body, the substance is transformed into a metabolite, which is characterized by pharmacological activity. Its concentration on average is about a third relative to the original substance.

As indicated in the instructions describing the features of the composition of Carbamazepine, the substance is capable of forming strong bonds with plasma proteins. For child's body parameter - up to 55%, for adult patients reaches 80%. In liquid spinal cord, secretions salivary glands the substance is observed in a concentration corresponding to the amount of the substance that has not reacted with plasma proteins. The ability to penetrate the placenta has been established. IN breast milk the compound is detected in amounts of 25-60% of plasma content.

Kinetics: how does it all happen?

Regardless of the dosage, Carbamazepine is transformed when passing through the liver. The dominant process option is epoxy. One active metabolite and one reaction product are formed that do not affect human body. Also, a metabolite is formed in small quantities, which has a very weak effect on the body. There is a possibility of indicating autometabolism.

As studies have shown, the half-life of the active compound with a single dose of the drug varies in the range of about 36 hours, the maximum limit is 65 hours. When taken again, the period reaches 12-24 hours. If a person passes combination treatment several drugs to increase the threshold of readiness for seizures, the half-life varies around 9-10 hours.

The drug is predominantly excreted in the form of inactive transformation products. Up to a third of the total dose leaves the body through intestinal tract, other volumes - with urine. Establishing when, to whom and from what “Carbamazepine” helps, it was not possible to identify specific kinetic features in elderly people. It has not yet been possible to collect enough reliable information about the kinetics of the drug in the event that patients have impaired liver and kidney function.

When will it help?

When are Carbamazepine tablets prescribed? Indications for use include those inherent in different variants symptoms (complex, simple). Can be used for generalized primary, secondary process, for mixed types. It is allowed to prescribe the drug for idiomatic neuralgia affecting glossopharyngeal nerve. The medicine is recommended for treatment affective disorder, polydipsia. The medication is ineffective for polyuria in the case of diabetes insipidus. It is recommended to use tablets for withdrawal syndrome against the background of alcohol addiction. In case of polyneuropathy associated with diabetes, the medicine relieves pain.

The practice of using Carbamazepine for idiopathic trigeminal neuralgia is widespread. The drug is prescribed if neuralgia is caused by multiple sclerosis. The product can be used as preventative measure, if the probability of affective disturbance is assessed above average. The drug is effective for schizoaffective problems and depression, manic psychosis.

When and how much?

Although the price of Carbamazepine is quite affordable (about one hundred rubles), this is not a reason to be careless about the drug dosage program. Do not use the product in excess, as this may cause undesirable consequences. The optimal program of use is chosen by the doctor based on the diagnosis and concomitant diseases. The tablets are used orally; the administration procedure does not depend on meals. It is necessary to take the drug with a small amount of pure liquid without additives.

Persons with epilepsy are well aware of the price of Carbamazepine, since the drug in question is prescribed very often for this diagnosis. It is recommended to use the medicine independently, if possible. First, the patient is prescribed a minimum dose per day, gradually increasing the amount, waiting pronounced effect. If the patient is already undergoing treatment for epilepsy, inclusion in the Carbamazepine program is allowed only in small doses. Previously used drugs are initially taken in the same dosages, but if necessary, the volumes are gradually adjusted.

Specific numbers

Adult patients with epilepsy are first prescribed 0.1-0.2 g once or twice a day for a day. The dosage is increased until it is obtained healing effect. As a rule, 0.4 g of the product up to four times daily is sufficient. Do not use the medicine in quantities of more than two grams per day.

For children three years old the drug is prescribed in an amount of 20-60 mg per day. The dosage is gradually increased. Volume adjustments are allowed every two days. The dose increase step is 20-60 mg.

Children over three years of age are initially recommended to take 0.1 g of the drug per day. gradual increase volume once a week. The dose increment is 0.1 g. The maintenance dosage usually varies around 110-120 mg per kilogram of weight. The daily dose is divided into several doses. For children under five years of age, 0.2-0.4 g, divided into two doses, is sufficient. Children under ten years of age are prescribed up to 0.6 g, divided into three doses, and for persons older and up to fifteen years of age inclusive, up to a gram per day is prescribed. The total volumes are divided into three portions.

In the case of trigeminal neuralgia, on the first day of treatment it is indicated to take 0.2-0.4 g, then the dose is increased until the pain stops. The dose increase step is 0.2 g per day. Usually, 0.4-0.8 g per day is enough for patients to relieve pain. Having achieved a pronounced effect, the dose is reduced until the desired result is maintained.

Features and diagnoses

If the reason for prescribing the drug is neurogenic pain, the patient is initially recommended to take 0.1 g of the drug twice a day, then the dose is increased. Maximum - 0.2 g per day. The volumes are increased until the pain is relieved. The maintenance dose varies between 0.2-1.2 g per day.

In case of old age and high sensitivity body, it is recommended to start therapy with 0.1 g twice a day.

In case of alcohol poisoning and withdrawal syndrome, the drug should be used three times daily, 0.2 g each. In severe cases, in the first days it is allowed to take 0.4 g three times. If withdrawal symptoms at the beginning of therapy manifest themselves with severe symptoms, “Carbamazepine” is combined with sedatives and sleeping pills .

For diabetes insipidus, Carbamazepine is usually prescribed in the amount of 0.2 g up to three times daily. Children are shown smaller doses, calculated by the doctor based on weight. If diabetes has caused neuropathy and pain, on average it is enough to take 0.2 g up to four times a day. To prevent exacerbation of affective disorder, schizoaffective psychosis, 0.6 g of the drug is prescribed four times a day.

If acute manic state, bipolar disorder, the patient should use 0.4-1.6 g of the drug per day. At acute condition it is necessary to quickly increase the dosage. As part of maintenance treatment, the volumes are increased gradually so that the substance is better tolerated by the body.

Adverse events

Side effects of Carbamazepine include a number of reactions from the central nervous system. Some people experience headaches, dizziness and sleepiness. Sometimes patients note weakness, tremors and paresis, dyskinesia and weakness of muscle tissue. There is a possibility of neuritis, dysarthria, tics, and nystagmus. It is noted that some hallucinated, became depressed, lost appetite, became anxious and became aggressive during treatment. There is a possibility of disorientation, exacerbation of psychosis, and excessive agitation.

Side effects of Carbamazepine include an allergic reaction. There is a possibility of developing hypersensitivity from several internal organs straightaway. In a minimal percentage of cases, the drug provoked aseptic meningitis, anaphylactic response, Quincke's edema, shortness of breath and fever, and pneumonia. Maybe Negative influence on the hematopoietic system, deterioration of stool, gastrointestinal activity. Some people have dry mouth, stomach pain, and inflammation of the tongue. The activity of liver enzymes may increase. There is a risk of cardiac dysfunction, thrombophlebitis, collapse, and fainting. In the case of ischemia, there is a danger of exacerbation of the condition.

Is it possible or not?

As can be seen from the instructions, there are contraindications for taking Carbamazepine tablets increased sensitivity To active component drug, as well as other medicines with similar chemical properties. Tricyclic antidepressants, for example, belong to this category. Do not use the composition if you are allergic to the auxiliary ingredients. The substance is not used against the background of acute porphyria. Carbamazepine is contraindicated in persons taking MAOIs, as well as those who completed such a course less than two weeks ago. Carbamazepine is prohibited for those who have impaired hematopoietic bone marrow function or an atrioventricular block. The drug is not prescribed to pregnant and lactating women.

Carbamazepine should be used extremely carefully if a sodium deficiency is detected, if the hematopoietic function of the bone marrow was previously suppressed under the influence of drugs. Use the product with caution if you are an elderly person. The restrictions are associated with prostatic hyperplasia, severe heart failure, and impaired functioning of the kidneys and liver, which are often found in such patients. When high blood pressure inside the eye, “Carbamazepine” is used only if it is possible to regularly check the patient’s condition.

Is there an alternative?

Analogues of Carbamazepine tablets include the following drugs:

• "Tegretol".
• "Finlepsin".

The choice in favor of a specific name must be agreed with the attending physician. It is strictly not recommended to replace the drug with an alternative one on your own. Such self-will can cause the ineffectiveness of the drug program and undesirable consequences for the body.

Features of use

Regarding the compatibility of Carbamazepine and alcohol. It is strictly forbidden to drink alcohol during treatment. This is associated with increased danger development adverse reactions, sharp deterioration the patient’s condition, and not always predictable. When using Carbamazepine as part of the treatment of alcohol withdrawal syndrome, the doctor special attention will draw attention to these limitations and risks associated with neglecting the basic rule of treatment.

There is a possibility of pregnancy during the period when the patient is being treated with Carbamazepine. In this case, as well as when deciding whether to take the drug if conception has already occurred, you need to evaluate what the obvious advantages therapeutic course and possible risks associated with bearing a child. It is especially important to correctly assess the situation in the first trimester. As observations have shown, if a mother has epilepsy, then her unborn child has an increased likelihood of developing defects.

Carbamazepine can induce abnormal development processes in the body. Similar features are inherent in all other medications effective for epilepsy. There are several known cases of children being born with developmental defects and diseases. A doctor, when offering a course of Carbamazepine to a patient, is obliged to report possible dangers. The patient is usually advised to undergo antenatal diagnosis.

Thank you

Most often, patients tolerate treatment with carbamazepine well if they carefully follow all the doctor’s instructions regarding the amount of the drug taken and the treatment regimen. But sometimes a number of side effects are still observed. Often their appearance is associated with an increase in the required dosage, while such effects disappear two to three days after the dosage is normalized. The occurrence of side effects from the central nervous system is also most often associated with overdoses or with individual metabolism of the drug. During such a course of treatment, it is necessary to monitor the level of the drug in the blood.

• The drug affects the functioning of the central nervous system. In ten percent of cases, there is a craving for sleep, dizziness, asthenia, from one to ten percent of patients suffer from migraine-like pain, disturbance of accommodation, less than one percent suffer from trembling of the limbs, nystagmus, tics, disturbances in the functioning of the organs of vision and speech, myasthenia, paresthesia.

• The drug affects the patient's psyche: from one to ten percent of patients suffer from visions or auditory hallucinations, aversion to food, nervousness, disorientation in space, and in isolated cases reactive psychoses were recorded.
• The drug may cause allergic manifestations. Most often these are rashes on the body, in isolated cases itching, lupus-like symptoms, Steven-Johnson syndrome, photosensitivity.
• In isolated cases, combined reactions of individual drug intolerance were observed, occurring with chills, vasculitis, rash on the body, swelling lymph nodes, joint pain, blood disorders and liver dysfunction. In addition, there is likely to be disruption of the kidneys, respiratory organs, myocardium, pancreas, and intestines.

• The drug affects blood production, ten percent of patients develop leukopenia, slightly less often thrombocytopenia, the level of eosinophils increases, even less often the level of leukocytes increases, and the amount of folic acid decreases. In isolated cases, aplastic anemia, agranulocytosis, aplasia, porphyria, and reticulocytosis are observed.
• The drug may affect the performance digestive system, quite often causing vomiting, drying out of the oral mucosa, less commonly, defecation disorders, epigastric pain, in isolated cases pancreatitis, ulceration of the oral mucosa.
• The drug can affect the functioning of the cardiovascular system, in isolated cases causing changes in intracardiac conduction, blood pressure, and exacerbation of coronary heart disease.
• Treatment with carbamazepine may affect the functioning of the glands internal secretion and metabolism, causing weight gain, swelling, disruption of the production of prolactin, thyroxine, thyroid-stimulating hormone.
• The drug may also affect work genitourinary system, causing in isolated cases kidney dysfunction, nephritis, frequent urge to urination, impaired potency.

Reviews

And my neurologist insistently continues to prescribe carbamazepine, although I have symptomatic epi and it doesn’t help me at all, only there are more side effects, I even left work, constant dizziness and disorientation. I told her about this, but she says that this cannot be!

Hello, my boyfriend is sick. He has epilepsy. The doctor prescribed us carbamazepine in an increasing dosage (the first two days, one tablet in the evening, the third and fourth days, one in the morning and evening, the fifth and sixth day, one in the morning and two in the evening, and on the seventh, two in the morning and two in the evening) yesterday he I drank for 4 days (1 in the morning and one in the evening) and today I need to drink for 5 days (1 in the morning and 2 in the evening). But this morning he called me and said that since yesterday he has been dizzy (“if I look far away, for example, at my feet, I feel dizzy”) yesterday and this morning he was dizzy. I worry. Is it worth drinking them further?. I just changed the pressure and it was 150 to 100..

Hello! My son took carbamazepine from February 17, 2017 to April 5 of this year. Epilepsy is questionable, but the first seizures were on February 28, 2016, then on February 17, from that moment he was prescribed carbamazepine. On April 2, we got up heat 39 degrees. Then, on April 5, a rash appeared, and the hospital diagnosed hemorrhagic vasculitis, bilateral pneumonia, and swollen lymph node. They refused to take the drug. On April 12, another attack occurred, she again gave carbamazepine, but the son became red and his body itched for two days, they again refused the drug. Allergic reaction passed. We were discharged from the hospital on April 19 and we still can’t get an appointment with a neurologist, either they don’t answer the phone, then there is no appointment with the doctor at all, and finally only on May 23 we can see a doctor. I hope that they will prescribe another medicine that does not have such side effects.