Tegretol CR 400mg

Tegretol CR general information

What is Tegretol CR used for?

Tegretol CR 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). Tegretol CR tablets can be used to treat epilepsy as first line therapy of in patients who have not responded to other antiepileptic drugs. Tegretol CR 400 is used to control neuropathic (nerve) pain, including idiopathic (of unknown cause) trigeminal neuralgia (pain originating 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. Other uses for Tegretol CR tablets include treatment of bipolar disorder, alcohol-withdrawal syndrome and to help control extreme thirst and urine production in diabetes, caused by a neurohormone (hormone produced by a nerve cell). Tegretol CR tablets help treat these different conditions working through a common mechanism to relieve symptoms.

How does Tegretol CR work?

Tegretol CR tablets 400mg contain carbamazepine, an anticonvulsant with neurotropic (affecting nerves) and psychotropic (affecting the brain to cause mood alteration) actions. Carbamazepine in Tegretol CR tablets 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 action of Tegretol CR 400 that prevents 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. The psychotropic effect of Tegretol CR tablets are thought to be due to the suppression by carbamazepine of the neurotransmitters (chemicals that allow nerve cells to communicate) dopamine and noradrenaline. Tegretol CR tablets are coated with a special coating for slow controlled release of the active ingredient.

What does Tegretol CR contain?

Tegretol CR 400 tablets contain the active ingredient carbamazepine (400mg), used to treat a variety of neurological conditions. They also contain cellulose-microcrystalline, silica-colloidal anhydrous, magnesium stearate, talc, ethylcellulose aqueous dispersion, acrylates copolymer, sodium starch glycollate, hypromellose, polyoxyl 40 hydrogenated castor oil, iron oxide red, iron oxide yellow, titanium dioxide.

Treating epilepsy with Tegretol CR

Tegretol CR tablets 400mg contain carbamazepine, an anticonvulsant with neurotropic (affecting nerves) 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 Tegretol CR tablets 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.

Tegretol CR for neuropathic pain

Tegretol CR tablets 400mg contain carbamazepine, an anticonvulsant with neurotropic (affecting nerves) action that is used to control neuropathic (nerve) pain, including idiopathic (of unknown cause) trigeminal neuralgia (pain originating 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 Tegretol CR tablets 400mg 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.

What are the side effects of Tegretol CR?

The most commonly reported side effects when taking Tegretol CR 400 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). Less common side effects include: restlessness, agitation or confusion, muscle pain or cramps, numbness or tingling in hands or feet (paraesthesia), hallucinations.

When should Tegretol CR not be used?

You should not use Tegretol CR 400 if you:

• are allergic to carbamazepine, related drugs like tricyclic antidepressants or any ingredients in Tegretol
• have a history of bone-marrow depression
• have hepatic porphyrias (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 pregnant or are breastfeeding without discussion with your doctor
• have kidney or liver disease
• 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 Tegretol, 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 Tegretol CR?

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

• Drugs that cause a serious reaction or increase side effects with Tegretol: 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 Tegretol: 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 treament
• Drugs that are affected by Tegretol: 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 Tegretol CR be taken?

You should take your Tegretol CR tablets 400mg swallowed whole with a glass of water, twice daily morning and evening with food. You should not crush or chew your tablets, as they are coated with a special coating for slow release of the active ingredient. The dose you take and for 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 Tegretol CR 400 for as long as recommended by your doctor.

How long should you take Tegretol CR?

You should continue to take your Tegretol CR 400 tablets for as long as recommended by your doctor.

Missed dose of Tegretol CR

If you miss a dose of Tegretol CR 400 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 Tegretol CR be stored?

You should store your Tegretol CR 400below 25°C in a cool dry place.