Generic Epitol

1. Denomination

Tegretol

2. Active Substance

Carbamazepine

3. Indications for Use.

Epilepsy (except for petit mal), manic states, preventive measures for manic-depressive disorders, alcohol abstinence, neuralgia of trifacial and glossopharyngeal nerves, diabetic neuropathy.

4. Action

Anti-convulsion drug, also takes moderate anti-manic, anti-depressive and analgetic actions. In non-sugar diabetes favors the normalization of water balance.

5. Posology and Administration

Carbamazepine should be administered strongly individually!
The drug should be taken orally, in adults - 100–1600 mg daily (in compliance with indications and evidence of disease), in children - 10–20 mg/kg daily in several intakes.

6. Counterindications

The medical drug is counterindicated in cardio conductivity defect, liver damages. Likewise there are several counterindications: hypersensitivity, disorders of marrowy blood formation (anemia, leukopenia), porphyria.

7. Should Be Taken with Precautions, if…

Before the start of therapy and in its process regular blood analyses (cell elements) and urine, liver function indexes control are recommended. With caution it should be administered in heart, liver or kidneys diseases, in hematologic disorders, elevated intraocular pressure, latent insanities, non-adequate reaction on distal stimuli, agitation, the diseases marked by convulsions of a mixed character, in elderly age.
One should not stop the treatment abruptly. Women are recommended an additional intake of folic acid (before the beginning of pregnancy or during it); in order to prevent elevated bleeding in the last weeks of pregnancy and in newborns it is possible to use vitamin K.

8. Interface with Other Medications

Administration on drug combination only the attending doctor has the right to do it; self-willed administration may result in adverse consequences and in the health impairment!

9. Overdosing

When there is overdosage the enhancement of symptoms and signs of side effects of Carbamazepine takes place.

10. Side Effects

On the part of central nervous system and peripheral nervous system: often – dizziness, balance problem in standing, headache, drowsiness, eye-movement disorders, buzzing in ears, aggressive behavior, hallucinations, impairment of consciousness, promotion of mental affections.
On the part of alimentary system: vomiting, nausea, dry mouth, diarrhea, constipation, loss of appetite, pains in the stomach, stomatitis.
On the part of cardio-vascular system: seldom – myocardial asequence, bradycardia, arrythmias, heart failure, collapse.
On the part of urinary system: seldom – compromised kidneys function, kidneys failure.
Moreover, increase of the body mass, edemas, metabolic imbalance, compromised thyroid gland, pneumonia, skin rash, itching, pain in legs are possible.

11. Pregnancy and Lactation

In the period of pregnancy and breastfeeding Carbamazepine should be administered with precaution, strongly on life-saving indication, when there is no smoother alternative.

12. Driving

Vehicles drivers and people operating mechanisms should refrain from the named kinds of activities during the treatment, especially in the beginning of Carbamazepine administration.

 THE CHOICE OF DRUG FOR DIFFERENT TYPES OF SEIZURE AND EPILEPSY SYNDROMES
Each drug has two names—the generic or chemical name (for example, sodium valproate), and the trade name (for example, Epilim), which is the name given by the maker of the drug. Traditionally but not invariably, generic drugs are written with an initial small letter, and the trade names with an initial capital letter. Doctors may write a prescription using either the generic or trade name. If the generic name is used, the pharmacist in the retail chemist or hospital pharmacy department can provide either the generic or trade drug. If, however, the doctor prescribes the drug using the trade name, then the pharmacist must provide the patient with that drug.
There are a number of other drugs which are used only in status epilepticus, when they are then given by either an injection into a vein (intravenous route) or by administering a special solution into the rectum. These drugs include chlormethiazole (Heminevrin), lignocaine (Xylocard), lorazepam (Ativan), paraldehyde (no trade name). Diazepam (Valium) is probably the drug most frequently employed in the UK.
Chlormethiazole is frequently used in status epilepticus associated with excessive alcohol consumption or in alcohol withdrawal seizures. Paraldehyde is frequently used in children (given intramuscularly or preferably into the rectum). Although an effective drug, it has a strong and characteristic smell. Lorazepam and lignocaine are more commonly used in North America than in the UK.
Two other drugs are frequently used in children, particularly in young children who have myoclonic seizures or infantile spasms. These drugs are prednisolone, (Prednesol, Deltacortril) which is given by mouth, and ACTH (which stands for adrenocorticotrophic hormone (Synacthen) which is given by intramuscular injection. Both these drugs have potential adverse effects common to all cortisone-like drugs, such as raising the blood pressure and blood sugar and increasing the risk of developing severe infections. Because of these possible
side-effects, other drugs are now being used to treat infantile spasms in young children, including vigabatrin and sodium valproate.

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Epilepsy

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