Carbamazepine (Intravenous route)
Serious and sometimes fatal dermatologic reactions, including toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), have been reported, especially in patients with the inherited allelic variant HLA-B*1502 who are almost exclusively of Asian ancestry. Avoid use of carbamazepine in patients testing positive for the allele unless the benefit clearly outweighs the risk. Discontinue if you suspect that the patient has a serious dermatologic reaction. Aplastic anemia and agranulocytosis have also been reported. Obtain a pretreatment complete blood count (CBC) and periodically monitor CBC. Consider discontinuing carbamazepine if significant bone marrow depression develops .
Uses of This Medicine:
Carbamazepine injection is used as a replacement therapy for oral carbamazepine to treat adults with certain types of seizures (epilepsy). Carbamazepine works in the brain and nervous system to control seizures. This medicine is an anticonvulsant.
This medicine is to be given only by or under the direct supervision of your doctor.
Before Using This Medicine:
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of carbamazepine injection in the pediatric population. Safety and efficacy have not been established.
Although appropriate studies on the relationship of age to the effects of carbamazepine injection have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of carbamazepine injection in the elderly. However, elderly patients are more likely to have hyponatremia, which may require caution.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Methylene Blue
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Dabigatran Etexilate
- Doxorubicin Hydrochloride Liposome
- Eslicarbazepine Acetate
- Ethinyl Estradiol
- Irinotecan Liposome
- Morphine Sulfate Liposome
- Tenofovir Alafenamide
- Vincristine Sulfate Liposome
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Influenza Virus Vaccine
- St John's Wort
- Valproic Acid
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.
- Grapefruit Juice
Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.
- Black Tea
Other medical problems—
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Anemia or
- Behavior or mood problems or
- Depression, history of or
- Glaucoma, or history of or
- Hyponatremia (low sodium in the blood) or
- Liver disease, or history of or
- Porphyria (an inherited disease)—Use with caution. May make these conditions worse.
- Asian ancestry (eg, Filipino, Chinese, Japanese, Korean, Taiwanese)—May increase the risk for serious skin reactions. Your doctor may order a special test before prescribing this medicine.
- Bone marrow depression or
- Kidney disease, moderate to severe—Should not be used in patients with this condition.
Proper Use of This Medicine:
A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given through a needle placed in one of your veins.
Precautions While Using This Medicine:
It is very important that your doctor check your progress closely while you are receiving this medicine. Your doctor may want to have certain tests done to see if you are receiving the right amount of medicine or if certain side effects may be occurring without you knowing it. Also, the amount of medicine you are receiving may have to be changed often.
Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
Do not use carbamazepine together with a monoamine oxidase inhibitor (MAOI) or during the first 14 days after you stop taking a MAOI. MAOIs are used for depression and some examples are isocarboxazid (Marplan®), phenelzine (Nardil®), selegiline (Eldepryl®), or tranylcypromine (Parnate®). Do not use this medicine together with boceprevir (Victrelis®), delavirdine (Rescriptor®), and nefazodone (Serzone®).
Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, a fever, or chills while you are using this medicine.
Check with your doctor right away if a fever, sore throat, rash, ulcers in the mouth, nosebleeds, bleeding gums, swollen glands, or small red or purple spots on the skin occur. These could be symptoms of a serious blood problem.
Carbamazepine may cause serious allergic reactions affecting multiple body organs (eg, liver or kidney). Check with your doctor right away if you have the following symptoms: a fever, dark urine, headache, rash, stomach pain, unusual tiredness, or yellow eyes or skin.
Carbamazepine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these unwanted effects, tell your doctor right away.
This medicine will add to the effects of alcohol and other CNS depressants (medicines that cause drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures (eg, barbiturates), muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.
This medicine may cause some people to become drowsy, dizzy, lightheaded, or less alert than they are normally, especially when they are starting treatment or increasing the dose. It may also cause blurred or double vision, weakness, or loss of muscle control in some people. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert and well-coordinated or able to see well.
Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).
Do not stop using this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent worsening of seizures and reduce the possibility of withdrawal symptoms.
Birth control pills containing estrogen may not work properly if you take them while you are using carbamazepine. Unplanned pregnancies may occur. Use a different or additional means of birth control while you are taking carbamazepine. If you have any questions about this, check with your doctor.
Grapefruit and grapefruit juice may increase the effects of this medicine by increasing the amount in the body. You should not eat grapefruit or drink grapefruit juice while you are receiving this medicine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Side Effects of This Medicine:
- Less common
- Back pain
- chest tightness
- nausea and vomiting
- pale skin
- trouble breathing
- troubled breathing with exertion
- unusual bleeding or bruising
- unusual tiredness or weakness
- decreased urine output
- fast or irregular heartbeat
- increased thirst
- muscle pain or cramps
- swelling of the face, ankles, or hands
- Incidence not known
- Bleeding gums
- blistering, peeling, or loosening of the skin
- blood in the urine or stools
- bloody, black, or tarry stools
- changes in behavior
- chest pain
- cough or hoarseness
- dark-colored urine
- decreased urine output
- general feeling of tiredness or weakness
- high fever
- joint or muscle pain
- light-colored stools
- lower back or side pain
- painful or difficult urination
- pinpoint red spots on the skin
- rapid, shallow breathing
- red skin lesions, often with a purple center
- red, irritated eyes
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- stiff neck or back
- stomach pain, continuing
- swelling of the face, ankles, or hands
- swollen or painful glands
- thoughts of killing oneself
- tightness in the chest
- yellow eyes or skin
- More common
- Sleepiness or unusual drowsiness
- Less common
- Double vision
- seeing double
- Incidence not known
- Abdominal or stomach pain
- burning, dry, or itching eyes
- difficulty having a bowel movement (stool)
- discharge, excessive tearing
- dry mouth
- loss of appetite
- redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
- redness, swelling, or soreness of the tongue
- swelling or inflammation of the mouth
- weight loss
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Last Updated: 9/4/2017