AdultPediatricDosage Forms & Strengths tablet, chewable (Epitol) 100mg tablet, immediate-release (Tegretol) 200mg tablet, extended-release (Tegretol XR) 100mg 200mg 400mg capsule, extended-release (Equetro, Carbatrol) 100mg 200mg 300mg oral suspension (Teril) 100mg/5mL IV solution (Carnexiv) 10mg/mL (200mg/20mL single-dose vial) Epilepsy Indicated for the treatment of partial seizures with complex symptomatology (eg, psychomotor, temporal lobe), generalized tonic-clonic seizures (grand mal), and mixed seizure patterns, which include the seizure types listed here or other partial or generalized seizures Maintenance dose range: 800-1200 mg/day PO in divided doses Therapeutic range: 4-12 mg/L (16.9-50.8 micromoles/L) Maximum dose of 1600 mg/day recommended (rarely, some patients have required 1.6-2.4 g/day) Tablet (immediate-release) Initial: 200 mg PO q12hr Increase qWeek by 200 mg/day divided PO q6-8hr Tablet/capsule (extended-release) Initial: 200 mg PO q12hr Increase qWeek by 200 mg/day PO divided q12hr Oral suspension Initial: 10 mL (200 mg) PO q6hr Increase qWeek by up to 200 mg/day PO divided q6-8hr IV solution Indicated as replacement therapy in adults for PO carbamazepine formulations, when PO administration is temporarily not feasible Approved as temporary use (ie, ≤7 days) for the following seizure types Partial seizures with complex symptomatology Generalized tonic-clonic seizures Mixed seizure patterns which include the above, or other partial or generalized seizures Dose The total daily dose of carbamazepine IV is 70% of the total daily PO dose from which patients are being Equally divide the total daily dose of the IV in four 30-minute infusions, separated by 6 hr Patients should be switched back to oral carbamazepine administration at their previous total daily oral dose and frequency of administration as soon as clinically appropriate IV administration has not been studies for >7 days Limitations of use Not indicated for absence seizures (including atypical absence); carbamazepine has been associated with increased frequency of generalized convulsions in these patients Trigeminal Neuralgia Indicated for pain associated with trigeminal neuralgia; beneficial results have also been reported in glossopharyngeal neuralgia; carbamazepine is not a simple analgesic and should not be used for the relief of trivial aches or pains Maintenance dose range: 400-800 mg/day PO in divided doses; attempts to reduce or discontinue the drug should be made at least every 3 months throughout the treatment period Maximum dose of 1200 mg/day recommended Tablet (immediate-release) Initial: 200 mg/day on day 1 divided q12hr Increase by up to 200 mg/day in increments of 100 mg q12hr, to dose range of 400-800 mg/day divided twice daily; not to exceed 1200 mg/day Tablet/capsule (extended-release) Initial (XR tablet): 200 mg/day PO on day 1 divided q12hr Initial (XR capsules): 200 mg PO once on the first day; may increase dose by up to 200 mg/day using increments of 100 mg q12hr to reach an effective/tolerated dose; not to exceed 1200 mg/day Increase by up to 200 mg/day in increments of 100 mg q12hr, to dose range of 400-800 mg/day divided twice daily; not to exceed 1200 mg/day Oral suspension Initial: 200 mg PO on day 1 divided q6hr Increase by up to 200 mg/day in increments of 50 mg q6hr, to dose range of 400-800 mg/day divided twice daily; not to exceed 1200 mg/day Bipolar Mania Equetro Indicated for treatment of patients with acute manic or mixed episodes associated with bipolar I disorder Initial: 200 mg PO q12hr Increase by increments of 200 mg/day; not to exceed 1600 mg/day Dosage Modifications Renal impairment Glomerular filtration rate <10 mL/min: Administer 75% of dose and monitor Peritoneal dialysis and hemodialysis: Administer 75% of dose and monitor Hepatic impairment Use caution; drug is metabolized primarily in the liver Restless Legs Syndrome (Off-label) 100-600 mg PO qHS for up to 5 weeks Schizophrenia (Off-label) 200-1300 mg/day for 2.5-8 weeks Postherpatic Neuralgia 100-200 mg PO qDay; may increase slowly to 1200 mg/day Intravenous Carbamazepine (Orphan) Orphan designation for treatment of epilepsy patients who cannot take anything by mouth Orphan sponsor Lundbeck, LLC; Four Parkway North; Deerfield, IL 60015 Dosage Forms & Strengths tablet, chewable (Epitol) 100mg tablet, immediate-release (Tegretol) 200mg tablet, extended-release (Tegretol XR) 100mg 200mg 400mg capsule, extended-release (Equetro, Carbatrol) 100mg 200mg 300mg oral suspension (Teril) 100mg/5mL Epilepsy Indicated for the treatment of partial seizures with complex symptomatology (eg, psychomotor, temporal lobe), generalized tonic-clonic seizures (grand mal), and mixed seizure patterns, which include the seizure types listed here or other partial or generalized seizures <6 Years Initial (oral suspension): 10-20 mg/kg/day PO q6hr Initial (tablet): 10-20 mg/kg/day PO q8-12hr Maintenance: For tablets or suspension may divide frequency into 3-4 times daily not to exceed 35 mg/kg/day 6-12 Years Initial (oral suspension): 50 mg PO q6hr Initial (tablet, immediate- or extended-release): 100 mg PO q12hr; may increase qWeek by 100 mg/day Maintenance: 400-800 mg/day PO q6-8hr (immediate-release); q12hr (extended-release) Not to exceed 1000 mg/day >12 Years Initial (oral suspension): 10 mL (200 mg) PO q6hr Initial (tablet, immediate- or extended-release tab/cap): 200 mg PO q12hr May increase by up to 200 mg/day qWeek; q12hr (extended-release tablet); q6-8hr (other formulations) 12-15 years: Dose not to exceed 1000 mg/day >15 years: Dose not to exceed 1200 mg/day Dosage Modifications Renal impairment Glomerular filtration rate <10 mL/min: Administer 75% of dose and monitor Peritoneal dialysis and hemodialysis: Administer 75% of dose and monitor Hepatic impairment Use caution; drug is metabolized primarily in the liver Dosing Considerations Important to initiate slowly by advancing dose every 5-7 days to minimize GI upset and allow autoinduction of liver enzymes to occur (autoinduction is complete at 3-5 weeks) Children <12 years who receive >400 mg/day may be converted to Carbatrol ER at the same dose, q12hr PO Monitor: CBC, LFTsInteraction CheckerEnter a drug name and carbamazepineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (46)apixabancarbamazepine will decrease the level or effect of apixaban by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Reduces anticoagulant effect by decreasing apixaban systemic exposure artemether/lumefantrinecarbamazepine will decrease the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacyatazanavircarbamazepine will decrease the level or effect of atazanavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.cabotegravircarbamazepine will decrease the level or effect of cabotegravir by increasing metabolism. Contraindicated. Cabotegravir is metabolized by UGT1A1 and UGT1A9. Strong UGT1A1 or UGT1A9 inducers decrease cabotegravir systemic exposure, thereby increasing potential for loss of virologic response.cariprazinecarbamazepine will decrease the level or effect of cariprazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. CYP3A4 is responsible for the formation and elimination of cariprazine's active metabolites. The effect of CYP3A4 inducers on cariprazine exposure has not been evaluated and the net effect is unclear.cobimetinibcarbamazepine will decrease the level or effect of cobimetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Avoid coadministration. Strong or moderate CYP3A inducers may decrease cobimetinib systemic exposure by >80% and reduce its efficacy.darunavircarbamazepine will decrease the level or effect of darunavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with carbamazepine may result in loss of therapeutic effect and development of resistance to darunavirdienogest/estradiol valeratecarbamazepine will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Women should not choose estradiol valerate/dienogest as their contraceptive while using strong CYP3A4 inducers due to potential decrease in contraceptive efficacy. Estradiol valerate/dienogest should not be used for at least 28 days after discontinuation of the inducer due to possibility of decreased contraceptive efficacy. doravirinecarbamazepine will decrease the level or effect of doravirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of doravirine with a strong CYP3A inducer may decrease doravirine plasma concentrations and/or effects. Potential for loss of virologic response and possible resistance to doravirine. efavirenzcarbamazepine, efavirenz. Either decreases levels of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of carbamazepine with NNRTIs may result in a loss of virologic response and possible resistance to the NNRTI. A decrease in AUC is observed for both carbamazepine (27%) and efavirenz (36%) when coadministered.elbasvir/grazoprevircarbamazepine will decrease the level or effect of elbasvir/grazoprevir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. The therapeutic effect of elbasvir/grazoprevir may be reduced if coadministered with strong CYP3A inducers and is therefore contraindicated.elvitegravir/cobicistat/emtricitabine/tenofovir DFcarbamazepine decreases levels of elvitegravir/cobicistat/emtricitabine/tenofovir DF by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. May lead to loss of virologic response and possible resistance.etravirinecarbamazepine will decrease the level or effect of etravirine by affecting hepatic enzyme CYP2C9/10 metabolism. Contraindicated. Coadministration of carbamazepine with NNRTIs may result in a loss of virologic response and possible resistance to the NNRTI.carbamazepine will decrease the level or effect of etravirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of carbamazepine with NNRTIs may result in a loss of virologic response and possible resistance to the NNRTI.fostemsavircarbamazepine will decrease the level or effect of fostemsavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of fostemsavir (prodrug) with strong CYP3A4 inducers significantly decreases temsavir (active moiety) plasma concentrations, which may lead to loss of virologic response and resistance.irinotecancarbamazepine will decrease the level or effect of irinotecan by affecting hepatic enzyme CYP2B6 metabolism. Contraindicated.irinotecan liposomalcarbamazepine will decrease the level or effect of irinotecan liposomal by affecting hepatic enzyme CYP2B6 metabolism. Contraindicated.isavuconazonium sulfatecarbamazepine will decrease the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.isocarboxazidcarbamazepine increases toxicity of isocarboxazid by unknown mechanism. Contraindicated. D/C MAO inhibitor 2 weeks before.ledipasvir/sofosbuvircarbamazepine will decrease the level or effect of ledipasvir/sofosbuvir by P-glycoprotein (MDR1) efflux transporter. Contraindicated. P-gp inducers decrease sofosbuvir levels, and therefore decrease conversion to sofosbuvir's active metabolite (GS-331007) responsible for 90% of pharmacologic effectlenacapavircarbamazepine will decrease the level or effect of lenacapavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lenacapavir with strong CYP3A inducers is contraindicated. linezolidcarbamazepine increases toxicity of linezolid by unknown mechanism. Contraindicated. D/C MAO inhibitor 2 weeks before.lonafarnibcarbamazepine will decrease the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lonafarnib is a sensitive CYP3A4 substrate. Coadministration with strong or moderate CYP3A4 inducers is contraindicated.lorlatinibcarbamazepine will decrease the level or effect of lorlatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lorlatinib with strong CYP3A inducers is contraindicated. Discontinue the strong CYP3A inducer for 3 plasma half-lives before initiating lorlatinib.lumacaftor/ivacaftorcarbamazepine will decrease the level or effect of lumacaftor/ivacaftor by aldehyde dehydrogenase inhibition. Contraindicated. Strong CYP3A inducers have minimal effect on lumacaftor exposure, but decreased ivacaftor exposure (AUC) by 57%. This may reduce the effectiveness of lumacaftor/ivacaftor. Therefore, coadministration is not recommended.lumefantrinecarbamazepine will decrease the level or effect of lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacylurasidonecarbamazepine decreases levels of lurasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated; decreases lurasidone Cmax by ~85%.mavacamtencarbamazepine will decrease the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated.carbamazepine will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.naloxegolcarbamazepine will decrease the level or effect of naloxegol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Use of naloxegol with strong CYP3A4 inducers is not recommendednefazodonenefazodone will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.nefazodone increases levels of carbamazepine by decreasing metabolism. Contraindicated.carbamazepine decreases levels of nefazodone by increasing metabolism. Contraindicated.nevirapinecarbamazepine decreases levels of nevirapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of carbamazepine with NNRTIs may result in a loss of virologic response and possible resistance to the NNRTI.nirmatrelvircarbamazepine will decrease the level or effect of nirmatrelvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Nirmatrelvir, a CYP3A4 substrate, is contraindicated with strong CYP3A4 inducers. Significantly reduced nirmatrelvir plasma concentrations may be associated with potential for loss of virologic response and possible resistance. Do not initiate nirmatrelvir/ritonavir immediately after discontinuing a strong 3A4 inducer owing to time needed for systemic clearance of the inducer.nirmatrelvir/ritonavircarbamazepine will decrease the level or effect of nirmatrelvir/ritonavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Nirmatrelvir, a CYP3A4 substrate, is contraindicated with strong CYP3A4 inducers. Significantly reduced nirmatrelvir plasma concentrations may be associated with potential for loss of virologic response and possible resistance. Do not initiate nirmatrelvir/ritonavir immediately after discontinuing a strong 3A4 inducer owing to time needed for systemic clearance of the inducer.ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)carbamazepine will decrease the level or effect of ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) by increasing metabolism. Contraindicated. Strong CYP2C8 inducers may reduce dasabuvir levels, and therefore decreased efficacy of Viekira Pakcarbamazepine will decrease the level or