**Carbatit 200mg Tablet (Carbamazepine) – Description & Key Information**

**1. Active Ingredient:** Carbamazepine (200mg per tablet)
**2. Drug Class:** Anticonvulsant (Anti-seizure medication) / Mood Stabilizer / Analgesic (for specific nerve pain).
**3. Primary Uses:**
* **Epilepsy:** Treatment of partial seizures (with or without generalization), generalized tonic-clonic seizures.
* **Trigeminal Neuralgia:** Treatment of the intense facial pain associated with this condition.
* **Bipolar Disorder:** Sometimes used as a mood stabilizer, particularly for acute mania or mixed episodes (though often not a first-line choice).

**4. Mechanism of Action:** While not fully understood, carbamazepine works primarily by:
* Blocking voltage-gated sodium channels in neurons. This stabilizes hyperexcitable nerve membranes, inhibits repetitive firing, and reduces the spread of seizure activity.
* Possibly affecting other neurotransmitter systems.

**5. Important Warnings & Precautions (CRITICAL):**
* **Black Box Warning (Most Serious):**
* **Aplastic Anemia & Agranulocytosis:** Potentially life-threatening bone marrow suppression leading to severely low blood cell counts. Requires regular blood monitoring (CBC).
* **Severe Dermatologic Reactions:** Including Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). Risk is higher in individuals with the HLA-B*1502 allele (found more commonly in Asian ancestry). Genetic testing may be recommended before starting.
* **HLA-B*1502 Screening:** Strongly recommended for patients of Asian descent before initiating therapy due to the significantly increased risk of SJS/TEN.
* **Suicidal Thoughts/Behavior:** Antiepileptic drugs (AEDs), including carbamazepine, increase the risk of suicidal thoughts or behavior. Patients and caregivers must be vigilant for mood/behavior changes.
* **Hormonal Contraception Interaction:** Carbamazepine **significantly reduces** the effectiveness of birth control pills, patches, rings, and possibly implants/progestin-only pills. Alternative or additional non-hormonal contraception is essential.
* **Hyponatremia:** Can cause low sodium levels in the blood, especially in the elderly. Symptoms include nausea, headache, confusion, lethargy. Monitoring may be needed.
* **Liver Toxicity:** Can cause hepatitis and elevated liver enzymes. Liver function tests may be monitored.
* **Pregnancy & Breastfeeding:**
* **Teratogenic:** Associated with an increased risk of major congenital malformations (neural tube defects, craniofacial defects, cardiovascular malformations). Use during pregnancy requires careful risk-benefit assessment and high-dose folate supplementation. Consider alternative AEDs if possible.
* **Breastfeeding:** Carbamazepine passes into breast milk and can cause adverse effects in the infant (drowsiness, poor sucking). Discuss risks/benefits with a doctor.
* **Withdrawal:** Do **not** stop abruptly. Sudden discontinuation can trigger seizures or rebound neuralgia. Must be tapered off gradually under medical supervision.

**6. Common Side Effects:**
* Dizziness, drowsiness, unsteadiness (ataxia)
* Nausea, vomiting
* Double vision (diplopia), blurred vision
* Headache
* Dry mouth
* Mild skin rashes
* Constipation or diarrhea

**7. Serious Side Effects (Require Immediate Medical Attention):**
* **Skin:** Severe rash, blistering, peeling skin, mouth sores (signs of SJS/TEN).
* **Blood/Infection:** Fever, sore throat, mouth ulcers, easy bruising/bleeding, unusual tiredness, frequent infections (signs of blood disorders).
* **Liver:** Yellowing of skin/eyes (jaundice), dark urine, severe nausea/vomiting, abdominal pain.
* **Heart:** Irregular heartbeat, fainting.
* **Neurological:** Severe dizziness, uncontrolled movements, seizures worsening.
* **Mental Health:** New or worsening depression, suicidal thoughts, aggression, agitation.
* **Allergy:** Hives, difficulty breathing, swelling (face/lips/tongue/throat).

**8. Significant Drug Interactions:** Carbamazepine is a **potent inducer of liver enzymes (CYP3A4)**. This means it can **decrease the effectiveness** of many other drugs metabolized by this system, including:
* Many other anticonvulsants (e.g., lamotrigine, valproate, topiramate, clonazepam, ethosuximide)
* Most oral hormonal contraceptives
* Many antidepressants (e.g., TCAs, some SSRIs)
* Blood thinners (e.g., warfarin, DOACs like apixaban/rivaroxaban)
* Some antibiotics (e.g., doxycycline)
* Some antifungal agents (e.g., itraconazole, ketoconazole)
* Some statins (e.g., simvastatin, atorvastatin)
* Some immunosuppressants (e.g., cyclosporine, tacrolimus)
* Some HIV medications
* **Grapefruit Juice:** Can *increase* carbamazepine levels significantly, increasing toxicity risk. Avoid grapefruit juice.

**9. Dosage (General – ALWAYS follow your doctor’s prescription):**
* Usually started at a low dose (e.g., 100-200mg once or twice daily) and gradually increased (“titrated”) over days/weeks to find the effective dose while minimizing side effects.
* Maintenance doses vary widely (often 600mg to 1200mg per day, divided into 2-4 doses).
* **Take exactly as prescribed.** Do not skip doses or stop suddenly.
* Can be taken with or without food, but consistency is best to avoid stomach upset.

**Key Points to Remember:**

1. **Blood Monitoring:** Regular Complete Blood Counts (CBC) and Liver Function Tests (LFTs) are crucial.
2. **Skin Reaction Vigilance:** Report any rash *immediately*.
3. **Birth Control Interaction:** Use alternative/reliable non-hormonal contraception.
4. **Never Stop Suddenly:** Tapering is essential.
5. **Inform All Healthcare Providers:** Tell every doctor, dentist, and pharmacist you see that you are taking carbamazepine due to its many interactions.
6. **Pregnancy Planning:** Discuss with your doctor well before conception.
7. **Carry Medical ID:** Consider wearing identification stating you take carbamazepine.

**This information is for general knowledge only and does not constitute medical advice. Always consult your doctor or pharmacist for personalized information regarding your condition, treatment, and potential risks/benefits of Carbatit (carbamazepine).**