Carbamazepine (often known by brand names like Tegretol) is a widely used medicine for seizures, certain nerve pain types, and bipolar disorder. If you or someone you care for is starting it, this page gives plain, useful facts so you can spot problems early and use it safely.
Carbamazepine calms overactive nerves in the brain. Doctors commonly prescribe it for focal (partial) seizures, trigeminal neuralgia (sharp facial pain), and as a mood stabilizer for bipolar disorder. It comes in immediate-release and extended-release pills, and dosing varies a lot depending on the condition and the person.
Typical starting doses are low—often 100–200 mg once or twice daily—and your doctor will raise the dose slowly. Maintenance doses commonly fall between 400–1200 mg per day, split into two or more doses. Don’t change the dose on your own.
Common side effects include drowsiness, dizziness, blurred vision, nausea, and clumsy balance. Those often get better after a few weeks. Still, some side effects need urgent attention: a new rash, high fever, yellowing skin or eyes, severe tiredness, or thoughts of harming yourself. These can signal serious reactions.
Carbamazepine can lower sodium in the blood (hyponatremia), cause low white blood cell counts, and affect liver tests. Because of these risks, your doctor will usually check blood tests early and then on a schedule—complete blood count, liver tests, and sometimes blood levels of the drug. The typical therapeutic blood level is about 4–12 mcg/mL, but your provider will interpret that for your situation.
There’s a known genetic risk: people of Asian ancestry should be tested for the HLA-B*1502 gene before starting carbamazepine because it raises the chance of a severe skin reaction (Stevens–Johnson syndrome).
Carbamazepine interacts with many drugs. It’s a strong enzyme inducer, so it can make hormonal birth control, warfarin, and many other medicines less effective. Always tell your prescriber and pharmacist every medicine, supplement, or herbal product you use.
Practical tips: don’t stop suddenly—seizures can return. If you’re pregnant or planning pregnancy, talk to your doctor; carbamazepine carries higher risk of birth defects and may need special planning and extra folic acid. If you buy medication online, use a reputable, licensed pharmacy and check credentials first.
If anything feels off—new rash, unusual bruising, severe dizziness, or confusion—call your provider or go to urgent care. Carbamazepine is effective for many people, but safe use depends on monitoring, knowing interactions, and keeping open communication with your healthcare team.
