Introduction About TEGRITAL 200MG TABLET

Tegrital 200 Tablet is a commonly prescribed medication used to manage conditions like epilepsy and nerve-related pain. It belongs to the class of drugs known as anticonvulsants and works by stabilizing electrical activity in the brain and reducing pain signals.

Tegrital 200mg Tablet can be taken either with or without food, but it is important to take it at the same time each day. Your doctor will determine the appropriate dose and frequency based on your specific needs, and the dosage may be gradually adjusted. Inform your doctor about all the medications you are currently taking, as many other drugs can interact with this one, ensuring its safe use.

It is important to take this medicine for as long as you are advised, even if you feel well. Missing even a single dose may trigger a seizure and, if you stop taking it abruptly, your condition may get worse. It is crucial to continue taking this medication for the full duration recommended, even if you feel better. Skipping just one dose could lead to a seizure, and suddenly stopping the medication may worsen your condition.

Common side effects of this medication include dizziness, headaches, upset stomach, nausea, skin rashes, vomiting, tiredness or drowsiness, unsteadiness (balance issues), constipation, dry mouth, and itching. Some individuals may also experience blurred vision and slurred speech. While most side effects are not severe, it is important to contact your doctor immediately if you notice a skin rash, feel depressed, or have thoughts of harming yourself.

Before starting Tegrital 200mg Tablet, inform your doctor if you have any heart conditions, liver or kidney disease, trouble with urination, or a history of mental health issues such as depression. These factors could influence your management plan. Your doctor may recommend blood tests, such as a CBC, before beginning management and at regular intervals during your management to monitor your progress.

Uses Of TEGRITAL 200MG TABLET

• Epilepsy
• Nerve-related pain

Benefits of TEGRITAL 200MG TABLET

1. Epilepsy Management: Tegrital helps control seizures, making it beneficial for patients with epilepsy.
2. Pain Relief: It is effective in managing nerve-related pain, such as trigeminal neuralgia.
3. Mood Stabilization: Tegrital is sometimes used off-label to manage certain mood disorders like bipolar disorder.
4. Reduces Abnormal Brain Activity: The active ingredient, Carbamazepine, helps normalize electrical impulses in the brain.

How TEGRITAL 200MG TABLET Works

Tegrital (Carbamazepine) works by stabilizing electrical activity in the brain and nerves. It primarily blocks voltage-gated sodium channels, reducing the ability of neurons to fire excessively, which helps prevent seizures in epilepsy. In conditions like trigeminal neuralgia, it calms overactive nerve signaling, reducing pain. Additionally, it has mood-stabilizing effects, likely by modulating neurotransmitter activity, which can help in managing mood disorders like bipolar disorder. Essentially, it helps control abnormal electrical impulses in the brain and nerves, easing symptoms of these conditions.

How to use TEGRITAL 200MG TABLET

Follow your doctor's instructions regarding the exact dosage. Do not exceed the recommended daily dosage.

How to Take Tegrital 200mg Tablet?

• Swallow the tablet whole with a glass of water. Do not crush, chew, or break the tablet.
• For best results, take the tablet at the same time each day.

Recommended Dosage Instructions:

For Epilepsy:

• Starting Dosage: Begin with a lower dose, which can be gradually increased based on your doctor's instructions.
• Gradual Increase: The dosage will typically be adjusted over time to achieve the desired therapeutic effect.
• Time of Day: Take the tablet at regular intervals as prescribed by your doctor.
• Food Considerations: It can be taken with or without food, depending on your doctor's recommendation.

For Nerve Pain:

• Starting Dosage: Typically, patients start with a small dose.
• Gradual Increase: Your doctor will adjust the dosage based on your response to the medication and its effectiveness.
• Time of Day: Take the tablet at regular intervals as prescribed by your doctor.
• Food Considerations: It can be taken with or without food, depending on your doctor's recommendation.

Visual Aid:

• A chart or visual aid would be helpful to show the "When to Take Tegrital 200mg for Epilepsy" and the typical dose adjustments over time.

Do Not Stop Suddenly:

Avoid abruptly stopping the medication without consulting your doctor, as this can lead to withdrawal symptoms or seizures.

What if I forgot to take TEGRITAL 200MG TABLET

If you miss a dose, take it as soon as you remember unless it's close to the time for your next dose. Do not take two doses at once.

Side Effects Of TEGRITAL 200MG TABLET

Like all medicines, Tegrital 200mg Tablet may cause certain side effects in some individuals, although not everybody gets them.

The most common side effects of taking Tegrital 200mg Tablet are:

• Dizziness
• Headaches
• upset stomach
• nausea
• skin rashes
• vomiting
• tiredness or drowsiness
• unsteadiness (balance issues)
• constipation
• dry mouth
• itching

When to consult your doctor?

• Severe allergic reactions (Stevens-Johnson syndrome or toxic epidermal necrolysis) symptoms such as rash, itching, swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
• Blood disorder symptoms such as unusual bruising or bleeding, pale skin, fever, sore throat, or any other signs of infection.
• Severe mood changes or mental health problems symptoms such as new or worsening thoughts of suicide, depression, or mood swings
• Liver problems symptoms such as dark urine, pale stools, yellowing of the skin or eyes (jaundice), or unusual fatigue
• Severe dizziness, lightheadedness, or fainting
• Severe headache or blurred vision
• Muscle cramps, weakness, or numbness
• Heart problems symptoms such as irregular heartbeat, chest pain, or palpitations.

How To Manage Side Effects

Dizziness Or Drowsiness

• Sit or Lie Down: If you feel dizzy, sit down or lie down immediately to prevent falling. Keep your head still and close your eyes if needed.
• Hydrate: Dehydration can cause dizziness, so drink water or electrolyte-replenishing drinks like sports drinks.
• Avoid Sudden Movements: When standing or sitting, do so slowly to avoid triggering dizziness. Take your time when getting up.
• Eat Small, Regular Meals: Low blood sugar can cause dizziness, so eat small meals throughout the day and avoid skipping meals.
• Fresh Air: Sometimes dizziness can be alleviated by taking slow, deep breaths in a well-ventilated area.

Headache

• Rest in a Quiet, Dark Room: Find a calm, quiet space away from bright lights and loud noises. Lie down and close your eyes.
• Hydrate: Dehydration can contribute to headaches, so drink plenty of water.
• Apply a Cold or Warm Compress: A cold pack on your forehead may reduce pain, or a warm compress on your neck or shoulders can relieve tension.
• Over-the-Counter Pain Relief: You can take over-the-counter pain relievers like acetaminophen or ibuprofen if appropriate for you. Follow the recommended dosage.
• Practice Relaxation Techniques: Deep breathing exercises, meditation, or gentle stretching can help reduce stress and alleviate headache symptoms.

Nausea And Vomiting

• Eat Small, Frequent Meals: Avoid heavy or greasy foods. Opt for bland foods like crackers, toast, or bananas.
• Stay Hydrated: Sip on clear fluids like water, ginger tea, or electrolyte drinks, Avoid caffeinated and carbonated beverages.
• Ginger: Ginger is a natural remedy for nausea or vomiting. Try ginger tea, ginger candies, or ginger ale (ensure it contains real ginger).
• Avoid Strong Odors: Minimize exposure to smells that might trigger nausea, such as perfumes or cooking odors.

Warning & Precautions

Pregnancy

Contraindicated

Tegrital 200mg Tablet is not recommended for use during pregnancy due to clear evidence of potential harm to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.

Breastfeeding

Contraindicated

Tegrital 200mg Tablet is not recommended for use while breastfeeding. Limited human studies indicate that the medication may transfer into breast milk and potentially harm the infant. Please consult your doctor.

Driving and Using Machines

Use with Caution

Do not drive or operate machines if you experience dizziness or drowsiness, or blurred vision.

Alcohol

Consult your doctor

Avoid consumption of alcohol while taking Tegrital 200mg Tablet since it may cause dizziness or drowsiness, or blurred vision.

Kidney

Use with Caution

Tegrital 200mg Tablet should be used with caution in patients having kidney diseases associated with low sodium level in the blood. Please consult your doctor before taking it.

Liver

Use with Caution

Tegrital 200mg Tablet should be used with caution in patients having liver diseases. Consult your doctor before taking it.

Allergy

Contraindicated

Do not take this medication if you are allergic to carbamazepine or similar medicines such as oxcarbazepine, phenytoin, primidone, phenobarbital, or antidepressants (such as amitriptyline or imipramine) or any other ingredients of this medicine.

Heart Disease

Contraindicated

Tegrital tablet is not recommended for use in patients having heart diseases. Please consult your doctor before taking it.

Use In Pediatrics

Consult your doctor

Tegrital 200mg Tablet is generally not recommended for use in children aged below 5 years. It should be used with caution in children and adolescents (aged between 5-15 years). Therefore, consult your pediatrician before taking.

Use In Geriatrics

Use with Caution

Tegrital 200mg Tablet should be used with caution in elderly patients. Dosage adjustment and careful monitoring are required in such patients. Consult your doctor before taking it.

Other Warnings for TEGRITAL 200MG TABLET

Before taking Tegrital 200mg Tablet, inform your doctor if you:

• have absence seizure (seizure with brief sudden lapses of consciousness)
• have any mental illness
• have any eye conditions such as glaucoma (increased pressure in the eyes)
• have any difficulties in retaining urine

Who should not take [GBNKEYWORD

Tegrital 200mg Tablet is not recommended for use if you:

•  have ever had any bone marrow disorders
•  have porphyria (a blood disorder)

Safety Advice

• Follow your doctor's instructions regarding the exact dosage. Do not exceed the recommended daily dosage.
• Swallow the tablet whole with a glass of water. Do not crush, chew, or break the tablet.
• For best results, take the tablet at the same time each day.
• Do not switch the brand of your medication and ensure that you have enough medicine present with you.
• Some healthy tips to help reduce seizures such as engage in daily yoga practice, ensure you get adequate sleep each night, minimize screen time, such as using mobile phones or laptops, take your medication consistently and on schedule.
• Your doctor may regularly perform tests to check your blood cell levels while you are on this medication.
• If you experience sudden mood changes or have thoughts of suicide, be sure to talk to your doctor immediately.
• Do not abruptly stop taking the medication without consulting your doctor, as it could lead to an increase in seizure frequency.
• It is advisable to avoid alcohol consumption, as it can heighten the risk of side effects such as dizziness or drowsiness.
• Make sure to inform your doctor about all the medications you are taking, including over-the-counter drugs and supplements, as Tegrital may interact with various medications, such as antidepressants, blood thinners, or birth control pills.
• Tegrital can cause drowsiness or dizziness, so it is best to avoid driving or operating heavy machinery until you are familiar with how the medication affects you.
• Let your doctor know If you are pregnant or planning to become pregnant or breastfeeding women.

Drug - Drug interaction

Inform your physician if you are taking any of the following medicine before taking Tegrital 200mg Tablet:

1. Amitriptyline (Antidepressant)

• Interaction: Tegrital can reduce the blood levels of amitriptyline, potentially making it less effective.
• Effect: Decreased antidepressant effect and possible relapse of depression or pain.
• Management: The dose of amitriptyline may need to be adjusted. Monitoring of symptoms is important.

2. Warfarin (Anticoagulant)

• Interaction: Carbamazepine may reduce the effectiveness of warfarin by increasing its metabolism.
• Effect: Increased risk of blood clots due to reduced anticoagulant effect.
• Management: Frequent monitoring of INR (International Normalized Ratio) levels is necessary to adjust the warfarin dose accordingly.

3. Oral Contraceptives (Birth Control Pills)

• Interaction: Tegrital may reduce the effectiveness of oral contraceptives by increasing the metabolism of estrogen and progestin.
• Effect: Increased risk of unintended pregnancy.
• Management: Use additional forms of contraception, such as barrier methods, while on Tegrital.

4. Phenytoin (Anticonvulsant)

• Interaction: Both drugs can increase the levels of each other, leading to toxicity.
• Effect: Increased risk of side effects, such as dizziness, ataxia (lack of coordination), and drowsiness.
• Management: Close monitoring of blood levels of both medications. Dosage adjustments may be needed.

5. Cimetidine (Antacid)

• Interaction: Cimetidine can increase the blood levels of carbamazepine, as it inhibits its metabolism.
• Effect: Higher levels of Tegrital can lead to toxicity, including symptoms like dizziness, unsteadiness, and drowsiness.
• Management: Consider reducing the dose of Tegrital or monitoring for side effects more closely when using both drugs.

6. Erythromycin (Antibiotic)

• Interaction: Erythromycin can inhibit the metabolism of carbamazepine, leading to higher blood levels of Tegrital.
• Effect: Increased risk of Tegrital toxicity, including nausea, vomiting, dizziness, and ataxia.
• Management: Regular monitoring of carbamazepine levels, and dose adjustment may be needed.

7. Grapefruit Juice

• Interaction: Grapefruit juice can inhibit the enzymes that metabolize carbamazepine, raising its blood levels.
• Effect: Increased risk of side effects such as sedation and ataxia.
• Management: Avoid excessive grapefruit juice consumption while on Tegrital.

8. Rifampin (Antibiotic)

• Interaction: Rifampin is a strong inducer of liver enzymes, which can decrease the blood levels of carbamazepine.
• Effect: Reduced effectiveness of Tegrital, possibly leading to a recurrence of seizures or mood instability.
• Management: Higher doses of Tegrital may be required, and regular monitoring of drug levels is recommended.

9. Alcohol

• Interaction: Alcohol can exacerbate the sedative and drowsiness effects of carbamazepine.
• Effect: Increased sedation, dizziness, and impaired motor coordination.
• Management: Avoid alcohol or use it cautiously while on Tegrital.

10. Clarithromycin (Antibiotic)

• Interaction: Clarithromycin can inhibit the metabolism of carbamazepine, raising its blood levels.
• Effect: Increased risk of side effects like dizziness, nausea, or ataxia.
• Management: Monitoring carbamazepine levels, and possibly reducing the dose of Tegrital.

Synopsis

More Information

How does Tegrital 200 help in controlling seizures, reducing nerve pain, and stabilizing moods in individuals with bipolar disorder?

1. Control of Seizures

• Anticonvulsant Effects: Tegrital is primarily used to control seizures in individuals with epilepsy or other seizure disorders. It works by stabilizing electrical activity in the brain, preventing abnormal bursts of electrical signals that lead to seizures.
• Prevention of Seizures: Tegrital is effective in preventing both partial and generalized seizures. It helps by inhibiting sodium channels, which prevents nerve cells from becoming overexcited and causing seizure activity.
• Long-term Management: It’s often used as a long-term treatment for those who experience recurrent seizures, providing stability and reducing the frequency of episodes.

2. Alleviation of Nerve Pain (Neuropathic Pain)

• Pain Relief: Tegrital is often prescribed to treat trigeminal neuralgia, a condition that causes severe, sharp pain in the face. It is also used for other types of neuropathic pain, where nerve damage or irritation leads to chronic pain sensations.
• Mechanism of Action: It alleviates pain by stabilizing overactive nerve impulses in the affected area, preventing the pain signals from reaching the brain.
• Effective for Chronic Pain: In many cases, Tegrital can provide significant relief from nerve pain that is resistant to other types of analgesics.

3. Stabilizing Moods in Bipolar Disorder

• Mood Stabilization: Tegrital is often used as a mood stabilizer in the treatment of bipolar disorder. It helps reduce the severity of manic and depressive episodes, preventing the extreme mood swings characteristic of the disorder.
• Prevention of Mania: The medication helps balance mood fluctuations by modulating the levels of certain neurotransmitters in the brain, thus preventing episodes of mania or hypomania.
• Reducing the Risk of Relapse: Long-term use of Tegrital can help maintain mood stability, reducing the likelihood of recurrent manic or depressive episodes.

Tegrital (Carbamazepine) 200mg is a versatile medication that addresses several medical issues, including seizure control, nerve pain relief, and mood stabilization in conditions like bipolar disorder. Its effectiveness in managing these symptoms has made it a commonly prescribed management in both neurological and psychiatric settings. As with any medication, it is important to follow a doctor’s instructions for proper use and monitoring of potential side effects.

What are some alternative medications to Tegrital for individuals who experience adverse reactions or find it ineffective? 

Key Differences:

• Lamotrigine and Oxcarbazepine are preferred for patients seeking a better side-effect profile.
• Valproate is more effective for generalized seizures but may cause more weight gain and liver problems.
• Levetiracetam has a lower side-effect profile and is generally preferred for its ease of use.
• Topiramate is particularly useful for patients with both seizures and migraine but can cause cognitive side effects.

Some Alternative Therapies for Managing Epilepsy and Nerve pain that People Using Tegrital Might Consider:

FAQs About TEGRITAL 200MG TABLET

References

1. James O. McNamara. Pharmacotherapy of the Epilepsies. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page – 594-596.
2. Jasdave S. Maan; Truc vi H. Duong, Abdolreza Saadabadi Carbamazepine. NIH National Library of Medicine, National center for biotechnology information. [Revised on 2nd May 2022] [Accessed on 17th Feb 2025]
3. Philip J Wiffen, Sheena Derry, R Andrew Moore, and Henry J McQuay. Carbamazepine for acute and chronic pain in adults. NIH National Library of Medicine, National centre for biotechnology information. PubMed Central. September 2014. [Accessed on 17th Feb 2025] 
4. Novartis Pharmaceuticals UK Limited. Electronic Medicines Compendium (EMC). [Revised in November 2020] [Accessed on 17th Feb 2025].

Author Details

Written By Dr. Karthikeyan Rajagopal - M.Pharm (Pharmacology)

Reviewed By Dr. Sankara Babu Gorle - MBBS, MD(Pharmacology) View profile

Last updated on 18 Feb 2025 | 03:25 PM(IST)