The risk of tegretol is on the production of white blood cells which need to be checked occasionally and liver toxicity.

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This drug is not a simple analgesic and should not be used for the relief of trivial aches or pains.

The relative risk for suicidal thoughts or behavior was higher in clinical trials for epilepsy than in clinical trials for psychiatric or other conditionsbut the absolute risk differences were similar for the epilepsy and psychiatric indications.

Carbamazepine mustthereforebe considered to be carcinogenic in Sprague-Dawley ratsBacterial and mammalian mutagenicity studies using carbamazepine produced negative resultsThe significance of these findings relative to the use of carbamazepine in humans isat presentunknown.

Epidemiological data suggest that there may be an association between the use of carbamazepine during pregnancy and congenital malformationsincluding spina bifidaThere have also been reports that associate carbamazepine with developmental disorders and congenital anomaliese.gcraniofacial defectscardiovascular malformationsand anomalies involving various body systemsDevelopmental delays based on neurobehavioral assessments have been reportedWhen treating or counseling women of childbearing potentialthe prescribing physician will wish to weigh the benefits of therapy against the risksIf this drug is used during pregnancyor if the patient becomes pregnant while taking this drugthe patient should be apprised of the potential hazard to the fetus.

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Combined PoisoningWhen alcoholtricyclic antidepressantsbarbituratesor hydantoins are taken at the same timethe signs and symptoms of acute poisoning with Tegretol may be aggravated or modified.

Isolated cases of neuroleptic malignant syndrome have been reported both with and without concomitant use of psychotropic drugs.

Patientstheir caregiversand families should be informed that AEDs increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of the signs and symptoms of depressionany unusual changes in mood or behavioror the emergence of suicidal thoughtsbehavioror thoughts about self-harmBehaviors of concern should be reported immediately to healthcare providers.

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Complete pretreatment blood countsincluding platelets and possibly reticulocytes and serum ironshould be obtained as a baselineIf a patient in the course of treatment exhibits low or decreased white blood cell or platelet countsthe patient should be monitored closelyDiscontinuation of the drug should be considered if any evidence of significant bone marrow depression develops.

Do not drink alcohol or take other drugs that make you sleepy or dizzy while taking TEGRETOL until you talk to your healthcare providerTEGRETOL taken with alcoholor drugs that cause sleepiness or dizziness may make your sleepiness or dizziness worseDo not driveoperate heavy machineryor do other dangerous activities until you knowhow TEGRETOL affects youTEGRETOL may slow your thinking and motor skills.

Congestive heart failureedemaaggravation of hypertensionhypotensionsyncope and collapseaggravation of coronary artery diseasearrhythmias and AV blockthrombophlebitisthromboembolisme.gpulmonary embolismand adenopathy or lymphadenopathy.

Because of the relationship of the drug to other tricyclic compoundsthe possibility of activation of a latent psychosis andin elderly patientsof confusion or agitation should be borne in mind.

Prior to initiating Tegretol therapytesting for HLA-B*1502 should be performed in patients with ancestry in populations in which HLA-B*1502 may be presentIn deciding which patients to screenthe rates provided above for the prevalence of HLA-B*1502 may offer a rough guidekeeping in mind the limitations of these figures due to wide variability in rates even within ethnic groupsthe difficulty in ascertaining ethnic ancestryand the likelihood of mixed ancestryTegretol should not be used in patients positive for HLA-B*1502 unless the benefits clearly outweigh the risksTested patients who are found to be negative for the allele are thought to have a low risk of SJS/TENsee BOXED WARNING and PRECAUTIONSLaboratory Tests

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