دواعي استعمال تجريتول سي ار 400مجم 20 قرص

Carbamazepine 400 mg controlled-release (prolonged-release) film-coated divisible tablets, pack of 20 (Novartis), listed in Egypt as an antiepileptic (carboxamide).

• Epilepsy: generalised tonic-clonic and partial seizures (not usually effective in absences or myoclonic seizures).الفئة: Adults and childrenelectronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)
• Paroxysmal pain of trigeminal neuralgia.الفئة: Adultselectronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)

• Particularly at the start or with high initial dose or in the elderly: dizziness, headache, ataxia, drowsiness, fatigue, diplopia, nausea, vomiting and allergic skin reactions; dose-related reactions usually abate within days.نشرة دولية لنفس التركيبة · electronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)

• Hypersensitivity to carbamazepine or structurally related drugs (e.g. tricyclic antidepressants); atrioventricular block; history of bone marrow depression; history of hepatic porphyrias; combination with MAO inhibitors.نشرة دولية لنفس التركيبة · electronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)

• Agranulocytosis and aplastic anaemia have been associated with carbamazepine; decreased platelet or white cell counts occur occasionally.نشرة دولية لنفس التركيبة · electronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)
• Patients of Han Chinese and Thai origin should whenever possible be screened for HLA-B*1502 before starting, as it strongly predicts carbamazepine-associated Stevens-Johnson syndrome.نشرة دولية لنفس التركيبة · electronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)
• Boxed warning: serious, sometimes fatal dermatologic reactions (TEN/SJS) linked to HLA-B*1502; aplastic anaemia and agranulocytosis.معلومة عامة عن المادة الفعالة · DailyMed (U.S. National Library of Medicine)
• Ataxia, dizziness, somnolence, hypotension, confusion and sedation may lead to falls and fractures.نشرة دولية لنفس التركيبة · electronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)

• CYP3A4 inhibitors and inducersCYP3A4 forms the active 10,11-epoxide; inhibitors may raise carbamazepine levels (adverse reactions), inducers may lower them.electronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)
• Monoamine oxidase inhibitorsCombination is contraindicated.electronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)

• Carbamazepine crosses the placenta; first-trimester exposure increases the risk of major congenital malformations (neural tube defects incl. spina bifida, craniofacial incl. cleft lip/palate, cardiovascular, hypospadias, skeletal). Should not be used in women of childbearing potential unless benefit outweighs risk after considering alternatives; specialist advice needed and abrupt discontinuation avoided.نشرة دولية لنفس التركيبة · electronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)
• Passes into breast milk (about 25-60% of plasma concentrations); breast-feeding possible if the infant is observed for adverse reactions (e.g. excessive somnolence, allergic skin reaction).نشرة دولية لنفس التركيبة · electronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)

• Plasma levels may help establish dose; epilepsy usually requires total plasma carbamazepine about 4-12 micrograms/mL (17-50 micromol/L).نشرة دولية لنفس التركيبة · electronic medicines compendium (emc, medicines.org.uk; MHRA-authorised)

• كاربامازيبين: Mechanism only partially elucidated; stabilises hyperexcited neuronal membranes, inhibits repetitive neuronal discharges and reduces synaptic propagation of excitatory impulses (UK SmPC 5.1); US label: blocks voltage-gated sodium channels.