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Taking tegretol for epilepsy. Getting headache and sweating on face with redness. Any relief?

been on tegretol for epilepsy for 25years.for the last 15 have had profuse sweating on face with redness sometimes on no exertion,.aches and pains for least 3 years all over body.just started getting bad headaches daily.been to g p many times with no joy but this last time my billirubin is high.they said to recheck in a month,also had yellowing of skin couple of weeks ago and itching.this weekend been getting sharp pain on left side like electric shock and in tips of fingers and toes.
Asked On : Wed, 23 Jan 2013
Answers:  1 Views:  45
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General & Family Physician 's  Response
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 (TEN), urticaria.
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.
Answered: Wed, 23 Jan 2013
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