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Health

Carbapine

, medical expert
Last reviewed: 04.07.2025
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Carbapine is an anticonvulsant drug that is a derivative of carboxamide. The active component carbamazepine causes blocking of Na channels inside the neuronal wall, thereby preventing the propagation of impulses.

The drug is often used in the treatment of combined or simple partial seizures, and also in tonic-clonic seizures (primary or secondary). The drug is also prescribed for the treatment of other types of epileptic seizures (excluding absences).

Indications Karbapina

It is used for the following disorders:

  • epilepsy (severe seizures, partial seizures accompanied by simple or complex manifestations, mixed types of epilepsy and generalized tonic-clonic seizures);
  • emotional disorders of a cyclical nature (having a manic-depressive nature of the disorder);
  • neuralgia (postherpetic, trigeminal or glossopharyngeal);
  • withdrawal syndrome in people with chronic alcoholism;
  • neuropathy of diabetic origin, which causes pain;
  • diabetes insipidus of central origin.

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Release form

The medication is produced in tablets of 0.2 g; there are 50 tablets in a pack.

Pharmacodynamics

The drug is prescribed for trigeminal neuralgia of various origins and other types of chronic pain. It is believed that carbamazepine is able to reduce the intensity of pain during trigeminal neuralgia by suppressing transmission within the nucleus of the tertiary nerve.

Pharmacokinetics

The medicine is almost completely absorbed in the gastrointestinal tract – evenly and at a low speed.

The bioavailability values of carbamazepine fluctuate within 58-96% and do not change with food intake. The plasma Cmax level is recorded after 2-8 hours. The half-life is quite long and equals approximately 30 hours. Because the drug induces the activity of intrahepatic enzymes, it increases the rate of its own metabolism and can reduce the half-life to 15 hours.

The distribution volume of the drug is in the range of 0.8-1.9 l/kg.

Dosing and administration

The medication should be taken orally, with food. The dosage of the drug is selected individually for each patient, taking into account the medicinal efficacy and plasma values of the active substance. The drug is prescribed for epilepsy both in monotherapy and together with other anticonvulsants (phenobarbital, phenytoin or Na valproate).

Adults

For epilepsy, 0.2 g of the drug is initially used 1-2 times a day; for elderly people - 0.1 g (0.5 tablets) with the same frequency. Then the dose is gradually increased to 0.4 g 2-3 times a day until the optimal daily dosage of 0.8-1.2 g is reached. An adult can take no more than 1.6 g of the drug per day.

In case of emotional disorders of cyclic nature: if treatment with lithium agents does not have an effect, the medication can be used in monotherapy or in combination with other drugs - during remission of the disease or its active phase. The daily dose is 1-1.6 g of Carbapine.

In case of neuralgia, first take 0.2 g of the drug per day. Then the medicine is used in a dosage of 0.4-0.8 g per day.

In case of withdrawal syndrome, an average of 0.6 g of the substance is taken per day, dividing the portion into 3 uses. In severe conditions (in the first days), the daily dosage can be increased to 1.2 g (in 3 uses).

In case of diabetic neuropathy (with pain), 0.2 g of the drug is administered on average 2-4 times per day.

Diabetes insipidus of central etiology: on average, 0.4-0.6 g of medication is used per day (2-3 uses).

In case of long-term use, the dose should be reduced with 3-month breaks to the minimum effective dosage (or complete withdrawal) in order to prevent the development of tolerance to the drug.

When therapy is completely discontinued, the dosage is reduced gradually over a 14-day period to prevent relapse of the disease.

Persons with severe renal impairment require ¾ of the standard daily dose for conventional therapy. No dosage adjustment is necessary after hemodialysis sessions.

Children

Children need to take 10-20 mg/kg of the medicine per day. At the age of 1-3 years – 0.2-0.3 g per day; 4-7 years – 0.3-0.5 g; 8-14 years – 0.5-1 g; 15-18 years – 0.8-1.2 g. The daily portion should be divided into 2 uses.

Children under 15 years of age can take no more than 1 g of the drug per day; over 15 years of age – a maximum of 1.2 g per day.

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Use Karbapina during pregnancy

The use of the medicine during pregnancy is permitted only if there are strict indications; it should not be used in the first trimester.

The medication is excreted in breast milk, which is why it should be used with extreme caution during breastfeeding. It is necessary to evaluate the benefits and risks of breastfeeding for the infant in such a situation. Breastfeeding can be performed by women using carbamazepine only if the infant is monitored for possible side effects (for example, severe drowsiness).

Contraindications

Main contraindications:

  • severe intolerance associated with elements of the drug or tricyclics;
  • AV block (excluding people with an implanted pacemaker);
  • problems with bone marrow hematopoiesis;
  • intermittent porphyria (in the active phase);
  • use with lithium medications or MAOIs.

Side effects Karbapina

Side effects often appear during combination therapy; they usually develop at the initial stage of treatment and depend on the portion size:

  • CNS lesions: dizziness, drowsiness, severe fatigue, confusion, headaches and impaired motor coordination are common. Elderly people may experience anxiety and confusion. Behavioral aggression, depression, tinnitus and mental retardation have also been reported sporadically. Involuntary movements (nystagmus or sweeping tremor) occasionally occur. In addition, elderly people and people with organic brain lesions may experience involuntary movements of the face and jaws (choreoathetosis or dyskinesia). Neuritis, speech disorders, myasthenia, dysgeusia and leg paresis have been reported sporadically. Most of these symptoms disappear on their own after 8-14 days or after a temporary reduction in the dose. For this reason, the medication is administered in small doses at the initial stage of therapy and then increased;
  • visual disturbances: conjunctivitis may occur, sometimes developing into ocular accommodation disorder, blurred vision and diplopia. Clouding of the lens of the eye may also occur;
  • problems related to the structure of muscles and bones: muscle and joint pain (myalgia or arthralgia) or muscle spasms develop sporadically. After discontinuing the medication, such symptoms disappear;
  • lesions of the mucous membranes and epidermis: development of epidermal signs of allergy - itching, erythema multiforme, urticaria, TEN, exfoliative dermatitis, photosensitivity, erythroderma, SJS and disseminated lupus erythematosus. Hyperhidrosis or alopecia occurs sporadically;
  • disorders of hematopoiesis: thrombocyto- or leukopenia, eosinophilia and leukocytosis. Leukopenia is usually benign. Hemolytic, aplastic or megaloblastic anemia, agranulocytosis and splenomegaly develop occasionally, and in addition, the lymph nodes enlarge;
  • problems with the gastrointestinal tract: sometimes vomiting, dry mouth or nausea, and loss of appetite occur. Occasionally, constipation or diarrhea occurs. Pain in the abdominal area and inflammation of the nasopharyngeal mucous membranes (glossitis with stomatitis and gingivitis) are observed sporadically. Such symptoms disappear after 8-14 days of therapy or after a temporary reduction in the dose of the drug;
  • liver damage: sometimes there is a change in the values of functional liver tests. Jaundice develops occasionally. Hepatitis is observed sporadically (granulomatous, cholestatic, as well as mixed or hepatocellular);
  • EBV and endocrine system disorders: galactorrhea (women) or gynecomastia (men) may occur occasionally. In addition, Carbamazepine may affect thyroid function, especially when combined with other anticonvulsants. Since carbamazepine has an antidiuretic effect, plasma Na levels may decrease occasionally (hyponatremia), causing headaches and vomiting, as well as confusion. Swelling and weight gain may occur occasionally. Plasma Ca levels may decrease;
  • problems with respiratory function: isolated cases of drug intolerance are observed, manifested in the form of dyspnea, fever, pulmonary fibrosis and inflammation;
  • disorders associated with the urogenital tract: hematuria, proteinuria or oliguria occasionally occur. Occasionally, renal failure or sexual dysfunction may develop;
  • Disorders of the cardiovascular system: occasionally in elderly people or people with heart problems, heart rhythm disorders and bradycardia may occur, and in addition, the course of coronary heart disease may worsen. AV block is observed occasionally, sometimes accompanied by loss of consciousness. A significant increase or decrease in blood pressure may occur (the latter usually occurs in the case of taking large doses of the drug). Along with this, the development of thrombophlebitis, vasculitis or thromboembolism has been noted;
  • manifestations of severe intolerance: occasionally vasculitis, fever, rashes, enlarged lymph nodes, changes in the number of leukocytes, arthralgia, changes in the values of the functional intrahepatic test, hepatosplenomegaly appear; in addition, other disorders of the systems and organs - kidneys, lungs, myocardium and pancreas.

It is necessary to immediately stop taking the drug if severe symptoms of allergy, exanthema, changes in blood laboratory values (neutro-, leukopenia- or thrombocytopenia) and fever occur.

Overdose

Carbamazepine causes significant depression of the central nervous system, which is why there is a risk of severe symptoms of intoxication.

Signs.

  • CNS dysfunction: CNS depression, hallucinations, agitation, disorientation, coma, and drowsiness. In addition, dysarthria, hyperreflexia developing into hyporeflexia, nystagmus, visual acuity disorder, ataxia, seizures, dyskinesia, hypothermia, myoclonus, and psychomotor disorders appear;
  • damage to the function of the cardiovascular system: cardiac conduction disorder accompanied by widening of the QRS system, tachycardia, increase or decrease in blood pressure values and cardiac arrest;
  • respiratory problems: pulmonary edema or respiratory depression;
  • gastrointestinal disorders: problems with the evacuation function of the stomach, vomiting and weakened motility of the colon;
  • signs associated with the urinary system: anuria or oliguria, hyponatremia and fluid retention.

Therapy.

There is no antidote. Initial therapy is based on the patient's clinical condition; hospitalization is also required. It is necessary to determine the level of carbamazepine in the blood plasma to confirm intoxication and assess its degree. Evacuation of gastric contents, gastric lavage, and the use of activated carbon are performed. Supportive and symptomatic procedures are performed in intensive care, cardiac activity is monitored, and EBV values are corrected.

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Interactions with other drugs

Drugs that may increase plasma levels of carbamazepine include erythromycin, verapamil, dextropropoxyphene with viloxazine, cimetidine, and diltiazem with isoniazid. When these drugs are used concomitantly, blood levels of carbamazepine should be monitored and the daily dose should be reduced if necessary.

Ethosuccinide, sodium valproate, phenobarbital with primidone and phenytoin can reduce plasma levels of drugs due to the induction of intrahepatic microsomal enzymes.

The drug reduces the half-life and increases the clearance rate (due to a decrease in concentration) of the following substances: warfarin with GCS, theophylline, haloperidol and doxycycline. The latter should be used with a 12-hour break.

It is prohibited to use Carbapine with MAOIs (at least a 14-day interval must be observed) and lithium substances.

When prescribing or discontinuing medication, the dose of anticoagulants should be changed (taking into account clinical values).

The drug increases the rate of metabolic processes of oral contraception, which is why it is necessary to select other contraceptives.

Carbamazepine reduces tolerance to alcoholic beverages, so people using the drug should refrain from drinking them during therapy.

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Storage conditions

Carbapine must be stored in a place protected from moisture penetration. Temperature indicators are in the range of 15-25°C.

Shelf life

Carbapine can be used for a period of 3 years from the date of sale of the medicinal substance.

Application for children

Use for children over 1 year of age. However, the medication should be used very carefully in people under 7 years of age, because there is a possibility of side effects.

Analogues

Analogues of the drug are Finlepsin, Zeptol, Tegretol with Carbalex, Oxapin and Carbamazepine with Timonil and Mezakar.

Attention!

To simplify the perception of information, this instruction for use of the drug "Carbapine" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.

Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.

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