Tegrazepin

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    Product name: Tegrazepin
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    Generic name: Carbamazepine
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    Dosage form: Oral tablets
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    Packaging: Box of 10 blisters of 10 scored tablets
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    Drug Category: Neurology and Psychiatry

Indications:

Epilepsy - generalised tonic-clonic and partial seizures. Note: Tegretol is not usually effective in absences (petit mal) and myoclonic seizures. Moreover, anecdotal evidence suggests that seizure exacerbation may occur in patients with atypical absences.
The paroxysmal pain of trigeminal neuralgia. 
For the prophylaxis of manic-depressive psychosis in patients unresponsive to lithium therapy

Dosage and Administration:

Carbamazepine is given orally, usually in two or three divided doses. Carbamazepine may be taken during, after or between meals, with a little liquid e.g. a glass of water. 
Epilepsy: The dose of carbamazepine should be adjusted to the needs of the individual patient to achieve adequate control of seizures. Determination of plasma levels may help in establishing the optimum dosage. In the treatment of epilepsy, the dose of carbamazepine usually requires total plasma-carbamazepine concentrations of about 4 to 12 micrograms/mL (17 to 50 micromoles/litre) (see warnings and precautions). 
Adults: It is advised that with all formulations of carbamazepine, a gradually increasing dosage scheme is used and this should be adjusted to suit the needs of the individual patient. Carbamazepine should be taken in a number of divided doses although initially 100-200mg once or twice daily is recommended. This may be followed by a slow increase until the best response is obtained, often 800-1200mg daily. In some instances, 1600mg or even 2000mg daily may be necessary. 
Elderly: Due to the potential for drug interactions, the dosage of carbamazepine should be selected with caution in elderly patients. 
Children and adolescents: It is advised that with all formulations of carbamazepine, a gradually increasing dosage scheme is used and this should be adjusted to suit the needs of the individual patient. Usual dosage 10-20mg/kg bodyweight daily taken in several divided doses. Carbamazepine tablets are not recommended for very young children. 5-10 years: 400 to 600mg daily (2-3 x 200mg tablets per day, to be taken in divided doses). 10-15 years: 600 to 1000mg daily (3-5 x 200mg tablets per day, to be taken in several divided doses). >15 years of age: 800 to 1200mg daily (same as adult dose). Maximum recommended dose: Up to 6 years of age: 35mg/kg/day 6-15 years of age: 1000mg/day >15 years of age: 1200mg/day. Wherever possible, anti-epileptic agents should be prescribed as the sole anti-epileptic agent but if used in polytherapy the same incremental dosage pattern is advised. When carbamazepine is added to existing antiepileptic therapy, this should be done gradually while maintaining or, if necessary, adapting the dosage of the other antiepileptic(s). 

Trigeminal neuralgia: Slowly raise the initial dosage of 200-400mg daily until freedom from pain is achieved (normally at 200mg 3-4 times daily). In the majority of patients a dosage of 200mg 3 or 4 times a day is sufficient to maintain a pain free state. In some instances, doses of 1600mg carbamazepine daily may be needed. However, once the pain is in remission, the dosage should be gradually reduced to the lowest possible maintenance level. Maximum recommended dose is 1200mg/day. When pain relief has been obtained, attempts should be made to gradually discontinue therapy, until another attack occurs. 
Elderly: Dosage in Trigeminal neuralgia Due to drug interactions and different antiepileptic drug pharmacokinetics, the dosage of carbamazepine should be selected with caution in elderly patients. In elderly patients, an initial dose of 100mg twice daily is recommended. The initial dosage of 100mg twice daily should be slowly raised daily until freedom from pain is achieved (normally at 200mg 3 to 4 times daily). The dosage should then be gradually reduced to the lowest possible maintenance level. Maximum recommended dose is 1200mg/day. When pain relief has been obtained, attempts should be made to gradually discontinue therapy, until another attack occurs. For the prophylaxis of manic depressive psychosis in patients unresponsive to lithium therapy: Initial starting dose of 400mg daily, in divided doses, increasing gradually until symptoms are controlled or a total of 1600mg given 

Contraindication:

Known hypersensitivity to carbamazepine or structurally related drugs (e.g. tricyclic antidepressants) or any other component of the formulation. 
Patients with atrioventricular block, a history of bone marrow depression or a history of hepatic porphyrias (e.g. acute intermittent porphyria, variegate porphyria, porphyria cutanea tarda). 
The use of carbamazepine is contraindicated in combination with monoamine oxidase inhibitors (MAOIs) or within 14 days after discontinuing an MAOIs