Carbamazepine (Tegretol)
Iminostilbene anticonvulsant and mood stabilizer that blocks voltage-gated sodium channels. Active metabolite CBZ-epoxide contributes to both efficacy and toxicity. Potent CYP3A4 inducer with notable autoinduction — initial half-life of 25-65 hours shortens to 12-17 hours with chronic dosing. First-line for trigeminal neuralgia and partial seizures. HLA-B*1502 testing recommended before initiation in at-risk populations due to SJS/TEN risk.
Projected serum levels — 200 mg, twice daily
Maintenance schedule: 200 mg twice daily (oral).
Loading schedule: 600 mg on day 1, then 200 mg twice daily — reaching therapeutic levels sooner.
Modeled steady state after ~5 days: peak ≈ 732 mg, trough ≈ 631 mg body load. Population-based estimate over 15 days for a 200 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.
Key facts
- Category
- Anticonvulsant
- Route modeled
- Oral
- Model confidence
- inferred
- Half-life
- 35 h
- Common dose
- 200 mg
- Suggested maximum
- 1.6k mg/day
- Reference dose range
- 100–1.6k mg (single dose)
- Suggested cadence
- twice daily
- Validated against
- 200 mg oral — Cmax 4 mg/L at 6 h
Documented interactions
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contraindicated
Alfuzosin (Uroxatral) + Carbamazepine (Tegretol)
Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Alfuzosin (Uroxatral) AUC by ~0.20x
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contraindicated
Alprazolam (Xanax) + Carbamazepine (Tegretol)
Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Alprazolam (Xanax) AUC by ~0.20x
-
contraindicated
Amlodipine (Norvasc) + Carbamazepine (Tegretol)
Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Amlodipine (Norvasc) AUC by ~0.20x
-
contraindicated
Astaxanthin + Carbamazepine (Tegretol)
Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Astaxanthin AUC by ~0.20x
-
contraindicated
Atogepant (Qulipta) + Carbamazepine (Tegretol)
Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Atogepant (Qulipta) AUC by ~0.20x
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contraindicated
Azithromycin (Z-Pack / Zithromax) + Carbamazepine (Tegretol)
Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Azithromycin (Z-Pack / Zithromax) AUC by ~0.20x
Serum checks 386 modeled interaction pairings for carbamazepine (tegretol) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.
Research behind this entry
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Carbamazepine in manic-depressive illness: a new treatment
Landmark study establishing carbamazepine as effective for acute mania in 12 of 19 bipolar patients, with marked improvement in manic symptoms independent of anticonvulsant effects.
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Carbamazepine pharmacokinetics: principles and pitfalls
Definitive PK review documenting carbamazepine autoinduction (half-life decreasing from 36h to 16h over weeks), active epoxide metabolite formation, and the clinical implications for dose titration.
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Comparison of carbamazepine and lithium in the treatment of mania
Randomized trial finding carbamazepine comparable to lithium for acute mania treatment, with 60% response rate, establishing it as a valid alternative mood stabilizer.
3 published studies referenced in the app, each with a plain-language summary.