Select a medication above to begin.
carbamazepine
generic
Black Box Warnings .
Serious Dermatologic Rxns and HLA-B*15:02 Allele
serious, sometimes fatal dermatologic rxns reported, incl. toxic epidermal necrolysis and Stevens-Johnson syndrome; risk 10x greater in some Asian countries; strong assoc. between risk and HLA-B*15:02 allele, which is found almost exclusively in Asian pts; screen pts of genetically at-risk ancestry (see pkg insert) for HLA-B*15:02 allele before initiating tx; pts testing positive should not be treated w/ carbamazepine unless benefit clearly outweighs risk
Aplastic Anemia/Agranulocytosis
risk 5-8x greater than that of general public but low overall risk in untreated general population; transient or persistent decr. platelet or WBC counts not uncommon w/ carbamazepine tx but majority of leukopenia cases do not progress to aplastic anemia or agranulocytosis; perform baseline and periodic hematological testing; if low or decr. WBC or platelet counts monitor closely, consider D/C tx if evidence of significant bone marrow depression
Adult Dosing .
Dosage forms: ER CAP: 100 mg, 200 mg, 300 mg; TAB: 100 mg, 200 mg; ER TAB: 100 mg, 200 mg, 400 mg; CHEWABLE: 100 mg; SUSP: 100 mg per 5 mL
seizure disorder
- [immediate-release form]
- Dose: 800-1200 mg/day PO divided bid-qid; Start: 200 mg PO bid, incr. by 200 mg/day qwk; Max: 1600 mg/day; Info: adjust dose based on tx response and serum levels; give w/ food; divide dose qid for susp; taper dose gradually to D/C
- [extended-release form]
- Dose: 400-600 mg ER PO bid; Start: 200 mg ER PO bid, incr. by 200 mg/day qwk; Max: 1600 mg/day ER; Info: adjust dose based on tx response and serum levels; may open ER cap, but do not crush/chew contents; do not cut/crush/chew ER tab; taper dose gradually to D/C
trigeminal neuralgia
- [immediate-release form]
- Dose: 200-400 mg PO bid; Start: 100 mg PO bid, may incr. by 200 mg/day; Max: 1200 mg/day; Info: adjust dose based on tx response and serum levels; give w/ food; divide dose qid for susp; taper dose gradually to D/C
- [extended-release cap form]
- Dose: 200-400 mg ER PO bid; Start: 200 mg ER PO qd x1 day, may incr. by 200 mg/day; Max: 1200 mg/day ER; Info: adjust dose based on tx response and serum levels; may open ER cap, but do not crush/chew contents; taper dose gradually to D/C
- [extended-release tab form]
- Dose: 200-400 mg ER PO bid; Start: 100 mg ER PO bid, may incr. by 200 mg/day; Max: 1200 mg/day ER; Info: adjust dose based on tx response and serum levels; do not cut/crush/chew ER tab; taper dose gradually to D/C
bipolar disorder (off-label)
- [800-1200 mg/day PO divided bid-qid]
- Start: 200 mg PO bid, may incr. by 200 mg/day; Max: 1600 mg/day; Info: adjust dose based on tx response and serum levels; give w/ food; divide dose qid for susp; taper dose gradually to D/C
renal dosing
- [adjust dose amount]
- CrCl <10: decr. usual dose by 25%
- HD: decr. usual dose by 25%, on dialysis days admin. after dialysis; no supplement; PD: decr. usual dose by 25%; no supplement
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: ER CAP: 100 mg, 200 mg, 300 mg; TAB: 100 mg, 200 mg; ER TAB: 100 mg, 200 mg, 400 mg; CHEWABLE: 100 mg; SUSP: 100 mg per 5 mL
seizure disorder
- [immediate-release form, <6 yo]
- Dose: 20-30 mg/kg/day PO divided bid-qid; Start: 10-20 mg/kg/day PO divided bid-qid, incr. by 5-10 mg/kg/day qwk; Max: 35 mg/kg/day; Info: adjust dose based on tx response and serum levels; give w/ food; divide dose qid for susp; taper dose gradually to D/C
- [immediate-release form, 6-12 yo]
- Dose: 400-800 mg/day PO divided bid-qid; Start: 100 mg PO bid, incr. by 100 mg/day qwk; Max: 1000 mg/day; Info: adjust dose based on tx response and serum levels; give w/ food; divide dose qid for susp; taper dose gradually to D/C
- [extended-release tab form, 6-12 yo]
- Dose: 200-400 mg ER PO bid; Start: 100 mg ER PO bid, incr. by 100 mg/day qwk; Max: 1000 mg/day ER; Info: adjust dose based on tx response and serum levels; do not cut/crush/chew ER tab; taper dose gradually to D/C
- [extended-release cap form, <12 yo]
- Dose: 200-400 mg ER PO bid; Max: 35 mg/kg/day up to 1000 mg/day ER; Info: for pts converting from IR form >400 mg/day; adjust dose based on tx response and serum levels; may open ER cap, but do not crush/chew contents; taper dose gradually to D/C
- [immediate-release form, 12-15 yo]
- Dose: 800-1200 mg/day PO divided bid-qid; Start: 200 mg PO bid, incr. by 200 mg/day qwk; Max: 1000 mg/day; Info: adjust dose based on tx response and serum levels; give w/ food; divide dose qid for susp; taper dose gradually to D/C
- [extended-release form, 12-15 yo]
- Dose: 400 mg ER PO bid; Start: 200 mg ER PO bid, incr. by 200 mg/day qwk; Max: 1000 mg/day ER; Info: adjust dose based on tx response and serum levels; may open ER cap, but do not crush/chew contents; do not cut/crush/chew ER tab; taper dose gradually to D/C
- [immediate-release form, >15 yo]
- Dose: 800-1200 mg/day PO divided bid-qid; Start: 200 mg PO bid, incr. by 200 mg/day qwk; Max: 1200 mg/day; Info: adjust dose based on tx response and serum levels; give w/ food; divide dose qid for susp; taper dose gradually to D/C
- [extended-release form, >15 yo]
- Dose: 400-600 mg ER PO bid; Start: 200 mg ER PO bid, incr. by 200 mg/day qwk; Max: 1200 mg/day ER; Info: adjust dose based on tx response and serum levels; may open ER cap, but do not crush/chew contents; do not cut/crush/chew ER tab; taper dose gradually to D/C
renal dosing
- [adjust dose amount]
- CrCl <10: decr. usual dose by 25%
- HD: decr. usual dose by 25%, on dialysis days admin. after dialysis; no supplement; PD: decr. usual dose by 25%; no supplement
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised