tegretol side effects
CV: Aggravation of coronary artery disease, aggravation of hypertension, arrhythmias, AV block, CHF, fainting, hypotension, syncope, thrombophlebitis.
CNS: Dizziness (44%); somnolence (32%); headache (22%); ataxia (15%); amnesia, asthenia (8%); anxiety, depression, manic depressive reaction (7%); speech disorder (6%); ataxia (5%); depersonalization, extrapyramidal syndrome
, insomnia, nervousness, suicide attempts (less than 5%); aseptic meningitis with myoclonus, cerebral artery insufficiency, confusion, depression with agitation, disturbances in coordination, drowsiness, fatigue, hyperacusis, involuntary movements, neuroleptic malignant syndrome
, paralysis, paresthesias, peripheral neuritis, talkativeness, visual hallucinations.
DERM: Rash (13%); pruritus (8%); alopecia, photosensitivity (less than 5%); aggravation of disseminated systemic lupus erythematosus, altered skin pigmentation, diaphoresis, erythema multiforme and nodosum, erythematous rash, exfoliative dermatitis
, hirsutism, pruritic rash, purpura, Stevens-Johnson syndrome
, toxic epidermal necrolysis
EENT: Amblyopia (6%); diplopia, ear pain, pharyngitis, rhinitis (less than 5%); blurred vision, conjunctivitis, dry pharynx, nystagmus, oculomotor disturbances, scattered punctuate cortical lens opacities, tinnitus.
GI: Nausea (29%); vomiting (18%); diarrhea, dyspepsia (10%); dry mouth (8%); constipation (5%); abdominal pain, anorexia, gastric distress, glossitis, pancreatitis, stomatitis.
GU: UTI (less than 5%); acute urinary retention, albuminuria, azotemia, elevated BUN, glucosuria, impotence, microscopic urine deposits, oliguria with elevated blood pressure, renal failure, urinary frequency.
HEMA/LYMPH: Leukopenia, lymphadenopathy (less than 5%); acute intermittent porphyria
, adenopathy, agranulocytosis, aplastic anemia, bone marrow suppression, eosinophilia, leukocytosis, pancytopenia, thrombocytopenia.
HEPA: Abnormal LFTs (less than 5%); cholestatic jaundice, hepatic failure, hepatitis, hepatocellular jaundice.
M/N: Decreased plasma calcium; elevated cholesterol, HDL cholesterol, and triglycerides; hyponatremia; SIADH; water intoxication.
MUSC: Back pain (5%); aching joints and muscles, leg cramps.
RESP: Bronchitis, sinusitis (less than 5%); dyspnea, pneumonia, pneumonitis, pulmonary hypersensitivity
OTHER: Infection, pain (12%); accidental injury (7%); chest pain (5%); edema, peripheral edema (less than 5%); chills, fever, lupus erythematosus–like syndrome, multi-organ hypersensitivity.
Aplastic anemia and agranulocytosis:
Has been reported with use. The risk is 5 to 8 times greater than in the general population.Obtain complete pretreatment hematological testing as a baseline. If, in the course of treatment, a patient exhibits low or decreased WBC or platelet count, monitor the patient closely.
Serious dermatologic reactions and HLA-B?1502 allele:
Serious and sometimes fatal dermatologic reactions, including Stevens-Johnson syndrome and TEN, have been reported in 1 to 6 per 10,000 carbamazepine users. Studies in patients of Chinese ancestry found a strong association between the risk of developing Stevens-Johnson syndrome or TEN and the inherited genetic allelic variant HLA-B?1502. Screen patients who are genetically at risk and, if positive for the allele, when possible, do not prescribe carbamazepine.