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Carbamazepine -- Contraindications

Abstract: Patients with certain known problems should avoid carbamazepine without discussing this with their doctor.

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Carbamazepine -- Contraindications

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Question(s): 
Written by: Petros Skapinakis, MD, MPH, PhD, lecturer of Psychiatry in the University of Ioannina Medical School, Greece. Eva Gerasi, postgraduate student in the Department of Psychiatry, University Hospital of Ioannina, Greece.
First version: 22 Jul 2008.
Latest revision: 29 Jul 2008.

What should I discuss with my healthcare provider before taking carbamazepine (Carbatrol, Epitol, Tegretol, Trimonil, Hermolepsin)?

Answer:

  • Patients should not take carbamazepine without first talking to their doctor if they
    • have ever had an allergic reaction to a tricyclic antidepressant such as amitriptyline (Elavil), clomipramine (Anafranil), doxepin (Sinequan), desipramine (Norpramin), amoxapine (Asendin), imipramine (Tofranil), or nortriptyline (Pamelor);
    • have taken a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) in the past 14 days; or
    • have a bone marrow disease or a history of bone marrow suppression.
    Carbamazepine is a drug that affects the nerves and brain. It works by decreasing impulses in nerves that cause seizures and pain.
  • Before taking carbamazepine, patients should tell their doctor if they have:
    • kidney disease;
    • liver disease;
    • heart disease;
    • a low level of red blood cells in their body (anemia); or
    • glaucoma.
    They may not be able to take carbamazepine, or they may require a dosage adjustment or special monitoring during treatment in such conditions.
  • Carbamazepine is in the FDA category D. This means that carbamazepine is known to be harmful to an unborn baby. Patients should not take this medication without first talking to their doctor about pregnancy.
  • Carbamazepine passes into breast milk and may harm a nursing infant. Patients should not take this medication without first talking to their doctor if they are breast-feeding a baby.
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