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Mar 28, 2024


What You Should Know About Carbamazepine

What is Carbamazepine?

Carbamazepine is known as an anticonvulsant or “anti-seizure” drug. It is used to prevent seizures from occurring in people who may be predisposed to these events.

What are Seizures?

Seizures are episodes of uncontrolled electrical activity in the brain, which can present in a number of different ways. For example, an absence seizure presents similarly to daydreaming, and an individual will become unresponsive and “stare off into space”. On the other hand, tonic-clonic seizures (otherwise known as grand-mal seizures) are more visually apparent, and present as uncontrollable muscle movements as well as possible drooling, biting your tongue, and/or loss of bladder/bowel control.

Seizures can be very dangerous when left uncontrolled, and therefore medication management is always necessary when someone has been diagnosed with a seizure disorder.

Read about Types of Seizures

Rare but Serious Dangers of Carbamazepine

Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)

These are serious skin conditions. They usually present with a rash and flu-like symptoms including a fever. SJS and TEN can be fatal if not caught and treated quickly. There are also serious drug reactions that can occur, such as “drug reaction with eosinophilia and systemic symptoms” (DRESS) which presents as a fever, rash, and can have involvement of various other organs. At any sign of a fever or rash when taking this medication, immediately seek medical attention.

Reduced red/white blood cell production

There is also the possibility of experiencing reduced white and/or red blood cell production while taking carbamazepine. This can be detected with blood tests, which is why it is important to get frequent bloodwork during the first few weeks of taking carbamazepine as well as regularly throughout the time you are on the medication.

Typical Side Effects of Carbamazepine

Side effects with carbamazepine are relatively common, especially during the first few weeks of taking the medication. Because of this, the medication is typically started at a relatively low dose and increased slowly if tolerated well.

The most common side effects experienced while taking carbamazepine include:

  • Nausea
  • Vomiting
  • Poor muscle control/unsteadiness
  • Dizziness
  • Drowsiness

Drugs That Interact with Carbamazepine

Many medications cannot be taken at the same time as carbamazepine. This is usually due to either carbamazepine increasing or decreasing the concentration of the other drug in your body, or vice versa. It can either increase the concentration of the medication to toxic levels or decrease its effectiveness in your body.

Some of the medications that are absolutely contraindicated with carbamazepine use include:

  • Monoamine oxidase inhibitors (MAOIs)
  • Nefazodone

There are many, many more medications that interact with carbamazepine. Be sure to speak with your healthcare provider about any and all prescription medications, over the counter medications, and supplements you may be taking before you start taking carbamazepine.

Can I Take Carbamazepine if I Am Pregnant or Breastfeeding?

No, carbamazepine should not be taken during pregnancy. The drug crosses the placenta from the mother’s blood to the fetal blood. Its use during pregnancy has been associated with fetal malformations, including spine, brain, and heart defects. You should inform your healthcare provider if you are pregnant or planning to become pregnant while on carbamazepine.

There is less of a firm boundary with breastfeeding while taking carbamazepine. The medication is excreted in breastmilk. However, it is not thought that there are serious long-term risks involved with infant exposure to carbamazepine in breastmilk. It is a decision between you and your healthcare provider if you choose to breastfeed despite the potential risk of carbamazepine exposure to your infant.

  1. Focal Onset Aware Seizures (Simple Partial Seizures). (2022). Retrieved 1 October 2022, from
  2. Tegretol (carbamazepine) – Access data FDA-Approved Drugs [Internet]. [Amended 09/2015; accessed 11/2022].

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