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Carbamazepine (oral) for preventing seizures
Carbamazepine (oral) for preventing seizures
This leaflet is about the use of carbamazepine to prevent epileptic seizures. (Seizures may also be called convulsions or fits.)
This leaflet has been written specifically for parents and carers about the use of this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Name of drug
Common brands: Tegretol®; Modified release: Carbagen® SR, Tegretol® Prolonged Release
Why is it important for my child to take this medicine?
It is important that your child takes carbamazepine regularly so that they have fewer seizures.
What is carbamazepine available as?
- Tablets: 100 mg, 200 mg, 400 mg
- Modified release tablets (Carbagen SR, Tegretol Prolonged Release): 200 mg, 400 mg
- Orange ‘chewtabs’: 100 mg, 200 mg
- Liquid medicine: 100 mg in 5 mL
When should I give carbamazepine?
Carbamazepine is usually given twice each day, usually once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example some time between 7 and 8 am, and between 7 and 8 pm.
Modified release tablets
Your doctor may prescribe modified release tablets (Carbagen SR, Tegretol Prolonged Release). These are usually given once each day, usually in the evening.Give the medicine at about the same times each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of carbamazepine (the dose) that is right for your child and gradually increase it. If you are not sure how much to give, check with your doctor, epilepsy nurse or pharmacist.
It is important that you follow your doctor’s instructions about how much to give.
How should I give it?
Tablets (white and beige–orange) should be swallowed whole with a glass of water, milk or juice. Your child should not chew the tablets. Do not crush these tablets.
Orange ‘chewtabs’ can be chewed. Ideally your child should drink a glass of water, milk or juice after swallowing the chewtabs
Liquid medicine: Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
When should the medicine start working?
It may take a few weeks for carbamazepine to work properly, so your child may still have seizures during this time. This is because the amount of medicine has to be increased slowly. Continue to give the medicine in the way that you have been told to by your doctor or epilepsy nurse. Carbamazepine may not stop your child’s seizures completely. If you are worried about whether it is helping, contact your doctor but continue to give the medicine.
What if my child is sick (vomits)?
- If your child is sick less than 30 minutes after taking a dose of carbamazepine, give the same dose again.
- If your child is sick more than 30 minutes after taking a dose of carbamazepine, you do not need to give them another dose. Wait until the next normal dose.
What if I forget to give it?
If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7 am, you can give the missed dose at any time up to 11 am. If you remember after that time, do not give the missed dose. Just give the next dose as usual.
Modified release tablets: Give the missed dose when you remember but you do not need to wake up a sleeping child to give a missed dose. You can give the missed dose in the morning as long as this is at least 12 hours before the next dose is due.
Never give a double dose of carbamazepine.
What if I give too much?
You are unlikely to do any harm if you give an extra dose of carbamazepine by mistake. If you think you may have given your child too much carbamazepine, contact your doctor or local NHS services (111 in England and Scotland; 0845 4647 in Wales).
Take the medicine container or pack with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they cause effects that we don’t want (side-effects).
Side-effects that you must do something about
If your child develops a blotchy red skin rash anywhere on their body, or gets blisters in their mouth, seems to get more infections than usual (e.g. bad colds, chest or skin infections, stomach upsets), seems to bruise more easily, or has bleeding that doesn't stop as quickly as you would expect, contact your doctor straight away, as they may be allergic to carbamazepine.
If your child has such a rash and is also generally unwell and has a fever (temperature above 38°c) or unusual bruises or bleeding, take them to your doctor or hospital straight away, as this may indicate a more serious reaction.
Other side-effects you need to know about
- Your child may be drowsy (sleepy), unsteady, dizzy, have blurred or double vision, or may get a tremor (shakiness)when they first start taking carbamazepine, or they may feel sick (nausea) or be sick (vomit). If these side-effects are still a problem after 2 weeks, contact your doctor but continue to give the carbamazepine.
There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.
Can other medicines be given at the same time as carbamazepine?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Carbamazepine should not be taken with some common drugs that you get on prescription. It is important to tell your doctor and pharmacist that your child is taking carbamazepine.
- Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.
Epilepsy and pregnancy
- Pregnancy presents a risk to both the mother with epilepsy and her unborn baby. If your daughter has sex, it is essential that she uses adequate contraception to prevent an unplanned pregnancy.
- If your daughter is worried that she may be pregnant, it is important that she sees your family doctor as early as possible. Your daughter should keep taking her medication until she sees her doctor.
Carbamazepine and pregnancy
- Carbamazepine may harm an unborn baby.
- The oral contraceptive pill does not work properly in women or girls who are taking carbamazepine.
Is there anything else I need to know about carbamazepine?
- Carbamazepine can make some types of epilepsy worse (absence seizures and myoclonic seizures). If you think your child’s seizures are becoming worse, contact your doctor or epilepsy nurse.
General advice about medicines for seizures
Do not suddenly stop giving any of these medicines to your child, as they may have a seizure. If you are worried, talk to your doctor but carry on giving the medicine to your child as usual.
If your child seems to have more seizures than usual, contact your doctor or epilepsy nurse.
- If your doctor decides to stop a particular medicine, they will discuss this with you. You will usually reduce the dose bit by bit.
Do not change the dose of any drug without talking to your doctor first.
- It is best that your child always has the same brand of each medicine, as there may be differences between brands. Keep a record of which medicines your child has. If you have any concerns or questions, speak with your child’s doctor or pharmacist.
- Try to give medicines at about the same times every day, to help you remember.
- Only give the medicine(s) to your child. Never give them to anyone else, even if their condition appears to be the same, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where should I keep this medicine?
- Keep the medicine in a cupboard, away from heat and direct sunlight.
- Make sure that children cannot see or reach the medicine
- Keep the medicine in the container it came in.
Who to contact for more information
Your child’s doctor, epilepsy nurse or pharmacist will be able to give you more information about carbamazepine and other medicines used to treat epilepsy.
You can also get useful information from:
- England - NHS 111
- Scotland - NHS 24
- Wales/Galw lechyd Cymru - NHS Direct
- Northern Ireland - NI Direct
- Young Epilepsy Helpline
01342 831 342
- Epilepsy Society Helpline
01494 601 400
- Epilepsy Action Helpline
0808 800 5050
Version 2.1, December 2013 (May 2014). © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by December 2016.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.