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Treatment of epilepsy (partial seizures and generalized tonic-clonic seizures); trigeminal neuralgia and other neuropathic pain where carbamazepine is indicated; sometimes used in bipolar disorder/mania under specialist care

Carbamazepine stabilizes hyperexcited nerve membranes by blocking voltage-gated sodium channels, reducing repetitive neuronal firing. This helps control seizures and decreases abnormal nerve pain transmission. The controlled-release (CR) formulation provides more stable blood levels over time.

Take tablet by mouth exactly as prescribed. Swallow whole; do not crush or chew (CR). Usually taken 1–2 times daily with or after food to reduce stomach upset; take at the same time each day. Dose is individualized and may be titrated gradually; do not stop abruptly without medical advice.

Dizziness, drowsiness, headache, nausea, vomiting, constipation, dry mouth, blurred/double vision, unsteadiness, fatigue, skin rash

Prescription-only medicine. May cause serious skin reactions (SJS/TEN) especially in patients with HLA-B*1502 (common in some Asian populations) and HLA-A*3101; seek urgent care for rash, blistering, fever. Risk of blood disorders (aplastic anemia/agranulocytosis) and liver injury—monitor CBC and LFTs if advised; report sore throat, fever, mouth ulcers, unusual bruising/bleeding, jaundice. Can cause hyponatremia (low sodium) leading to confusion, seizures. Causes drowsiness—avoid driving/operating machinery until effects are known. Avoid abrupt withdrawal (may trigger seizures). Use caution in hepatic impairment, cardiac conduction problems, glaucoma, elderly. Not recommended in patients with bone marrow depression. May reduce effectiveness of hormonal contraceptives—use additional contraception.

Potent enzyme inducer—reduces effect of oral contraceptives, warfarin, doxycycline, many antiretrovirals. Levels increased by macrolide antibiotics (erythromycin/clarithromycin), azole antifungals (fluconazole/itraconazole), verapamil/diltiazem, grapefruit juice. Levels decreased by rifampicin, phenytoin, phenobarbital. Additive CNS depression with alcohol, benzodiazepines, opioids. Serious interaction with MAO inhibitors (avoid; require washout). Increased risk of hyponatremia with diuretics (e.g., hydrochlorothiazide).

Store below 25°C in a dry place, protected from light and moisture. Keep in original blister pack and out of reach of children.

Zeptol CR 400 Tablet (Sun Pharma), Tegretol CR 400 Tablet (Novartis), Mazetol CR 400 Tablet, Zen Retard 400 Tablet, Carbamazepine CR 400 mg tablets (generic brands)