Neurology
- Active ingredient (INN)
- сarbamazepine
- Composition (active ingredients)
- carbamazepine - 200,0 mg
- Фармакотерапевтическая группа
- antiepileptic agent
- Pharmacotherapeutic group
- tablets 200 mg № 40, 50
- Сonditions of supply
- on prescription
Indications
Epilepsy complex or simple partial epileptic seizures (with or without loss of consciousness) with or without secondary generalization;Generalized tonic-clonic epileptic seizures;
Mixed forms of epileptic seizures;
Acute manic conditions and maintenance therapy of bipolar affective disorders in order to prevent exacerbations or to weaken the clinical manifestations of exacerbation;
Alcohol withdrawal syndrome;
Idiopathic trigeminal neuralgia and trigeminal neuralgia with multiple sclerosis (typical and atypical);
Idiopathic neuralgia of the glossopharyngeal nerve;
Carbamazepine is generally ineffective in case of absences and myoclonus epilepsy.
Dosage regimen
The drug should be taken orally, regardless of the meal with a small amount of liquid.
The drug can be used both in the form of monotherapy, and as part of combination therapy.
Considering the drug interactions with other drugs and the pharmacokinetics of antiepileptic drugs, elderly patients should be selected with caution in the dose of carbamazepine.
Epilepsy
If possible, the drug should be prescribed as monotherapy.
The drug is not used for small seizures (petit mal, absences) and myoclonic seizures.
Treatment begins with a small daily dose, which is subsequently slowly increased until the optimal effect is achieved. The dose of carbamazepine is selected individually to achieve adequate control of convulsive conditions.
To select the optimal dose of the drug, it is recommended that the concentration of the active substance in the blood plasma be determined.
In the treatment of epilepsy, a dose of carbamazepine is required, corresponding to a total concentration of carbamazepine in the blood plasma at a level of 4-12 μg / ml (17-50 μmol / l).
When carbamazepine is added to other antiepileptic drugs taken, the dose of carbamazepine is gradually increased. If necessary, carry out appropriate dose adjustment of the drugs.
The initial dose of carbamazepine for adults is 100-200 mg 1 or 2 times a day. Then the dose is slowly increased to achieve the optimal therapeutic effect; it is usually achieved at a dose of 400 mg 2-3 times a day. Some patients may need to increase the daily dose to 1600 mg or 2000 mg.
Trigeminal neuralgia
The initial dose for adults is 200-400 mg per day. It is slowly increased until pain disappears (usually up to a dose of 200 mg 3-4 times a day). Then the dose is gradually reduced to the minimum maintenance. The maximum recommended dose for adults is 1200 mg / day.
When resolving the pain, the drug should be gradually discontinued until the next pain attack occurs.
The recommended initial dose for elderly patients is 100 mg 2 times a day, then the dose is slowly increased until the pain syndrome resolves, which is usually achieved with a dose of 200 mg 3-4 times a day. Next, you should gradually reduce the dose to the minimum maintenance. With trigeminal neuralgia in this category of patients, the maximum recommended dose is 1200 mg / day. When resolving the pain syndrome, therapy with the drug should be gradually discontinued until the next pain attack occurs.
Alcohol withdrawal syndrome
The average dose is 200 mg 3 times a day. In severe cases, the dose may be increased during the first few days (for example, up to a dose of 400 mg 3 times a day).
In severe manifestations of alcohol withdrawal, treatment begins with the use of the drug in combination with drugs that have sedative and hypnotic effects (for example, clomethiazole, chlordiazepoxide). After resolving the acute phase, treatment with the drug can be continued as monotherapy.
Polyuria and polydipsia of neurohormonal nature in diabetes insipidus of central origin
The average dose for adults is 200 mg 2-3 times a day.
Pain syndrome for diabetic neuropathy
The average dose is 200 mg 2-4 times a day.
Acute manic conditions and supportive treatment of affective (bipolar) disorders
The daily dose is 400-1600 mg. The average daily dose is 400-600 mg (in 2-3 doses). In an acute manic state, the dose should be increased rather quickly. With maintenance therapy for bipolar disorders, in order to ensure optimal tolerance, each subsequent dose increase should be small, the daily dose increases gradually.
Discontinuation of the drug
Sudden discontinuation of the drug can trigger epileptic seizures, so carbamazepine should be withdrawn gradually over a period of 6 months or more. If it is necessary to cancel the drug in a patient with epilepsy, the transition to another antiepileptic drug should be carried out under the cover of the drug indicated in such cases.
Use in children
The main indication for the use of the drug carbamazepine in children is epilepsy. This dosage form of the drug should be used to treat the same as in adults, forms of epilepsy in children older than 4 years. Treatment can be started with a dose of 100 mg / day; the dose is increased gradually, no more than 100 mg per week.
Supporting doses: for children, 10-20 mg / kg of body weight per day is established (in several doses).
- Child age
-
daily dose
- 4-5 years old
-
200-400 mg per day
- 6-10 years
-
400-600 mg per day
- 11-15 years old
-
600-1000 mg per day
- > 15 years
-
800-1200 mg (as for adults)
Maximum doses: for children aged <6 years is 35 mg kg / day, 6-15 years - 1000 mg / day, & gt; 15 years - 1200 mg / day.
Since there is not enough reliable information regarding the use of the drug for other indications in children, it is recommended that the dosage regimen be selected in accordance with the age and weight of the child, not exceeding the dosages indicated in the table.
