Tegretol
Tegretol is a medicine used to prevent epileptic seizures, reduce nerve pain, and help with alcohol withdrawal symptoms and certain agitated states.
Form
tabletti
Strength
200 mg
Active Ingredient
Carbamazepine
Manufacturer
Novartis Finland Oy
How to Use
Dosage
For adults, the usual starting dose is 100-200 mg once or twice a day. Doses for children and elderly people are usually lower.
Method
Take Tegretol with or after a meal. Swallow the tablets with liquid. Tablets can be broken in half at the score line if needed.
Important
The usual daily dose for adults is 400-1600 mg, but some patients may need higher doses.
Possible Side Effects
COMMON
- •Low white blood cell count
- •Feeling dizzy
- •Clumsiness / coordination problems
- •Drowsiness
- •Tiredness
- •Nausea
- •Vomiting
- •Increased liver enzyme (gamma-GT) levels, usually not serious
- •Skin inflammation with itchy rash and redness; itchy rash; severe hives
- •Low platelet count
- •High eosinophil count (a type of white blood cell)
- •Swelling of lower limbs (feet, ankles, or shins)
- •Fluid retention in the body, weight gain
- •Low sodium levels in the blood; decreased blood concentration due to an effect similar to antidiuretic hormone, which can rarely lead to "water intoxication" with drowsiness, vomiting, headache, and confusion.
- •Headache
- •Double vision
- •Accommodation disorders (difficulty focusing eyes, e.g., blurred vision)
- •Dry mouth
- •Increased alkaline phosphatase levels in the blood (a liver value)
RARE
- •Abnormal involuntary movements (e.g., tremor)
- •Nystagmus (involuntary eye movements)
- •Diarrhea
- •Constipation
- •Increased liver transaminase levels
- •Exfoliative dermatitis (flaking skin inflammation) and severe redness of the skin
- •High white blood cell count
- •Lymph node disease
- •Folic acid deficiency
- •Delayed hypersensitivity reactions affecting multiple organs, with symptoms like fever, rash, blood vessel inflammation, lymph node disease, pseudolymphoma, joint pain, low white blood cell count, high eosinophil count, enlarged liver or spleen, abnormal liver values; syndrome with destruction and disappearance of bile ducts inside the liver (symptoms can also appear in other organs, e.g., lungs, kidneys, pancreas, heart muscle, or large intestine)
- •Visual or auditory hallucinations
- •Depression
- •Loss of appetite
- •Restlessness
- •Hostility
- •Agitation
- •Confusion
- •Movement disorders involving the mouth and face
- •Eye movement disorders
- •Speech disorders (e.g., dysarthria, slurred speech)
- •Involuntary movements
- •Peripheral nerve disease
- •Sensory illusions (paresthesias)
- •Partial paralysis
- •Heart conduction disorders
- •High or low blood pressure
- •Upper abdominal pain
- •Jaundice (yellowing of skin or eyes)
- •Liver inflammation
- •Systemic lupus erythematosus (connective tissue disease)
- •Itching
- •Muscle weakness
- •Agranulocytosis (severe lack of white blood cells)
- •Pancytopenia (lack of all blood cells)
- •Aplasia of red blood cells (total lack of red blood cells)
- •Anemia (low red blood cell count)
- •Megaloblastic anemia (anemia due to B12 vitamin or folic acid deficiency)
- •Various porphyrias (metabolic disorders with high porphyrin levels in urine and blood, which can involve skin symptoms or stomach pain)
- •High reticulocyte count (young red blood cells) and possibly hemolytic anemia (anemia due to premature breakdown of red blood cells)
- •Aseptic meningitis (brain membrane inflammation not caused by bacteria)
- •Anaphylactic reactions (severe allergic reactions), angioneurotic edema (sudden swelling in the skin, mucous membranes, or internal organs)
- •Increased blood prolactin levels (a hormone for milk production), which can lead to enlarged breasts in men or milk discharge in women
- •Various thyroid disorders
- •Bone metabolism disorders leading to osteomalacia (softening of bones) or osteoporosis
- •Increased blood cholesterol and triglyceride levels
- •Activation of psychosis
- •Taste disturbances
- •Neuroleptic malignant syndrome (associated with drug use, symptoms include difficulty swallowing, muscle stiffness, sweating, fever, decreased consciousness, fluctuating blood pressure)
- •Lens opacities (clouding of eye lens)
- •Conjunctivitis (inflammation of the eye's outer membrane)
- •Increased eye pressure
- •Hearing problems (e.g., ringing in ears, sensitive or poor hearing)
- •Various heart rhythm disorders, which can include fainting
- •Circulatory collapse
- •Heart failure
- •Worsening of coronary artery disease
- •Thrombophlebitis (vein inflammation), blood clots (e.g., in the lungs)
- •Lung hypersensitivity reactions, with typical symptoms like fever, shortness of breath, lung inflammation or pneumonia
- •Inflammation of the tongue and mouth
- •Pancreatitis (inflammation of the pancreas)
- •Granulomatous hepatitis (a type of liver inflammation)
- •Liver failure
- •Erythema multiforme and nodosum (skin reactions)
- •Photosensitivity reactions
- •Skin pigment changes
- •Purpura (red spots on the skin)
- •Acne
- •Excessive sweating
- •Hair loss
- •Increased hair growth (very rarely reported, but link unclear)
- •Joint pain
- •Muscle pain or cramps
- •Kidney inflammation
- •Kidney failure
- •Impaired kidney function (symptoms include blood in urine, decreased urine output, increased urea in blood)
- •Changes in urination frequency
- •Urinary retention (difficulty emptying bladder)
- •Sexual dysfunction/impotence
- •Abnormal sperm production (decreased sperm count and/or motility)
Important Warnings
- Do not use if you are allergic to carbamazepine or any other ingredients in this medicine.
- Do not use if you have severe heart disease.
- Do not use if you have had a serious blood disorder.
- Do not use if you have a disorder in porphyrin production (hepatic porphyria), which is important for liver function and blood formation.
- Avoid using Tegretol with certain antidepressants called MAO inhibitors.
Show 15 more warnings
- Tegretol can harm an unborn baby. Women who can get pregnant must use effective birth control during treatment and for two weeks after the last dose.
- Serious skin rashes (like Stevens-Johnson syndrome) have been reported. If you get a rash or other skin problems, stop taking Tegretol right away and contact your doctor.
- If you have developed Stevens-Johnson syndrome or toxic epidermal necrolysis while using Tegretol, you must never use this medicine again.
- Seek immediate medical help if you experience allergic reactions such as swelling of lips, eyelids, face, or mouth, sudden breathing difficulties, fever, swollen lymph nodes, rash, or blisters.
- Contact your doctor if your seizures become more frequent.
- Contact your doctor if you have suicidal thoughts.
- Contact your doctor if you notice hepatitis-like symptoms, such as yellowing of the skin or eyes.
- If you use hormonal contraception and experience irregular vaginal bleeding or spotting during Tegretol treatment, talk to your doctor.
- Contact your doctor if you become pregnant or are planning to have a baby.
- Contact your doctor if you have kidney problems linked to low sodium levels in your blood, or if you take medicines that lower blood sodium.
- Contact your doctor if you experience dizziness, drowsiness, low blood pressure, or confusion due to Tegretol treatment, as these can lead to falls.
- Do not stop taking Tegretol suddenly without talking to your doctor, as this can increase seizures.
- Avoid alcohol during Tegretol treatment, as it can worsen seizures and reduce alcohol tolerance.
- Do not drink grapefruit juice or eat grapefruit, as they can increase the effect of Tegretol.
- Tegretol can cause drowsiness, dizziness, blurred vision, double vision, or poor muscle control, especially at the start of treatment or with increased doses. Be careful when driving or operating machines.
Use in Elderly Patients
Category D
Avoid use in older adults. Hyponatraemia is a common adverse effect. Numerous potential adverse effects, such as hematological changes and risk of hepatic injury. May increase the need for a vitamin D supplement. Consider the numerous potential and significant interactions before starting and discontinuing the use. Avoid grapefruit. (updated 10.11.2025)