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Doctors' Answers to "Frequently Asked Questions" - Tegretol
Answer: It is present although I do not have quantified data. You can check with the manufacturer,(Novartis 888-669-6682) but not recommended for nursing mothers.
Answer: If it was the Tegretol alone, it would have happened with the initial taking of the drug. This also assumes your blood levels have been checked regularly and are normal and your liver has not experienced any changes with the medication. The liver is responsible for the metabolism of both tegretol as well as your sexual hormones, changes here could theorectically cause this problem.
Answer: First of all ensure that your levels are in the therapeutic range. If so, then there aren't many answers. Viagra can be helpful for the sexual problems. As to the lethargy, this will last as long as you are taking the drug. There are other medical options, discuss these with your md.
Answer: It is thought to affect the p450 system which affects the metabolism of the tegretol. If you eat regular amounts, it probably doesn't matter since your md will just adjust the dosage. Sporadic amounts could be a problem. Although this is to be considered, I have never thought it much of a clinical problem since the levels have to be followed(and the dosage adjusted) regardless of your diet.
Answer: Shouldn't be unless your levels are too high or you are experiencing toxicity. You need blood counts and liver functions. I'd check a B12 level and Thyroid also-common causes of decreased memory and not related to the tegretol.
Answer: Usually tegretol will continue to work and you won't develop tolerance if the blood levels are maintained. The facial heat is probably the neuralgia.
Answer: Most physicians would put you on seizure medications at least six months following this surgery to avoid exactly the problem you describe. You will need to be on Tegretol for a long while, some would advocate forever, certainly at least a year. Once your Tegretol levels are stable and there is no evidence of liver toxicity you can start 1-2 drinks a day watching your liver functions to ensure there is no liver toxicity. You are describing a potential lethal situation(untreated or unresolved seizures) don't take these lightly. They need to be suppressed. Your doctors are right on target with the MRI and EEGs. The risk of Tegretol is on the production of White Blood Cells(which need to be checked occasionally) and liver toxicity.
Answer: Tegretol can clearly cause harm to a fetus. There appears to be an association between in and spina bifida, not a good drug with pregnancy.
Answer: This is the first place to start and usually works, if your blood levels are where they need to be. Have these been checked? Dilantin is sometimes of help or seeing a pain specialist for ablation of the nerve itself.
Tegretol and Hormones? [posted
Answer: None that I'm aware of.
Answer: Helps many patients, but not FDA approved. However, we use this drug for lots of non-FDA approved indications.
Tegretol & Weight Gain
Answer: Possibly, have you checked serum levels? On the other hand, girls tend to add a lot of weight just prior to the start of menses, usually seen at age 12.
How to Cease Medicating with Tegretol
Answer: Not a usual reaction with Tegretol, but does occur. However, the mechanism appears to have something to do with hunger control and not metabolic changes. Most weight gain due to medications will slowly improve if the medication is removed. Have your tried neurontin?
Tegretol & Determining if
Seizures Will Occur [posted 11/6/98]
Answer: It can cause liver problems, but usually won't if monitoring of liver functions is done occasionally. As to getting off, it would depend on what your EEG looks like. If you still have spike activity, I think it would be futile. However, if the EEG is normal or nearly so, you might be able to stop the Tegretol. It would depend on how frequent the seizures were and your previous EEG, but, possible. Discuss this with your neurologist.
Tegretol Time Release
Answer: Test the level at that time.
Should I Start Taking Tegretol for
Answer: Well, tegretol might be of help;but, I would try Zostrix cream first. Available OTC in .025 or .075. Start with the .025-apply it to affected areas twice a day(once a day the first week if it stings too much). It will take 3-4 weeks to work, so don't give up on it. But, tends to be very effective and without the side effects of tegretol.
Tegretol & Short Term Memory
Answer: I assume that your drug levels have been checked and are in the correct range? If so, I'd try other drugs. Your short term memory can be tested quantatively before and after discontinuing the Tegretol to see if there is any effect.
Answer: Tegretol is commonly used for other conditions other than seizure disorders. In particular, a condition called Tic douloureux caused by 5th facial nerve pain. If this is what he/she is treating you for it is the drug of choice. It certainly sounds like this from your description and is probably not related to the previous Bell's Palsy. I'd probably keep on it, but it sounds like your communication with your physician is less than perfect.
Answer: I'll need to know more specifics concerning her chemo. But, I'd check her Tegretol levels closely.
Answer: Stopping the Tegretol didn't cause the seizures-- her basic problem did. When someone has a seizure disorder it will usually initiate seizures until a drug reaches appropriate levels and suppresses the seizure focus. When one has trouble with a seizure drug it is common to stop the drug and allow it to "wash out" of the system prior to starting a second drug. This is to prevent confusion when the second drug is started as to whether they symptoms are due to the first seizure drug or the second. It is common to have several seizures as one searches for the appropriate drug at appropriate levels(to avoid toxic reactions).
Answer: What have your blood levels been doing? If they are higher, its probably the new tegretol. If the same probably not. However, you can see fairly easily by switching back to the old tegretol for a couple of weeks.
Answer: Tegretol is an anti-seizure drug often prescribed after brain surgery to prevent any subsequent seizures due to irritation of the brain with the surgery. It is usually tolerated well, but blood levels are very important as is checking the white blood cell levels which it can occasionally effect. Sedation, itching, and liver toxicity are the most common effects seen in my patients. Antinuclear antibody(abbreviated ANA) is a diagnostic test for Systemic Lupus Erythematosis. It is also elevated in other connective tissue diseases-- like Rheumatoid Arthritis. There are some drugs that can cause the body to produce these antibodies(called drug induced Lupus). These include procainamine, isoniazid, hydralazine, methydopa, quinidine, interferon, some birth control pills, chlorpromazine, etc. Tegretol is not usually on this list.
Answer: Tegretol has many uses other than seizures. It is used in chronic pain, for example. I am not aware of the "calming" effect other than the normal mild sedative effective of the drug. It may be that he is having temporal lobe seizures which produce behavioral changes. You might discuss this with his physicians and see if a re-trial of the medicine would be in order. You do not mention why he was taken off the medication.
Answer: Tegretol was initially an anti-seizure drug. This is still its main use. However, it is also used in chronic pain syndromes, migraine headache prevention, and facial pain syndromes. These are not all FDA approved but clinically used commonly.
Answer: The issue is the drug level not the oral dosage of the drug. I'd be aware of her current level (obviously successful) and try to maintain the same level with the new medication. Tegretol lasts a long time when ingested and decreasing the frequency is helpful in compliance.
Answer: The symptoms of the Tegretol should be gone within 10-12 days after stopping. There is no withdrawal phenomenon with Tegretol. It may be that this is one of the manifestations of his seizure disorder.
Answer: The peripheral neuropathy of diabetes mellitus usually occurs after 15 or more years of diabetes. There are many reports of neuropathy occurring before this time, but that is a good start. Also, the neuropathy of diabetes begins in the feet and is not felt in the hands until the numbness extends to the knees or thereabouts. If you have numbness in both the feet and the hands simultaneously, I strongly doubt that this is neuropathy of diabetes mellitus. Id ask for a neurologists opinion on the matter.
Tegretol - Drug Interactions
Answer: Tegretol(carbamazepine) is a drug used mainly in seizure control. It has several potential interactions including phenobarbital, dilantin, primidone, coumadin, doxycycline, theophylline, haloperidol, valproic acid, cimetidine, erythomycin, propoxyphene, isoniazid, fluoxetine, calcium channel blockers, and terfenadine. I know of no special interaction with the cephalosporins, and cefzil in particular.
Tegretol - Generic
Answer: Tegertol is a drug used mainly in seizure disorders. It is also occasionally used to treat chronic pain and certain types of facial pain. I haven't seen a major difference in seizure patients treated with tegrotol. This drug has drug levels available and keeping the drug in the therapeutic range seems more important than the manufacturer. However, I have individual patients who seem not to tolerate generic, either with different side effects or with lack of efficacy. I would ensure that your pharm deat keeps the same manufacturer and notify you of changes. This seems to affect how drugs are used more than whether they are brand name.
Tegretol - Allergic Reaction
Answer: Tegretol (carbamazine) is a drug used in treating seizure disorders and trigeminal neuralgia. Because of it's unusual ability to treat trigeminal neuralgia, it is often used in pain clinics for different chronic pain syndromes although the strict FDA guidelines are for treating only trigeminal neuralgia. This is common practice of most physicians to use known drugs in less than "strict" applications if they work. The unfortunate part of Tegretol is its side effects. It needs to be watched extremely closely with regular blood tests and close monitoring. The most serious effects are its effect on white blood cells, platelets, and liver function. Use with other drugs, particularly dilantin, coumadin, certain antibiotics, theophylline, cimetidine(Tagamet), and calcium channel blockers have been reported to drastically affect the serum levels. Severe dermatologic reactions such as Stevens-Johnson Syndrome and Lyell's Syndrome can occur with this drug and have caused fatalities. Consequently, skin rashes are not taken lightly while on Tegretol. Also, the drug levels appear to have little to do with these dermatologic reactions. Unfortunately, there is no similar drug to try - it is in a class by itself.
I'm interested in the treatment protocol and/or effects from above treatment.
Answer: Trigeminal Neuralgia is pain along the distribution of the trigeminal nerve. This is usually to the front of the face. This disorder is initially treated medically with carbamezepine, but there are surgical options. A recent study in the New England Journal of Medicine showed great improvement with a brouical approach. This should be discussed with a neurosurgeon.
Tegretol and Phenergan
Answer:Tegretol(carbamazepine) is a drug that is mainly used for seizure
control. It also is used to treat a condition called Trigeminal Neuralgia which is pain
from one of the facial nerves. It is commonly used by physicians in chronic pain syndromes
with mild success-although not approved for this indication. Tegretol levels need to be
followed closely due to the toxic effects of this drug at higher levels. Toxic effects are
impairment of levels of consciousness, cardiac irregularities and neurologic symptoms.
Other side effects not so related to blood level are decreasing white blood cell counts
and various severe skin disorders-both of which can be fatal. The drug should not be used
with the class of anti-depressants called MAO inhibitors as well as tricyclic
anti-depressants. Other drugs like phenergan are not a Specific problem if the drug level
is checked regularly.
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