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Carbamazepine (Tegretol)

A mood stabilizer and anti-seizure medicine. Effective, but it needs blood monitoring and interacts with many other drugs.

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What It Is

Carbamazepine treats bipolar mania, seizures, and certain nerve pains.

It speeds up the liver’s breakdown of many medicines (including itself), so doses and interactions need attention.

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How to Take It

Take with food to reduce stomach upset and dizziness. Swallow extended-release forms whole.

Take consistently; do not stop suddenly.

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Black Box Warnings

  • Serious skin reactions (Stevens-Johnson syndrome). People of Asian ancestry should be tested for the gene HLA-B*1502 before starting.
  • Serious blood problems — rare drops in red cells, white cells, or platelets (aplastic anemia/agranulocytosis).
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Common (Usually Mild) Side Effects

  • Dizziness, drowsiness.
  • Nausea.
  • Double or blurred vision.
  • Unsteadiness.

Serious — Seek Care Now

  • Any rash, especially with blisters, peeling, or mouth/eye sores.
  • Fever, sore throat, mouth sores, easy bruising — possible blood problem.
  • Low sodium: headache, confusion, weakness, nausea.
  • Yellow skin/eyes (liver).
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Alcohol & Interactions

Avoid alcohol — it adds to drowsiness and dizziness.

Many interactions: it can make birth control pills less effective and lower levels of many drugs. Always check before adding or stopping a medicine.

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Required Monitoring

Blood count (CBC) — baseline and periodically
Liver tests (LFTs)
Sodium level
Carbamazepine blood level
HLA-B*1502 gene test before starting if you have Asian ancestry

This is general information, not a substitute for your prescriber's advice. Never start, stop, or change a dose on your own — some of these medicines need a slow, supervised taper. Bring this sheet to your appointments and ask questions.