Epitol : Uses, Side Effects, Interactions & More


Epitol (Carbamazepine) can cause life-threatening allergic reactions called Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). These allergic reactions can cause serious damage to the skin and internal organs. The risk of SJS or TEN is higher in people of Asian descent who have a genetic (inherited) risk factor. If you are Asian, your doctor will usually order a test to see if you have the genetic risk factor before prescribing Epitol. If you do not have this genetic risk factor, your doctor may prescribe Epitol, but there is still a slight risk that you will develop SJS or TEN. Call your doctor right away if you develop a painful rash, hives, blistering or peeling of the skin, easy bruising, mouth sores, or fever during your treatment with Epitol. Stevens-Johnson syndrome or toxic epidermal necrolysis usually occurs during the first months of treatment with Epitol.

Epitol can lower the number of blood cells made by your body. In rare cases, the number of blood cells can decrease enough to cause serious or life-threatening health problems. Tell your doctor if you have ever had bone marrow depression (decreased number of blood cells) or any other blood disorder, especially if it was caused by another medicine. If you experience any of the following symptoms, call your doctor immediately: sore throat, fever, chills, or other signs of infection that come and go or do not go away; difficulty breathing; fatigue; unusual bleeding or bruising, such as heavy menstrual bleeding, a nosebleed, or bleeding gums; small red or purple spots or spots on the skin; or mouth sores ..

Keep all appointments with your doctor and the laboratory. Your doctor will order certain laboratory tests before and during your treatment to check your body’s response to Epitol.

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you start treatment with Epitol and each time you get a refill. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs) or the manufacturer’s website to obtain the Medication Guide.

Why is this medication prescribed?

Epitol (Carbamazepine) is used alone or in combination with other medications to control certain types of seizures in people with epilepsy. It is also used to treat trigeminal neuralgia (a condition that causes pain in the facial nerve). Epitol prolonged-release capsules (Equetro brand only) are also used to treat episodes of mania (frantic, abnormally excited, or irritated mood) or mixed episodes (symptoms of mania and depression occurring at the same time) in patients with the disorder. bipolar I (manic-depressive disorder; an illness that causes episodes of depression, episodes of mania, and other abnormal moods). Epitol is in a class of medications called anticonvulsants. It works by reducing abnormal electrical activity in the brain.

How should this medicine be used?

Epitol comes as a tablet, a chewable tablet, an extended-release (long-acting) tablet, an extended-release capsule, and as a suspension (liquid) to take by mouth. The regular tablet, chewable tablet, and suspension are usually taken two to four times a day with meals. To remind you to take Epitol, take it at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any parts you don’t understand. Take Epitol exactly as directed. Do not take more or less, or take it more often than prescribed by your doctor.

Swallow the extended-release tablets whole; do not split, chew, or crush them. The extended-release capsules can be opened and the pearls inside can be sprinkled on food, such as a teaspoon of applesauce or similar food. Do not crush or chew the extended-release capsules or the pearls they contain.

Shake the suspension well before each use to mix the medicine evenly.

Your doctor will start with a low dose of Epitol and gradually increase it.

Epitol can help control your condition, but it will not cure it. It may take a few weeks or longer before you feel the full benefit of Epitol. Keep taking Epitol even if you feel fine. Do not stop taking Epitol without consulting your doctor, even if you experience side effects such as unusual changes in behavior or mood. If you have a seizure disorder and you suddenly stop taking Epitol, your seizures may get worse. Your doctor will likely reduce your dose gradually.

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Other uses for this medicine

Epitol is also sometimes used to treat mental illness, depression, post-traumatic stress disorder, drug and alcohol withdrawal, restless leg syndrome, diabetes insipidus, certain pain syndromes, and a disease in children called chorea. Talk to your doctor about the possible risks of using this drug for your condition.

This medicine may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking Epitol,

  • Tell your doctor and pharmacist if you are allergic (rash, wheezing, hives, difficulty swallowing or breathing, swelling of the face, eyes, eyelids, lips or tongue) to Epitol, amitriptyline (Elavil), amoxapine, clomipramine (Anafranil) , desipramine (Norpramin), doxepin (Silenor, Zonalon), imipramine (Tofranil), nortriptyline (Pamelor), oxcarbazepine (Trileptal), protriptyline (Vivactil), other medications for seizures such as phenobarbital, phenytoin (Dilatentin (), or primitin , phenytoin Mysoline), any other medications, or any of the ingredients in Epitol preparations. Ask your pharmacist or see the Medication Guide for a list of ingredients.
  • Tell your doctor if you are taking nefazadone or certain non-nucleoside reverse transcriptase inhibitors (NNRTIs) such as delavirdine (Rescriptor). Your doctor will probably tell you not to take Epitol with these medications. Also, tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor, such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine ( Parnate). , or if you have stopped taking an MAO inhibitor in the past 14 days. Your doctor will probably tell you not to take Epitol. If you stop taking Epitol, you must wait at least 14 days before you start taking an MAO inhibitor.
  • Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: acetaminophen (Tylenol); acetazolamide (Diamox); albendazole (Albenza); alprazolam (Panax); aminophylline; anticoagulants (“blood thinners”) such as apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Savaysa), rivaroxaban (Xarelto), and warfarin (Coumadin, Jantoven); antidepressants such as amitriptyline (Elavil), bupropion (Wellbutrin, Zyban), buspirone (BuSpar), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), fluoxetine (Prozac, Sarafem), fluvoxamine (Lurtatylzax), northatilzaxine (Pamelor); antifungals such as fluconazole (Diflucan), itraconazole (Onmel, Sporanox), ketoconazole, and voriconazole (Vfend); aprepitant (Emend); aripiprazole (Abilify); buprenorphine (Butrans, Sublocade); bupropion (Aplenzin, Wellbutrin, Zyban); cimetidine (Tagamet); ciprofloxacin; cisplatin (Platinol); corticosteroids such as dexamethasone and prednisolone (Prelone); clarithromycin (Biaxin, in Prevpac); clonazepam (Klonopin); clozapine (Clozaril); cyclophosphamide; cyclosporine (Gengraf, Neoral, Sandimmune); dalfopristin and quinupristin (Synercid); danazol (Danocrine); dantrolene (Dantrium); diltiazem (Cardizem, Diltzac, Tiazac, others); diuretics (water pills); doxorubicin (Adriamycin, Rubex); doxycycline (Vibramycin); erythromycin (E.E.S., E-Mycin, Erythrocin); eslicarbazepine (Aptiom); everolimus (Afinitor, Zortress); felodipine (Plendil); haloperidol (Haldol); HIV protease inhibitors, including atazanavir (Reyataz), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Fortovase, Invirase); ibuprofen (Advil); imatinib (Gleevec); isoniazid (INH, Laniazid, in Rifater); levothyroxine (Levoxyl, Synthroid); lithium (Lithobid); loratadine (Claritin); lorazepam (Ativan); loxapine (Adasuve); certain medications to treat malaria such as chloroquine (Aralen) and mefloquine; medications for anxiety or mental illness; other seizure medications such as ethosuximide (Zarontin), felbamate (Felbatol), fosphenytoin (Cerebyx); Lamotrigine (Lamictal), methsuximide (Celontin), oxcarbazepine (Trileptal), phenobarbital, fensuximide (Milontin) (not available in the US), phenytoin (Dilantin, Phenytek), primidone (Mysoline), tiagabine (Gabitril), topmax and valproic acid (Depakene, Depakote); lapatinib; Methadone (Dolophine, Methadose); midazolam; Niacinamide (nicotinamide, vitamin B3); olanzapine; omeprazole; oxybutynin; propoxyphene (Darvon); praziquantel (Biltricide); quetiapine; quinine; rifampicin (Rifadin, Rimactane); risperidone; sedatives sertraline (Zoloft); sirolimus; sleeping pills; tacrolimus (Prograf); tadalafil (Adcirca, Cialis); temsirolimus (Torisel); terfenadine (Seldane) (not available in the US); theophylline (Theo-24, Theochron, others); ticlopidine; tramadol (Ultram); trazodone tranquilizers; troleandomycin (TAO); Verapamil (Calan, Verelan); zileuton (Zyflo); ziprasidone (Geodon) and zonisamide (Zonegran). Many other medications can also interact with Epitol, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you closely for side effects.
  • If you are taking other liquid medicines, do not take them at the same time as Epitol suspension.
  • Tell your doctor if you have or have ever had glaucoma (a condition in which increased pressure in the eye can cause gradual loss of vision). or heart, kidney, thyroid, or liver disease.
  • You should know that Epitol may decrease the effectiveness of hormonal contraceptives (contraceptive pills, patches, rings, injections, implants or intrauterine devices). Use another method of birth control while taking Epitol. Tell your doctor if you have unexpected vaginal bleeding or think you may be pregnant while taking Epitol.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Epitol can harm the fetus. If you become pregnant while taking Epitol, call your doctor immediately.
  • If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Epitol.
  • You should know that Epitol can make you drowsy. Do not drive a car or operate machinery until you know how this medicine affects you.
  • Remember that alcohol can increase the drowsiness caused by this drug.
  • You should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while taking Epitol for the treatment of epilepsy, mental illness or other conditions. A small number of adults and children 5 years of age and older (about 1 in 500 people) who took anticonvulsants such as Epitol to treat various conditions during clinical studies became suicidal during their treatment. Some of these people developed suicidal thoughts and behaviors as early as a week after starting the drug. There is a risk that you will experience changes in your mental health if you take an anti-seizure medication such as Epitol, but there may also be a risk that you will experience changes in your mental health if your condition is not treated. You and your doctor will decide if the risks of taking an anti-seizure medicine are greater than the risks of not taking the medicine. You, your family, or your caregiver should call your doctor immediately if you experience any of the following symptoms: panic attacks; agitation or restlessness; New or worsening irritability, anxiety, or depression; acting on dangerous impulses; Difficulty falling asleep or staying asleep; aggressive, angry, or violent behavior; mania (frantic, abnormally excited mood); talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; give away prized possessions; or any other unusual change in behavior or mood. Make sure your family or caregiver knows what symptoms may be serious so they can call your doctor if you are unable to seek treatment on your own.
  • If you have fructose intolerance (an inherited condition in which the body lacks the protein necessary to break down fructose [a fruit sugar found in certain sweeteners such as sorbitol]), you should know that the oral suspension is sweetened with sorbitol. Tell your doctor if you have a fructose intolerance.
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What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit or drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for the one you forgot.

What side effects can this medication cause?

Epitol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • dizziness
  • thinking abnormal
  • difficulty speaking
  • uncontrollable shaking of a part of the body
  • constipation
  • dry mouth

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING and SPECIAL PRECAUTION sections, call your doctor immediately:

  • confusion
  • rash
  • fast, slow, or pounding heartbeat
  • yellowing of the skin or eyes
  • dark urine
  • pain on the right side of your stomach area
  • loss of appetite
  • nausea
  • vomiting
  • vision changes
  • fatigue
  • swelling of your face, eyes, eyelids, lips, or tongue
  • difficulty swallowing or breathing
  • headache, new or increased number of seizures, difficulty concentrating, confusion, weakness, or unsteadiness
  • severe rash with one or more of the following: fever, muscle or joint aches, red or swollen eyes, blisters or peeling skin, mouth sores, or swelling of your face or neck

Epitol may cause other side effects. Call your doctor if you have any unusual problems while taking this medicine.

If you experience a serious side effect, you or your doctor can submit a report online to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

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What should I know about storage and disposal of this medication?

Keep this medicine in the container it came in, tightly closed, and out of the reach of children. Store at room temperature, protected from light, excess heat, and moisture (not in the bathroom).

It is important to keep all medicines out of the sight and reach of children, since many containers (such as those containing weekly pills and those for eye drops, creams, patches and inhalers) are not resistant to children and small children can easily open them. To protect young children from poisoning, always close the safety caps and immediately place the medicine in a safe place, one that is upright and out of their sight and reach. http://www.upandaway.org

Unnecessary medications must be disposed of in special ways to ensure that pets, children, and others cannot consume them. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medications is through a drug take-back program. Talk to your pharmacist or contact your local garbage / recycling department to find out about take-back programs in your community. See the FDA Safe Drug Disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, has trouble breathing, or cannot wake up, immediately call 911 for emergency services.

Symptoms of overdose may include the following:

  • unconsciousness
  • seizures
  • restlessness
  • muscle twitching
  • abnormal movements
  • shaking of a part of your body that you cannot control
  • unsteadiness
  • drowsiness
  • dizziness
  • vision changes
  • irregular or slowed breathing
  • rapid or pounding heartbeat
  • nausea
  • vomiting
  • difficulty urinating

What other information should I know?

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking Epitol.

Epitol can interfere with the results of home pregnancy tests. Talk to your doctor if you think you might be pregnant while taking Epitol. Do not try to take the home pregnancy test.

The extended-release tablet does not dissolve in the stomach after swallowing it. Slowly releases the medicine as it passes through your digestive system. You may notice the coating of the tablet in your stool.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you each time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.

Brand Names

  • Carbatrol®
  • Epitol®
  • Equetro®
  • Tegretol®
  • Tegretol®-XR

Disclaimer: DrLinex has made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.

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