Performance Comparison of Microfluidic and Immunomagnetic Platforms for Pancreatic CTC Enrichment
November 15, 2025
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Brand Name :
Epitol, Tegretol, Carbatrol, Equetro, Tegretol XR
Synonyms :
carbamazepen ,carbamazepine, carbamazepine
Class :
Dibenzapine anticonvulsants
Brand Name :
Epitol, Tegretol, Carbatrol, Equetro, Tegretol XR
Synonyms :
carbamazepen ,carbamazepine, carbamazepine
Class :
Dibenzapine anticonvulsants
Dosage Forms & Strengths
Immediate release tablet
200mg
Chewable tablet
100mg
Extended-release capsule
100mg
200mg
300mg
Extended-release tablet
100mg
200mg
400mg
Intravenous solution
10mg/ml
Oral suspension
100mg/5ml
Immediate release::
Initial dose:
Tablets: 100mg orally twice a day
Oral suspension: 50mg orally every 6 hours
Increase every week by 200mg/dose divided every 6-8 hours
Maintenance dose: 400 to 800mg /day
Maximum dose: 1200mg /day
Extended-release:
Initial dose:
Tablets: 200mg orally once a day/100mg orally twice a day
Increase every week by 200mg/dose divided every 6-8 hours
Maintenance dose: 400 to 800mg /day
Maximum dose: 1200mg /day
Indicated for bipolar mania:
Extended-release capsules:
Initial dose: 200mg orally twice a day
Increase every week by 200mg/dose divided every 6-8 hours
Maximum dose: 1600mg /day
Maintenance dose: 800 to 1200mg /day
Maximum dose:1600mg/day
Immediate release:
Initial dose:
Tablets: 200mg orally twice a day
Oral suspension: 100mg orally every 6 hours
Increase every week by 200mg/dose divided every 6-8 hours
Maximum dose: 1600mg /day
Extended-release:
Initial dose: 200mg orally twice a day
Increase every week by 200mg/dose divided every 6-8 hours
Maximum dose: 1600mg /day
Dosage Forms & Strengths
Immediate release tablet
200mg
Chewable tablet
100mg
Extended-release capsule
100mg
200mg
300mg
Extended-release tablet
100mg
200mg
400mg
Oral suspension
100mg/5ml
Indicated for epilepsy:
<6 years of age:
Initial dose(Oral suspension):10 to 20mg/kg/day orally every 6 hours
Initial dose(Tablet): 10 to 20mg/kg/day orally every 8-12 hours
Maintenance dose:400 to 800mg/day
Maximum dose: 1000mg/day
6-12 years:
Initial dose(Oral suspension):100mg orally every 6 hours
Initial dose(Tablet): 100mg orally every 12 hours
Maintenance dose:400 to 800mg/day
Maximum dose: 1000mg/day
Over 12 years of age:
Initial dose(Oral suspension):100mg orally every 6 hours
Initial dose(Tablet): 200mg orally every 12 hours
Maintenance dose:800 to 1200mg/day
Maximum dose: 1000mg/day
Refer adult dosing
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
may decrease the levels of serum concentration of hormonal contraceptives
It may diminish the effect when combined with lonafarnib by affecting CYP3A4 metabolism
It may diminish the effect when combined with irinotecan liposomal by affecting CYP3A4 metabolism
It may diminish the levels when combined with efavirenz by CYP3A4 metabolism
may diminish the concentration of serum when combined with cannabinoid products
may diminish the concentration of serum when combined with cannabinoid products
may diminish the serum concentration when combined with hormonal contraceptives
may diminish the serum concentration when combined with hormonal contraceptives
may diminish the serum concentration when combined with hormonal contraceptives
may diminish the serum concentration when combined with hormonal contraceptives
carbamazepine: they may increase the myelosuppressive effect of clozapine
may diminish the serum concentration when combined with hormonal contraceptives
may diminish the serum concentration when combined with hormonal contraceptives
when both drugs are combined, there may be a decreased effect of nilotinib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
hydroxyzine may enhance the CNS depressant effect of CNS depressants
may increase the serum concentration of CYP3A4 substrates
may increase the central nervous system depressant effect
may increase the CNS depressant effect of opioid agonists
may diminish the serum concentration
may enhance the serum concentration of calcium channel blockers
may diminish the serum concentration
budesonide and formoterol (inhalation)Â
may enhance the serum concentration of CYP3A4 inhibitor
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may decrease the serum concentration when combined with CYP3A4 Inducers (Strong)
may increase or decrease the activity of this enzyme when combined with sparsentan
may diminish the serum concentration when combined with alfentanil
may diminish the serum concentration when combined with apixaban
may diminish the serum concentration when combined with aripiprazole
may diminish the serum concentration when combined with atogepant
may diminish the serum concentration when combined with belumosudil
may diminish the serum concentration when combined with ubrogepant
may diminish the serum concentration when combined with fenfluramine
brexpiprazole : they may diminish the serum concentration of CYP3A4 Inducers
CYP2C19 Inducers: they may diminish the serum concentration of brivaracetam
cabozantinib :they may diminish the serum concentration of CYP3A4 Inducers
clarithromycin: they may enhance serum concentrations of CYP3A4 Inducers
cyclosporin: they may diminish the serum concentration of CYP3A4 Inducers
dexamethasone: they may diminish the serum concentration of CYP3A4 Inducers
diltiazem: they may diminish the serum concentration of CYP3A4 Inducers
enzalutamide: they may diminish serum concentrations of the active metabolites of CYP3A4 inducers
CYP3A4 inducers: they may diminish the serum concentration of eravacycline
erlotinib: they may diminish the serum concentration of CYP3A4 inducers
exemestane: they may diminish the serum concentration of CYP3A4 Inducers
felodipine: they may diminish the serum concentration of CYP3A4 Inducers
CYP3A4 inducers: they may diminish the serum concentration of ganaxolone
may diminish the serum concentration of zanubrutnib
drospirenone/ethinyl estradiol/levomefolateÂ
may diminish the serum concentration of Hormonal Contraceptives
It may diminish the effect when combined with irinotecan liposomal by affecting CYP2B6 metabolism
may diminish the serum concentration of Voxelotor
brigatinib: they may diminish the serum concentration of CYP3A4 Inducers
daclatasvir: they may diminish the serum concentration of CYP3A4 Inducers
guanfacine: they may diminish the serum concentration of CYP3A4 Inducers
CYP3A4 Inducers: they may diminish the serum concentration of larotrectinib
lefamulin: they may diminish the serum concentration of CYP3A4 Inducers
lorlatinib: they may increase the hepatotoxic effect of CYP3A4 Inducers
lurasidone: they may diminish the serum concentration of CYP3A4 Inducers
maraviroc: they may diminish the serum concentration of CYP3A4 Inducers
mitapivat: they may diminish the serum concentration of CYP3A4 Inducers
perampanel: they may diminish the serum concentration of CYP3A4 Inducers
pirtobrutinib: they may diminish the serum concentration of CYP3A4 Inducers
ripretinib: they may diminish the serum concentration of CYP3A4 Inducers
may diminish the concentration of serum when combined with methylprednisolone
may diminish the serum concentration of Hormonal Contraceptives
etonogestrel/ethinyl estradiolÂ
may diminish the serum concentration of Hormonal Contraceptives
ranolazine: they may enhance the serum concentration of CYP3A4 Inducers
sirolimus: they may enhance the serum concentration of CYP3A4 Inducers
triazolam: they may enhance the serum concentration of CYP3A4 Inducers
may diminish the serum concentration when combined with hormonal contraceptives
may diminish the serum concentration when combined with hormonal contraceptives
may diminish the serum concentration when combined with hormonal contraceptives
myelosuppressive activities of lipegfilgrastim can increase if carbamazepine is used in combination
the efficacy of norethisterone is reduced when taken with carbamazepine
by affecting intestinal metabolism, the effect of atazanavir may be decreased
simvastatin: it may diminish the serum concentration of CYP3A4 Inducers
it decreases the concentration of rilpivirine in the serum
It may diminish the effect when combined with pemigatinib by affecting CYP3A4 metabolism
it increases the toxicity of MAO inhibitors
it increases the toxicity of MAO inhibitors
it increases the toxicity of MAO inhibitors
it increases the toxicity of MAO inhibitors
it increases the toxicity of MAO inhibitors
when both drugs are combined, there may be a decreased effect of cabozantinib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased level of serum concentration of alpelisib   
when both drugs are combined, there may be an increased metabolism of erlotinib  
the effect of carbamazepine is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
when both drugs are combined, there may be a reduced level or effect of romidepsin by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
carbamazepine decreases the effect of ixazomib by altering intestinal/hepatic CYP3A4 enzyme metabolism
carbamazepine decreases the effect of lapatinib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
carbamazepine decreases the effect of fedratinib by altering the intestinal/hepatic CYP3A4 enzyme metabolism
they both increase the effect of each other when used simultaneously
they both increase the effect of each other when used simultaneously
it increases the effect of CNS depressants
CNS depressants increase the effect of flunarizine
it increases the effect of CNS depressants
May enhance the toxic effects of the other by pharmacodynamic synergism
may increase the CNS depressant effect
it increases the concentration of CYP3A4 substrates in the serum
it increases the concentration of CYP3A4 substrates in serum
may decrease the level of effectiveness through P-glycoprotein MDR1 efflux transporter
it enhances by affecting the hepatic enzyme CYP2B6 metabolism
they decrease the concentration of doravirine in the serum
relugolix/​estradiol/​norethindroneÂ
it decreases by affecting the hepatic enzyme CYP3A4 metabolism
it decreases by affecting the hepatic enzyme CYP3A4 metabolism
may diminish the serum concentration
may diminish the serum concentration
may decrease the serum concentration of macimorelin
may decrease the serum concentration of lenacapavir
they decrease the concentration of buprenorphine in the serum
may enhance the metabolism
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish serum concentrations of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
they decrease the concentration of glasdegib in the serum
they decrease the concentration of active metabolites of infigratinib in the serum
may enhance the serum concentration of elbasvir/grazoprevir
it increases the concentration of CYP3A4 substrates in the serum
abrocitinib: they may diminish the serum concentration of CYP2C19 Inducers
CYP3A4 Inducers: they may diminish the serum concentration of avapritinib
CYP3A4 Inducers: they may diminish the serum concentration of capmatinib
ceritinib: they may diminish the serum concentration of CYP3A4 Inducers
crizotinib: they may diminish the serum concentration of CYP3A4 Inducers
duvelisib: they may diminish the serum concentration of CYP3A4 Inducers
The serum concentration of Avacopan may be decreased by strong CYP3A4 inducers
they decrease the concentration of lurbinectedin in the serum
CYP3A4 inducers decrease the concentration of nimodipine in the serum
may diminish the concentration of serum when combined with lemborexant
may enhance the concentration of serum when combined with CYP3A4 substrates
may enhance the concentration of serum when combined with CYP3A4 substrates
bosutinib: they may diminish the serum concentration of CYP3A4 Inducers
cariprazine: they may diminish the serum concentration of CYP3A4 Inducers
cobimetinib: they may diminish the serum concentration of CYP3A4 Inducers
daridorexant: they may diminish the serum concentration of CYP3A4 Inducers
deflazacort: they may diminish serum concentrations of CYP3A4 Inducers
CYP3A4 Inducers: they may diminish the serum concentration of elacestrant
fedratinib: they may diminish the serum concentration of CYP3A4 Inducers
flibanserin: they may diminish the serum concentration of CYP3A4 Inducers
ibrexafungerp: they may diminish the serum concentration of CYP3A4 Inducers
ivabradine: they may diminish the serum concentration of CYP3A4 Inducers
mavacamten: they may diminish the serum concentration of CYP3A4 Inducers
neratinib: they may diminish the serum concentration of CYP3A4 Inducers
olaparib: they may diminish the serum concentration of CYP3A4 Inducers
olutasidenib: they may diminish the serum concentration of CYP3A4 Inducers
omaveloxolone: they may diminish the serum concentration of CYP3A4 Inducers
pemigatinib: they may diminish the serum concentration of CYP3A4 Inducers
rimegepant: they may diminish the serum concentration of CYP3A4 Inducers
ulipristal: they may diminish the serum concentration of CYP3A4 Inducers
venetoclax: they may diminish the serum concentration of CYP3A4 Inducers
voclosporin: they may diminish the serum concentration of CYP3A4 Inducers
vonoprazan fumarate: they may enhance the serum concentration of CYP3A4 Inducers
vorapaxar: they may diminish the serum concentration of CYP3A4 Inducers
may diminish the serum concentration when combined
may diminish the concentration of serum when combined with antihepaciviral products
may diminish the concentration of serum when combined with axitinib
may diminish the concentration of serum when combined with dasabuvir
may diminish the concentration of serum when combined with entrectinib
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the risk of adverse/toxic effect of antipsychotic agents
may enhance the risk of adverse/toxic effect of antipsychotic agents
may enhance the risk of adverse/toxic effect of antipsychotic agents
may enhance the risk of adverse/toxic effect of antipsychotic agents
may enhance the risk of adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may enhance the adverse/toxic effect of antipsychotic agents
may reduce the level of serum concentration of estrogen drugs
bazedoxifene/conjugated estrogens
may reduce the level of serum concentration of estrogen drugs
may reduce the level of serum concentration of estrogen drugs
may reduce the level of serum concentration of estrogen drugs
may reduce the level of serum concentration of estrogen drugs
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration when combined with CYP1A2 substrates
CYP3A4 inhibitors increase the concentration of carbamazepine in the serum
CYP3A4 inhibitors increase the concentration of carbamazepine in the serum
CYP3A4 inhibitors increase the concentration of carbamazepine in the serum
CYP3A4 inhibitors increase the concentration of carbamazepine in the serum
CYP3A4 inhibitors increase the concentration of carbamazepine in the serum
may enhance the metabolism of clobetasol propionate
may diminish the serum concentration when combined with neuromuscular-blocking agents
may diminish the serum concentration when combined with neuromuscular-blocking agents
may diminish the serum concentration when combined with neuromuscular-blocking agents
may diminish the serum concentration when combined with neuromuscular-blocking agents
may diminish the serum concentration when combined with neuromuscular-blocking agents
may enhance the metabolism when combined with acetaminophen
It may enhance the toxicity when combined with mipomersen
may decrease the levels of serum concentrations
may decrease the levels of serum concentrations
may decrease the levels of serum concentrations
may decrease the levels of serum concentrations
may decrease the levels of serum concentrations
may decrease the levels of serum concentrations
may decrease the levels of serum concentrations
may decrease the levels of serum concentrations
may decrease the levels of serum concentrations
may decrease the levels of serum concentrations
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may enhance the concentration of serum when combined with carbamazepine
may enhance the concentration of serum when combined with carbamazepine
may enhance the concentration of serum when combined with carbamazepine
may enhance the concentration of serum when combined with carbamazepine
may enhance the concentration of serum when combined with carbamazepine
it decreases the concentration of thyroid products in serum
it decreases the concentration of thyroid products in serum
it decreases the concentration of thyroid products in serum
it decreases the concentration of thyroid products in serum
It may enhance the effect when combined with cannabidiol by affecting CYP3A4 metabolism
It may diminish the effect when combined with lumateperone by affecting CYP3A4 metabolism
It may enhance the effect when combined with miconazole vaginal by affecting CYP3A4 metabolism
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
It may diminish the levels when combined with tamsulosin by affecting CYP3A4 metabolism
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
The potential for increased CNS depression risk or seriousness occurs when carbamazepine is used together with pinazepam
The potential for increased CNS depression risk or seriousness occurs when carbamazepine is used together with pipecuronium
When carbamazepine is used together with bromisoval, the risk or seriousness of CNS depression is enhanced
When captodiame is used together with carbamazepine, there is a risk or seriousness of CNS depression is enhanced
The potential for CNS depression may enhanced when carbamazepine is used together with fencamfamin
Combining tegafur with carbamazepine can reduce tegafur’s metabolism
When carbamazepine is used together with niaprazine, the risk or seriousness of CNS depression is enhanced
When carbamazepine is used together with levosulpiride, the risk or seriousness of CNS depression is enhanced
When dexrabeprazole and carbamazepine is used together, this leads to reduction in the dexrabeprazole’s metabolism
When carbamazepine is used together with fluconazole, this leads to reduction in the carbamazepine metabolism
When chlordiazepoxide is used together with carbamazepine, this leads to enhanced risk or seriousness of CNS depression
When carbamazepine is used together with melitracen, this leads to enhanced risk or seriousness of CNS depression
When carbamazepine is used together with andrographolide, this leads to enhanced risk or seriousness of bleeding
When emylcamate is used together with carbamazepine, this leads to enhanced risk or seriousness of CNS depression
When acepromazine is used together with carbamazepine, this leads to enhanced risk or seriousness of CNS depression
cefpirome leads to a reduction in the rate of excretion of carbamazepine which leads to increased level of serum
carbamazepine: it may decrease the serum concentration of bamifylline
dihydroartemisinin/piperaquineÂ
combination of dihydroartemisinin/piperaquine with carbamazepine will decrease the levels of DHA/PPQ in blood
carbamazepine: it may decrease the excretion rate of metheglobinemia associated agents
carbamazepine: it may decrease the excretion rate of metheglobinemia associated agents
carbamazepine: it may decrease the excretion rate of metheglobinemia associated agents
carbamazepine: it may decrease the excretion rate of metheglobinemia associated agents
carbamazepine: it may decrease the excretion rate of metheglobinemia associated agents
carbamazepine may decrease the excretion rate of almasilate, leading to higher serum levels
may decrease the level of serum concentration
may decrease the level of serum concentration
may decrease the level of serum concentration
may decrease the level of serum concentration
it may decrease the levels of serum concentration
it may decrease the levels of serum concentration
it may decrease the levels of serum concentration
it may decrease the levels of serum concentration
it may decrease the levels of serum concentration
Decreased therapeutic efficacy of carbamazepine.
when both drugs combine carbamazepine will increase the effect of ifosfamide by affecting the enzyme CYP3A4 metabolism.
cyclophosphamide effect of action decreased by affecting enzyme CYP3A4 metabolism
when both drugs are combined, there may be an increased metabolism of paclitaxel  
belzutifan on interacting with brentuximab has its effect decreased by altering the intestinal or hepatic CYP3A4 enzyme metabolism.
increases serum level of cabazitaxel by affecting the enzyme CYP3A4
May decrease the serum level of docetaxel by affecting the enzyme CYP3A4
carbamazepine decreases the effect of gefitinib by altering the intestinal/ hepatic CYP3A4 enzyme metabolism
CYP3A4 inhibitors increase the concentration of carbamazepine in serum
CYP3A4 inducers decrease the concentration of carbamazepine in serum
it decreases the concentration of thyroid products in serum
oxymetholone decreases the metabolism and increases the toxicity of carbamazepine
it decreases the effect or level of finasteride by altering the intestinal/hepatic enzyme CYP3A4 metabolism
topiramate increases the CNS depressing effect of carbamazepine
it decreases the concentration of antiseizure agents in the serum
may decrease the level by affecting hepatic enzyme CYP3A4 metabolism
it may increase the toxicity of each other
may diminish the serum concentration
may alter the level by affecting CYP450 enzyme metabolism
may decrease the level by affecting hepatic enzyme CYP3A4 metabolism
may decrease the levels of serum concentration of clozapine
hydrocodone/​chlorpheniramine/​pseudoephedrineÂ
may diminish the serum concentration
may enhance the serum concentration of CYP3A4 inhibitors
may decrease the serum concentration
may decrease the serum concentration of erdafitinib.
they decrease the concentration of rilpivirine in the serum
may decrease the serum concentration of macitentan
may decrease the level of serum concentration of pretomanid
CYP3A4 Inducers may decrease the serum concentration of eliglustat
may decrease the serum concentration of encorafenib
may decrease the serum concentration of estazolam
may diminish the serum concentration of corticosteroids
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may diminish the serum concentration of CYP3A4 inducers
may decrease the level of serum concentrations of itraconazole
may diminish the serum concentration when combined with selpercatinib
may diminish the serum concentration when combined with upadacitinib
may reduce the levels of serum concentration of tivozanib
may diminish the serum concentration when combined with tolvaptan
may diminish the serum concentration of lidocaine
may diminish the serum concentration when combined with nintedanib
may diminish the serum concentration when combined with ziprasidone
may enhance the serum concentration when combined
eszopiclone: they may diminish the serum concentration of CYP3A4 Inducers
ethosuximide: they may diminish the serum concentration of CYP3A4 Inducers
hydrocodone: they may diminish the serum concentration of CYP3A4 Inducers
mefloquine: they may diminish the serum concentration of CYP3A4 Inducers
meperidine: they may diminish the serum concentration of CYP3A4 Inducers
methadone: they may diminish the serum concentration of CYP3A4 Inducers
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may enhance the serum concentration of Buprenorphine
estrogens esterified/methyltestosterone            Â
may diminish the serum concentration when combined
may enhance the metabolism when combined
may enhance the concentration of serum when combined with fluticasone
alprazolam: they may diminish the serum concentration of CYP3A4 Inducers
aprepitant: they may diminish the serum concentration of CYP3A4 Inducers
codeine: they may diminish serum concentrations of CYP3A4 Inducers
copanlisib: they may diminish the serum concentration of CYP3A4 Inducers
omeprazole: they may diminish the serum concentration of CYP2C19 Inducers
diazepam: they may diminish the serum concentration of CYP3A4 Inducers
disopyramide: they may diminish the serum concentration of CYP3A4 Inducers
elvitegravir: they may diminish the serum concentration of CYP3A4 Inducers
everolimus: they may diminish the serum concentration of CYP3A4 Inducers
fentanyl: they may diminish the serum concentration of CYP3A4 Inducers
ibrutinib: they may diminish the serum concentration of CYP3A4 Inducers
idelalisib: they may diminish the serum concentration of CYP3A4 Inducers
ifosfamide: they may diminish serum concentrations of CYP3A4 Inducers
imatinib: they may diminish the serum concentration of CYP3A4 Inducers
lapatinib: they may diminish the serum concentration of CYP3A4 Inducers
lercanidipine: they may diminish the serum concentration of CYP3A4 Inducers
levamlodipine: they may diminish the serum concentration of CYP3A4 Inducers
mianserin: they may diminish the serum concentration of CYP3A4 Inducers
midazolam: they may diminish the serum concentration of CYP3A4 Inducers
may diminish the concentration of serum when combined with istradefylline
midostaurin: they may diminish the serum concentration of CYP3A4 Inducers
naldemedine: they may diminish the serum concentration of CYP3A4 Inducers
naloxegol: they may diminish the serum concentration of CYP3A4 Inducers
osimertinib: they may diminish the serum concentration of CYP3A4 Inducers
oxycodone: they may diminish the serum concentration of CYP3A4 Inducers
prednisone: they may diminish the serum concentration of CYP3A4 Inducers
quetiapine: they may diminish the serum concentration of CYP3A4 Inducers
quinidine: they may diminish the serum concentration of CYP3A4 Inducers
quinine: they may diminish the serum concentration of CYP3A4 Inducers
regorafenib: they may diminish the serum concentration of CYP3A4 Inducers
repaglinide: they may diminish the serum concentration of CYP3A4 Inducers
ribociclib: they may diminish the serum concentration of CYP3A4 Inducers
samidorphan: they may diminish the serum concentration of CYP3A4 Inducers
sorafenib: they may diminish the serum concentration of CYP3A4 Inducers
thiotepa: they may enhance serum concentrations of CYP3A4 Inducers
ticagrelor: they may diminish serum concentrations of CYP3A4 Inducers
toremifene: they may diminish serum concentrations of CYP3A4 Inducers
trabectedin: they may diminish the serum concentration of CYP3A4 Inducers
tramadol: they may diminish the serum concentration of CYP3A4 Inducers
trazodone: they may diminish the serum concentration of CYP3A4 Inducers
tucatinib: they may diminish the serum concentration of CYP3A4 Inducers
vemurafenib: they may diminish the serum concentration of CYP3A4 Inducers
verapamil: they may diminish the serum concentration of CYP3A4 Inducers
vilazodone: they may diminish the serum concentration of CYP3A4 Inducers
zolpidem: they may diminish the serum concentration of CYP3A4 Inducers
zopiclone: they may diminish the serum concentration of CYP3A4 Inducers
may decrease the concentration of serum when combined with methylergometrine
may diminish the serum concentration of each other when combined
may diminish the concentration of serum when combined with aripiprazole lauroxil
may diminish the concentration of serum when combined with artemether and lumefantrine
may diminish the concentration of serum when combined with atazanavir
benzhydrocodone/acetaminophenÂ
may diminish the concentration of serum when combined with benzhydrocodone
it decreases the concentration of CYP3A4 inducers in serum
nicardipine: they may diminish the serum concentration of CYP3A4 Inducers
clopidogrel: they may diminish the serum concentration of CYP3A4 Inducers
dapoxetine: they may diminish the serum concentration of CYP3A4 Inducers
cimetidine: they may diminish the serum concentration of CYP3A4 Inducers
diazoxide: they may diminish the serum concentration of CYP3A4 Inducers
flunarizine: they may diminish the serum concentration of CYP3A4 Inducers
melatonin: they may diminish the serum concentration of CYP3A4 Inducers
atosiban: they may diminish the serum concentration of CYP3A4 Inducers
alfuzosin: they may diminish the serum concentration of CYP3A4 Inducers
amiodarone: they may enhance the serum concentration of carbamazepine
cannabis: they may enhance the serum concentration of CYP3A4 inducers
propofol: they may enhance the serum concentration of CYP3A4 inducers
tacrolimus: they may enhance the serum concentration of CYP3A4 Substrates
warfarin: they may enhance the serum concentration of CYP3A4 inducers
the rate of excretion of carbamazepine may be decreased with aurothiglucose
the rate of metabolism of tocofersolan can be raised when taken with carbamazepine
the risk of adverse effects can be increased
moxisylyte: it may decrease the excretion rate of carbamazepine
an increase in rate of metabolism may be seen
When carbamazepine is used together with lomitapide, this leads to an enhancement in lomitapide’s metabolism
may decrease the level of serum concentration
may decrease the level of serum concentration
may decrease the level of serum concentration
it may reduce the therapeutic effect
it increases the effect of CNS depressants
it increases the effect of CNS depressants
it increases the effect of CNS depressants
CYP3A4 inducers decrease the concentration of opioids
CYP3A4 inducers decrease the concentration of opioids
CYP3A4 inducers decrease the concentration of opioids
CYP3A4 inducers decrease the concentration of opioids
CYP3A4 inducers decrease the concentration of hormonal contraceptives in the serum
CYP3A4 inducers decrease the concentration of hormonal contraceptives in the serum
CYP3A4 inducers decrease the concentration of hormonal contraceptives in the serum
CYP3A4 inducers decrease the concentration of hormonal contraceptives in the serum
they increase the toxicity of iobitridol
seizure lowering agents increase the toxic or adverse effects of iohexol
by altering the gastrointestinal absorption, the concentration of cyanocobalamin may be reduced with carbamazepine
Mechanism of action
These drugs work by binding to and stabilizing the inactivated state of sodium channels in neurons, which reduces the excitability of the neuron and can lead to decreased activity in areas of the brain such as the thalamus and decreased synaptic transmission and summation of temporal stimulation. This can ultimately lead to decreased neuronal discharge, which can have therapeutic effects in certain conditions such as seizures, pain, and hypertension.
Spectrum
It is a medication that belongs to a class of drugs called anticonvulsants. It is primarily used to treat seizures and bipolar disorder. It is also used off-label for several other conditions, such as neuropathic pain, trigeminal neuralgia, and borderline personality disorder. It works by decreasing abnormal electrical activity in the brain. The therapeutic range for carbamazepine is 4-12 mcg/ml; levels above this may cause adverse effects such as drowsiness, ataxia, and diplopia.
Frequency defined:
>10%
Dizziness
Nausea
Ataxia
Drowsiness
Vomiting
1-10%
Dry mouth
Rare
Stevens-Johnson syndrome
Punctate cortical lens opacities
Myocardial infarction
Hepatic failure
Frequency undefined:
Pancytopenia
Eosinophilia
Porphyria
Congestive heart failure
Hypotension
Pancreatitis
Leukocytosis
Eosinophilia
Edema
Drowsiness
Tinnitus
Speech disturbances
Leg cramps
Fever and chills
Leukopenia
Black box warning
It is used to treat seizures and certain types of chronic pain. The FDA has issued a black box warning for carbamazepine due to an increased risk of severe skin reactions, such as Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). These reactions can be fatal and occur anytime during treatment, including after the first dose.
Patients should be closely monitored for signs of skin reactions, and if any symptoms occur, the medication should be discontinued immediately. Additionally, before starting treatment with carbamazepine, patients should be screened for the HLA-B*15:02 allele, as it is associated with a higher risk of developing SJS or TEN
Contraindications
Documented hypersensitivity to the drug, history of bone marrow suppression, administration of MAO inhibitors within the last 14 days, coadministration with nefazodone, and coadministration with NNRTIs are all contraindicated. Additionally, patients with jaundice or hepatitis should not take carbamazepine, and it is especially not recommended during the first trimester of pregnancy due to the risk of fetal carbamazepine syndrome.
Caution
Cardiac disorders: These may cause cardiac conduction disturbances, so patients with a history of cardiac disorders should be closely monitored.
Liver dysfunction: It should be used with caution in patients with liver dysfunction, as it may cause liver damage.
Blood disorders: It may cause blood disorders, such as aplastic anemia, agranulocytosis, and thrombocytopenia. Regular blood tests are recommended for patients taking the drug.
Dizziness and drowsiness: It may cause dizziness and drowsiness, so patients should be advised to avoid activities that require mental alertness until they know how the drug affects them.
Hyponatremia: It may cause hyponatremia, a condition characterized by low sodium levels in the blood.
Interactions: It may interact with other medications, so you must inform your healthcare provider of all medications and supplements you are taking.
Withdrawal: Rapid withdrawal of carbamazepine may cause seizures; it should be tapered off gradually under the guidance of a healthcare professional.
Pregnancy and breast-feeding: It should be used with caution during pregnancy and breastfeeding, as it may cause congenital disabilities and may be excreted in breast milk.
Pregnancy consideration: It should be used with caution during pregnancy, as it may cause congenital disabilities.
Lactation: Excretion of the drug in human breast milk is known
Pregnancy category:
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category
Pharmacology
It is an anticonvulsant and mood-stabilizing drug. The exact mechanism of action has yet to be fully understood, but it is thought to involve several mechanisms.
Sodium channel inhibition: It blocks voltage-dependent sodium channels, which reduces neuronal hyperexcitability and seizures.
Calcium channel inhibition: It also blocks voltage-dependent calcium channels, which can affect neurotransmitter release.
Glutamate inhibition: It may inhibit the release of the excitatory neurotransmitter glutamate, which can also reduce neuronal hyperexcitability.
Modulation of GABAergic neurotransmission: It can also increase the activity of the inhibitory neurotransmitter GABA, further reducing neuronal hyperexcitability.
Hormonal modulation: It may also affect the levels of certain hormones, such as cortisol and melatonin
Pharmacodynamics
It treats seizures and the symptoms of trigeminal neuralgia by inhibiting sodium channels. In bipolar disorder, carbamazepine has been found to decrease mania symptoms in a clinically significant manner, according to the Young Mania Rating Scale (YMRS). It has a narrow therapeutic index.
Pharmacokinetics
Absorption: It is well-absorbed from the gastrointestinal tract, with a bioavailability of 85% when given as an oral suspension. The peak serum time for immediate-release tablets is 4.5 hours; for extended-release tablets is 3-12 hours; and for oral suspension is 1.5 hours.
Distribution: It is highly protein-bound, with a protein binding of 75-90%. The volume of distribution is 1.5 L/kg in neonates, 1.9 L/kg in children, and 0.59-2 L/kg in adults.
Metabolism: It is metabolized in the liver by the cytochrome P450 enzyme system, primarily by the CYP3A4 and CYP2C19 isoenzymes. The primary active metabolite is carbamazepine-10,11-epoxide, which also contributes to its anticonvulsant effect.
Elimination/Excretion: The half-life of carbamazepine is 25-65 hours after initial dosing, but it decreases to 10-20 hours after autoinduction. The half-life for extended-release tablets is 35-40 hours. It is eliminated mainly through the urine (72%) and, to a lesser extent, through the feces (28%)
Administration
For Intravenous use only
It is available for intravenous use only; it should be diluted with 100 mL of a compatible diluent, such as 0.9% NaCl, lactated Ringer’s solution, or D5W. The measured dose should be transferred to a 100 mL bag of the compatible solution. The solution should be visually inspected for particulate matter, cloudiness, or discoloration before administration, and if any of these are present, the solution should be discarded and not used.
Oral administration
It should be taken with food to reduce the risk of stomach upset. Extended-release tablets should not be chewed, crushed, or cut, as this can affect the controlled release of the medication and lead to a higher risk of side effects. The extended-release tablets should be swallowed whole.
Storage
carbamazepine IV solutions before dilution should be stored at 20-25°C (68-77°F) with excursions permitted to 15-30°C (59-86°F). Once diluted, the solution should be used within a specific time frame depending on storage conditions:
It is essential to follow these storage guidelines to ensure the stability and potency of the medication. Any solution that has been stored beyond the recommended time frame or has been frozen should be discarded and not used.
Patient information leaflet
Generic Name: carbamazepine
Pronounced: [ kar-ba-MAZ-e-peen ]
Why do we use carbamazepine?
It is a medication that is used to treat several conditions, including:
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