Indications 

Carbatrol ER is a prescribed medication indicated for the management of seizures and nerve pain conditions, including trigeminal neuralgia (intense, unilateral facial pain) and diabetic neuropathy (nerve damage resulting from diabetes). 

Furthermore, Carbatrol ER is indicated for the treatment of bipolar disorder, a mental condition characterized by significant fluctuations in mood, energy, activity, and focus. 

As an anticonvulsant, Carbatrol ER works by diminishing the spread of seizure activity within the brain and reinstating the normal balance of nerve function. 

Uses and Dosage 

Before taking Carbatrol ER and with every prescription refill, carefully review the accompanying medication guide and patient information leaflet. Should any inquiries arise, consult with your healthcare provider or pharmacist. 

Carbatrol ER dosing is individualized, considering the patient’s medical condition and treatment response.  

To mitigate potential side effects, your doctor may advise starting this medication at a low dose and incrementally adjusting it as needed. Adhere closely to your doctor’s guidance in this regard. 

Typically, this medication is taken twice daily without regard to food intake.  

The capsules can either be ingested whole or opened and sprinkled onto a spoonful of soft food like applesauce.  

Ensure that the entire mixture of food and medicine is swallowed. Avoid crushing or chewing the capsules or their contents when sprinkled. 

For the best results, take Carbatrol ER exactly as directed at the same times daily. Refrain from modifying the prescribed dosage or frequency without prior consultation with your doctor. 

If a dose is missed, take it as soon as possible unless the next dose is near. In the latter case, take only one dose, not two. 

Avoid abrupt discontinuation of Carbatrol ER even if you feel well, as it may lead to heightened seizure activity. Adhere to your doctor’s guidance regarding gradual dose reduction. 

Side Effects 

Listed below are the potential adverse effects of Carbatrol ER. Tell your doctor right away if any of these symptoms persist or worsen. 

Common Side Effects 

• Dizziness, impaired coordination, walking difficulties 
• Nausea, vomiting 
• Drowsiness 

Serious Side Effects 

• Any skin rash, regardless of its severity 
• Loss of appetite, right-sided upper stomach pain, or dark urine 
• Irregular heartbeats (slow, fast, or pounding) 
• Indications of anemia or any problems: 
  • Fever 
  • Chills 
  • Sore throat 
  • Mouth sores 
  • Bleeding gums 
  • Nosebleeds 
  • Pale skin 
  • Easy bruising 
  • Unusual tiredness 
  • Lightheadedness 
  • Shortness of breath 
• Low sodium levels in the body, characterized by: 
  •  Headache 
  • Confusion 
  • Severe weakness 
  • Unsteadiness 
  • Increased seizures 

Inform your doctor if any of the serious side effects above occur. 

Seek immediate medical attention if you experience: 

• A severe drug reaction with systemic effects, characterized by symptoms like: 
  • Skin rash 
  • Fever 
  • Swollen glands 
  • Muscle aches 
  • Severe weakness 
  • Unusual bruising 
  • Yellowing of the skin or eyes. 
• A severe skin reaction, marked by symptoms such as: 
  • Fever 
  • Sore throat 
  • Eye discomfort 
  • Skin pain 
  • A spreading red or purple rash with blistering and peeling 

Promptly inform your doctor of any emerging or deteriorating symptoms, including abrupt alterations in mood or behavior, depression, anxiety, sleep disturbances, agitation, hostility, restlessness, irritability, or any suicidal or self-harm ideation. 

Allergic Reactions 

In rare cases, Carbatrol ER may trigger a serious allergic response. Get immediate medical assistance if you observe any indications of an allergic reaction, such as: 

• Hives 
• Difficulty breathing 
• Face or throat swelling 

This list does not cover all side effects of Carbatrol ER. Inform your doctor if other side effects occur while taking this medication. 

Cautions 

Before starting treatment with Carbatrol ER, inform your doctor if you have any known allergies, particularly to: 

• Carbamazepine  
• Any of the inactive ingredients in this capsule 
• Other anti-seizure medications (e.g., fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone) 
• Tricyclic antidepressants (e.g., amitriptyline, desipramine) 

To ensure Carbatrol is safe for you, disclose to your physician your medical background, especially if you have a history of: 

• Blood disorders like porphyria and anemia 
• Glaucoma 
• Heart conditions, including coronary artery disease, heart failure, and irregular heartbeat 
• Kidney disease 
• Liver disease 
• Mental and mood disorders such as depression 
• Imbalances in minerals like low levels of sodium or calcium in the blood 

Some products that may interact with Carbatrol ER are isavuconazonium, voriconazole, and orlistat. To lower the chance of such drug interactions, inform all healthcare providers of any current or recently started or stopped medications, including prescription and over-the-counter drugs, vitamins, and herbal supplements. 

Avoid the concurrent use of MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) with Carbatrol ER, as it may lead to a potentially life-threatening drug interaction.  

Furthermore, most MAO inhibitors should not be taken for two weeks before starting Carbatrol ER. Consult your doctor for guidance on the appropriate timing of starting or discontinuing this medication in relation to MAO inhibitors. 

Refrain from consuming grapefruit products while on Carbatrol ER, as they can potentially interact with carbamazepine, resulting in undesirable side effects. 

Various medications can influence the elimination of carbamazepine in the body, potentially impacting the effectiveness of Carbatrol ER. Examples include: 

• Macrolide antibiotics (like erythromycin) 
• Rifamycins (such as rifabutin) 
• St. John’s wort, among others 

The use of Carbatrol ER can accelerate the metabolism of other medications in the body, potentially altering their effectiveness. Drugs affected may include: 

• Artemether/lumefantrine 
• Certain anticoagulants (e.g., apixaban, rivaroxaban) 
• Specific calcium channel blockers (nifedipine, nimodipine)  
• Nefazodone 
• HIV NNRTIs (e.g., efavirenz, etravirine, rilpivirine) 
• Praziquantel 
• Ranolazine 

Examine the packaging of all your medications, including items like allergy or cough-and-cold preparations, as they may contain ingredients that induce drowsiness. Consult your pharmacist for guidance on the safe use of such products. 

Ensure to inform your healthcare provider or pharmacist if you are using substances or medications that induce drowsiness, including: 

• Alcohol and marijuana (cannabis) 
• Antihistamines (e.g., cetirizine, diphenhydramine) 
• Sleep or anxiety medications (e.g., alprazolam, diazepam, zolpidem) 
• Muscle relaxants (e.g., carisoprodol, cyclobenzaprine) 
• Opioid pain relievers (e.g., codeine, hydrocodone) 

Carbatrol ER can potentially disrupt specific laboratory tests, like thyroid function and certain pregnancy tests, leading to inaccurate results. Ensure that lab personnel and all your healthcare providers are aware of your use of this medication. 

Carbatrol ER might induce drowsiness or dizziness. Refrain from driving or operating machinery until you have assessed this medication’s impact on your condition. 

The use of Carbatrol ER heightens vulnerability to sunburn. Refrain from prolonged sun exposure or tanning bed usage and ensure adequate protection by wearing shielding garments and applying sunscreen with a minimum SPF of 30 while outdoors. 

Inform your doctor if you are pregnant or intend to become pregnant, as Carbatrol ER may pose risks to the fetus. In the event of pregnancy while taking this medication, promptly contact your doctor. 

Carbatrol ER can diminish the efficacy of hormonal birth control methods like pills, patches, or rings, potentially leading to pregnancy. Consult your doctor or pharmacist to determine whether you should implement additional reliable backup contraception measures while on this medication.  

Moreover, inform your doctor if you experience new spotting or breakthrough bleeding, as these could indicate reduced effectiveness of your birth control. 

Breastfeeding is not recommended during the treatment with Carbatrol ER.