Zeptol CR 400mg Tablet

Uses of

• Epilepsy/Seizures
• Trigeminal Neuralgia
• Diabetic Nerve Pain

How does

This medication belongs to the class anticonvulsant. It works by reducing the excitation of the brain cells by inhibiting the sodium channels thus inhibiting the repetitive firing of brain cells.

Side Effects of

The common, uncommon, and rare side effects of Zeptol CR 200mg Tablet include:

COMMON:

1. Reduced WBC count causing frequent infections.
2. Dizziness, tiredness, losing balance, nausea, or vomiting.
3. Abnormal bleeding and bruising.
4. Fluid retention and swelling.
5. Weight gain.

UNCOMMON:

1. Abnormal uncontrollable body movements including tremors or tics.
2. Abnormal eye movements.
3. Diarrhea and constipation.

RARE:

1. Disorders of lymph glands.
2. Increased blood pressure (may cause symptoms like dizziness, flushed face, headache, fatigue, and nervousness).
3. Hallucinations, confusion, restlessness, depression, anxiety, and loss of appetite.
4. Abnormalities in speech.
5. Numbness and tingling of hands and feet.
6. Muscle weakness.

Quick Suggestions:

• Take your medication regularly as directed by your doctor as missing doses can trigger seizures.
• Do not change the brand of your medicine and make sure that you have a sufficient amount of medicine present with you.
• It may cause dizziness and sleepiness. Do not drive or do anything that requires mental focus until you know how it affects you.
• Your doctor may get regular tests done to monitor the level of blood cells in your blood while taking this medication.
• Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
• Inform your doctor if you notice a rash or other skin changes such as reddish spots or circular patches while taking this medicine.
• Do not stop taking the medication suddenly without talking to your doctor as it may increase the seizure frequency.

Indication

Carbamazepine is indicated for- 

• Partial and secondary generalized tonic-clonic seizures
• Primary generalized tonic-clonic seizures
• Trigeminal neuralgia
• Prophylaxis of bipolar disorder

Pharmacology

Carbamazepine exerts its effects on the nervous system by reducing polysynaptic responses and blocking post-tetanic potentiation. It is effective in treating both partial and generalized convulsions, as well as mixed types, but it is not effective in treating petit mal seizures (also known as absence seizures). Additionally, Carbamazepine is known to be effective in relieving pain associated with trigeminal and glossopharyngeal neuralgia.

Dosage & Administration of

Adult Dose:

• Epilepsy: Initial dose of either 200mg twice daily (tablet and extended-release tablet) or 1 teaspoon four times daily (suspension), with a maximum dose of 1600mg daily. The maintenance dose is usually 800-1200mg daily.
• Trigeminal neuralgia: Initial dose of 100-200mg twice daily, increased gradually as needed. The maintenance dose is typically 400-800mg daily in divided doses, with a maximum of 1.2g daily.
• Prophylaxis of bipolar disorder: Initial dose of 400mg daily in divided doses, increased gradually as necessary. The maintenance dose is usually 400-600mg daily in divided doses, with a maximum of 1.6g daily.

Child Dose:

• Epilepsy (Age <6 years): Initial dose of 10-20mg/kg/day, given every 6 hours for oral suspension, and every 8-12 hours for tablets. Maintenance dose not to exceed 35mg/kg/day divided into 3-4 times daily.
• Epilepsy (Age 6-12 years): Initial dose of 50mg every 6 hours for oral suspension and 100mg every 12 hours for tablets, increased weekly by 100mg/day. The maintenance dose is 400-800mg/day every 6-8 hours for immediate-release tablets and every 12 hours for extended-release tablets, not to exceed 1000mg/day.
• Epilepsy (Age >12 years): Initial dose of 10mL (200mg) every 6 hours for oral suspension and 200mg every 12 hours for tablets, increased by up to 200mg/day weekly. The maintenance dose is 400-800mg/day every 6-8 hours for immediate-release tablets, every 12 hours for extended-release tablets, or every 6-8 hours for other formulations. Does not to exceed 1000mg/day for ages 12-15 years and 1200mg/day for ages >15 years.

Please note that these dosages are general guidelines and should always be followed as per the specific instructions of the prescribing physician. Dosage may vary based on individual patient conditions and response to treatment. Always consult a healthcare professional before starting or making changes to any medication.

Interaction

Drug interactions can be complex and potentially dangerous. It is important to be aware of potential interactions with other medicines, foods, or beverages to ensure the safe and effective use of Zeptol 200Mg Tablet Cr. Here are some key points regarding drug interactions with Zeptol 200Mg Tablet Cr:

• Interaction with Alcohol: It is not recommended to consume alcohol while taking Zeptol 200Mg Tablet Cr as it can increase the risk of side effects like dizziness and difficulty in concentration. Avoid activities that require mental alertness, such as driving or operating machinery, while on this medication.
• Interaction with Other Medicines: Zeptol 200Mg Tablet Cr may interact with various other medicines, including benzodiazepines, corticosteroids, antiepileptic drugs, antidepressants, and blood thinners like warfarin. Monitoring for altered response and possible dose adjustments may be necessary when using these medicines together.
• Interaction with Specific Medicines: There are certain medicines like cimetidine, clarithromycin, and fluconazole that can inhibit the metabolism of Zeptol 200Mg Tablet Cr, leading to increased blood levels and potential toxicity. Careful monitoring is required in such cases.
• Interaction with Disease Conditions: Caution should be exercised when using Zeptol 200Mg Tablet Cr in patients with depression and suicidal thoughts. Frequent monitoring of depression symptoms is necessary, and dose adjustments may be needed based on the patient's outcomes. Similarly, patients with mild to moderate liver disease should be monitored regularly with liver function tests, and appropriate dose adjustments or alternative medicines should be considered.

Contraindications

• Hypersensitivity
• Bone marrow depression
• Porphyria
• Pregnancy.

Pregnancy & Lactation

Pregnancy: Zeptol CR 400mg Tablet is categorized as Pregnancy Category D. This means that there is evidence of risk to the fetus based on human data, but the potential benefits to the mother may outweigh the risks in certain situations. It should only be used during pregnancy if considered necessary and prescribed by a physician. Pregnant women should consult their doctor before taking Zeptol CR 200mg Tablet to discuss the potential risks and benefits.

Lactation: Zeptol CR 400mg Tablet enters breast milk, and it is not recommended to be used while breastfeeding. The American Academy of Pediatrics (AAP) states that the drug is compatible with nursing, but adverse reactions in the breastfeeding infant are possible. Therefore, the importance of the drug to the mother should be taken into account before deciding whether to discontinue breastfeeding or the drug. Lactating women should consult their doctor to discuss the potential risks and benefits of using Zeptol CR 200mg Tablet while breastfeeding.

Precautions & Warnings

• Vertigo and Drowsiness: Zeptol CR 400mg Tablet can cause vertigo and drowsiness. Patients should exercise caution when engaging in potentially hazardous activities, such as operating machinery or driving, to prevent accidents.
• Skin Reactions: If patients experience a skin rash, itching, or any unexplained skin reaction while taking Zeptol CR 400mg Tablet, they should inform their doctor immediately.
• Liver Problems: Zeptol CR 400mg Tablet can rarely cause liver problems. Patients should seek medical consultation if they notice symptoms such as yellowing of the skin or eyes (jaundice), dark urine, nausea, vomiting, abdominal pain, or loss of appetite, which could be signs of liver issues.
• Interaction with Hormonal Contraceptives: Carbamazepine, the active ingredient in Zeptol CR 400mg Tablet, can decrease blood levels of hormonal contraceptives containing estrogen and/or progesterone. This can lead to reduced contraceptive effectiveness or breakthrough bleeding. Women taking this medication should use a contraceptive containing at least 50 micrograms of estrogen, or non-hormonal contraceptive methods such as condoms.
• Gradual Discontinuation: Zeptol CR 400mg Tablet should not be abruptly stopped unless advised by the doctor. Sudden discontinuation can lead to the return of symptoms. If the medication needs to be stopped, it should be done gradually under the supervision of a healthcare specialist.
• Special Attention for Certain Conditions: Patients with mixed seizures, including absence crises, a history of heart disease, liver disease, psychotic disease, high intraocular pressure (glaucoma), blood disorders caused by other medications, or previous carbamazepine therapy interrupted due to side effects or allergy should be particularly cautious while taking Zeptol CR 400mg Tablet. They should discuss their medical history with their doctor before starting the medication.

As always, patients should follow their doctor's advice and report any unusual or concerning symptoms experienced while taking Zeptol CR 400mg Tablet. Proper communication with the healthcare provider is essential to ensure safe and effective use of the medication.

Storage Conditions

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.