Tegrital (Carbamazepine 400mg)

Tegrital general information

What is Tegrital used for?

Tegrital tablets 400mg are used to treat a variety of neurological conditions, primarily to control seizures in several forms of epilepsy, ranging from partial to generalized tonic-clonic seizures; although they are not effective in forms of epilepsy that do not have seizures (absence and myoclonic).  Tegrital 400 can be used for monotherapy or in conjunction with other medications.  Tegrital tablets 400mg are also used to control neuropathic (nerve) pain, which is described as burning or shooting pain and is usually caused by nerve damage or a malfunctioning nervous system.  Tegrital tablets 400mg are used to control idiopathic neuropathic pain (of unknown cause) trigeminal neuralgia (pain originating from the trigeminal nerve in the face) and trigeminal neuralgia due to multiple sclerosis; also idiopathic glossopharyngeal neuralgia (severe pain in the tongue, throat, ear, and tonsils) and painful diabetic neuropathy.  Other uses for Tegrital 400 include control of mania (a mental illness characterised elevated mood and overactivity with increased energy and irritability, insomnia and heightened self-esteem), treatment of bipolar disorder (where periods of mania alternate with periods of depression), symptom control in alcohol-withdrawal syndrome and to help control extreme thirst and urine production in diabetes insipidus, caused by a neurohormone (hormone produced by a nerve cell).  Tegrital 400 helps treat these different conditions working through a common mechanism to relieve symptoms.

How does Tegrital work?

Tegrital tablets 400mg contain carbamazepine, an anticonvulsant with neurotropic (affecting nerves) and psychotropic (affecting the brain to cause mood alteration) actions.  Carbamazepine in Tegrital 400 regulates nerve function by acting directly on nerve cells to stabilise the nerve membranes and “calm down” nerves that have become hyperexcited (overactive in sending out nerve signals) and inhibits the repetitive firing and transmission of excitatory nerve messages, which reduces the impulses that cause seizures and pain.  It is thought that the neurotropic and antiepileptic effects of carbamazepine in Tegrital 400 that prevent repetitive firing of nerve messages may be due to the blocking action of carbamazepine on the sodium channels in nerve cell membranes that control the flow of sodium ions, which triggers the nerve cell to send out a nerve impulse; also blocking release of glutamate, which is the main excitatory neurotransmitter in the brain, is thought to contribute to this action.  The psychotropic and antimanic effects of carbamazepine in Tegrital tablets 400mg are thought to be due to suppression of the neurotransmitters (chemicals that allow nerve cells to communicate) dopamine, that plays a major role in controlling the pleasure and reward centres of the brain, and noradrenaline,the neurotransmitter that regulates the body’s ability to respond to danger and excitement and is involved in mood disorders like mania.  These combined actions of carbamazepine in Tegrital tablets 400mg help control symptoms in various neurological conditions.

What does Tegrital contain?

Tegrital tablets 400mg contain the active ingredient carbamazepine, used to treat a variety of neurological conditions.  They also contain cellulose-microcrystalline, carmellose sodium, silica-colloidal anhydrous, magnesium stearate.

Treating epilepsy with Tegrital

Tegrital tablets 400mg contain carbamazepine, an anticonvulsant with neurotropic (affecting nerves) and psychotropic (affecting the brain to cause mood alteration) action, that is used to control seizures in several forms of epilepsy, ranging from partial to generalized tonic-clonic seizures; although they are not effective in controlling symptoms in forms of epilepsy that do not have seizures (absence and myoclonic).  Epilepsy is due to an imbalance of neurotransmitters (chemicals that allow nerve cells to communicate), which cause bursts of electrical activity in the brain sending nerve signals from the brain to the central nervous system that triggers seizures.  Carbamazepine in Tegrital 400 regulates nerve function by acting directly on nerve cells to stabilise the nerve membranes and “calm down” nerves that have become hyperexcited (overactive in sending out excitatory nerve signals) and inhibits the repetitive firing and transmission of excitatory nerve messages, which reduces the impulses that cause seizures.  Also blocking release of glutamate, which is the main excitatory neurotransmitter in the brain, is thought to contribute to this action.

Tegrital for neuropathic pain

Tegrital tablets 400mg contain carbamazepine, an anticonvulsant with neurotropic (affecting nerves) and psychotropic (affecting the brain to cause mood alteration) action, that is used to control neuropathic (nerve) pain, including idiopathic (of unknown cause) trigeminal neuralgia (pain originiating from the trigeminal nerve in the face) and trigeminal neuralgia due to multiple sclerosis, idiopathic glossopharyngeal neuralgia (severe pain in the tongue, throat, ear, and tonsils) and diabetic neuropathy.  Carbamazepine in Tegrital 400 regulates nerve function by acting directly on nerve cells to stabilise the nerve membranes and “calm down” nerves that have become hyperexcited (overactive in sending out excitatory nerve signals) and inhibits the repetitive firing and transmission of excitatory nerve messages, which reduces the impulses that cause nerve pain.  Also blocking release of glutamate, which is the main excitatory neurotransmitter in the brain, is thought to contribute to this action.

Tegrital for mania

Tegrital tablets 400mg contain carbamazepine, an anticonvulsant with neurotropic (affecting nerves) and psychotropic (affecting the brain to cause mood alteration) action that is used to control mania (a mental illness characterised elevated mood and overactivity with increased energy and irritability, insomnia and heightened self-esteem).  Tegrital tablets 400mg are also used in the treatment of bipolar disorder (where periods of mania alternate with periods of depression).  The psychotropic and antimanic effects of carbamazepine in Tegrital tablets 400mg are thought to be due to suppression of the neurotransmitters (chemicals that allow nerve cells to communicate) dopamine, that plays a major role in controlling the pleasure and reward centres of the brain, and noradrenaline, the neurotransmitter that regulates the body’s ability to respond to danger and excitement and is involved in mood disorders like mania. 

What are the side effects of Tegrital?

The most commonly reported side effects when taking Tegrital tablets 400mg include dizziness or light headedness, tiredness or drowsiness, weakness, unsteadiness when walking (ataxia), headache, nausea, vomiting, dry mouth, dermatitis, urticaria (hives), diarrhoea, constipation, blurred or double vision, tremor, nystagmus (involuntary movements of the eye), oedema (fluid retention), weight increase.  Less common side effects include: restlessness, agitation or confusion, muscle pain or cramps, numbness or tingling in hands or feet (paraesthesia), hallucinations

When should Tegrital not be used?

You should not use Tegrital tablets 400mg if you:

• are allergic to carbamazepine, related drugs like tricyclic antidepressants or any ingredients in Tegrital
• have a history of bone-marrow depression
• have hepatic porphyries (impaired production of porphyrin, a pigment important for liver function and blood formation)
• have irregular heartbeat caused by a condition called A-V block
• have a history of mental illness
• have systemic lupus erythematosus
• are taking monoamine oxidase inhibitors (MAOI) medicines or within 14 days of taking a MAOI
• take high doses of the vitamin nicotinamide or drink large amounts of grapefruit juice
• are taking medicines that interact with Tegrital including antidepressants like fluvoxamine, nefazodone and tricyclic antidepressants, the antiinflammatories dextropropoxyphene, ibuprofen, danazol for endometriosis, some antibiotics like erythromycin and clarithromycin, antifungals like itraconazole, ketoconazole, fluconazole, isoniazid and rifampicin for tuberculosis, antihistamines like loratadine and terfenadine, antipsychotics like olanzapine clozapine, haloperidol, olanzapine, risperidone, antivirals like ritonavir, acetazolamide for fluid retention, glaucoma and some seizures, diltiazem and verapamil for angina and high blood pressure, omeprazole for peptic ulcers, the muscle relaxants oxybutynin and dantrolene, ticlopidine to prevent blood clots, the anticonvulsants valproic acid, valpromide, primidone and progabide, quetiapine and Loxapine for mental health disorders, the sedative valnoctamide, the analgesics methadone, paracetamol, phenazone, tramadol, the antibiotic doxycycline, antidepressants like bupropion, citalopram, nefazodone, trazodone, tricyclic antidepressants, some antiepileptics like, clonazepam, oxcarbazepine, phenytoin, the antifungal itraconazole, the antihelmintic praziquantel, imatinib, cisplatin or doxorubicin for cancer treatment, alprazolam and midazolam for anxiety, theophylline for asthma, oestrogen and progesterone for HRT and contraception, felodipine and digoxin for heart failure, corticosteroids like prednisolone, immunosuppressant like cyclosporine, thyroid hormones like levothyroxine, the antiemetic metoclopramide,  lithium for mood disorders, diuretics like hydrochlorothiazide and furosemide, isotretinoin for acne, herbal preparations containing St John's wort

What medications interact with Tegrital?

Several medications interact with Tegrital tablets 400mg and should either not be taken while you are taking Tegrital or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Tegrital: the anticonvulsants valproic acid, valpromide, primidone and progabide, quetiapine and loxapine for mental health disorders, the sedative valnoctamide, isoniazid for tuberculosis, the antiemetic metoclopramide,  lithium for mood disorders, diuretics like hydrochlorothiazide and furosemide
• Drugs that affect Tegrital: antidepressants like fluvoxamine, nefazodone and tricyclic antidepressants, the antiinflammatories dextropropoxyphene, ibuprofen, danazol for endometriosis, some antibiotics like erythromycin and clarithromycin, antifungals like itraconazole, ketoconazole, fluconazole, isoniazid and rifampicin for tuberculosis, antihistamines like loratadine and terfenadine, antipsychotics like olanzapine, antivirals like ritonavir, diltiazem and verapamil for angina and high blood pressure, omeprazole for peptic ulcers, the muscle relaxants oxybutynin and dantrolene, ticlopidine to prevent blood clots, also the vitamin nicotinamide or large amounts of grapefruit juice, isotretinoin for acne, herbal preparations containing St John's wort, theophylline for asthma, cisplatin or doxorubicin for cancer treatment
• Drugs that are affected by Tegrital: the analgesics methadone, paracetamol, phenazone, tramadol, the antibiotic doxycycline, anticoagulants like warfarin, antidepressants like bupropion, citalopram, nefazodone, trazodone, tricyclic antidepressants, some antiepileptics like, clonazepam, oxcarbazepine, phenytoin, the antifungal itraconazole, the antihelmintic praziquantel, imatinib for cancer treatment, antipsychotics like clozapine, haloperidol, olanzapine, risperidone, antivirals like ritonavir, alprazolam and midazolam for anxiety, theophylline for asthma, oestrogen and progesterone for HRT and contraception, felodipine and digoxin for heart failure, corticosteroids like prednisolone, immunosuppressant like cyclosporine, thyroid hormones like levothyroxine

How should Tegrital be taken?

You should take your Tegrital tablets 400mg swallowed whole with a glass of water, usually twice daily morning and evening with food, which may be increased to three times daily with meals.  The dose you take and how often depends on your condition, what you are being treated for and your doctor’s recommendations and may be increased or decreased, depending on how well your condition is controlled.  You should continue to take your Tegrital tablets 400mg for as long as recommended by your doctor, as it helps to control your condition but does not cure it.

How long should you take Tegrital?

You should continue to take your Tegrital tablets 400mg for as long as recommended by your doctor, as it helps to control your condition but does not cure it.

Missed dose of Tegrital

If you miss a dose of Tegrital tablets 400mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Tegrital be stored?

You should store your Tegrital tablets 400mg below 25°C in a cool dry place.