Tegretol CR 400mg Tablet
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Overview
Tegretol CR 400mg Tablet contains carbamazepine 400mg in a controlled-release formulation, an antiepileptic medicine also used to treat trigeminal neuralgia (severe facial nerve pain) and certain mood disorders such as bipolar disorder. It has a narrow therapeutic index, meaning the difference between an effective dose and a dose causing side effects is small, so it must be taken exactly as prescribed and monitored closely by your doctor.
Carbamazepine works by blocking voltage-gated sodium channels in nerve cells, stabilising overactive nerve membranes and reducing the repetitive firing that underlies seizures and certain types of nerve pain. The controlled-release formulation releases the medicine gradually, giving steadier blood levels over the day.
How it Works
Carbamazepine blocks voltage-gated sodium channels in a use-dependent manner, preferentially stabilising rapidly firing or hyperexcitable neurons without significantly affecting normal nerve activity. This reduces the abnormal, repetitive electrical discharges responsible for seizures, dampens the transmission of certain pain signals in trigeminal neuralgia, and helps stabilise mood in bipolar disorder.
Directions for Use
Swallow Tegretol CR 400mg Tablet tablets whole with a glass of water – do not crush, chew, or break the tablet, as this is a controlled-release formulation designed to release the medicine slowly over time. Take at consistent times each day, with or without food, and never switch to a different brand or generic version of carbamazepine without your doctor’s specific instruction, as differences in formulation can affect seizure control or increase side effects.
Dosage
Tegretol CR 400mg Tablet dosing is individualised and usually started at a low dose, increased gradually by your doctor based on your response and blood levels, since both the seizure-control effect and the risk of side effects depend closely on the exact dose. Regular blood tests to check carbamazepine levels, blood counts, and liver function are typically required.
Shelf Life
Use this product before the expiry date stated on the packaging. Do not use the medicine if the expiry date has passed.
Storage Instructions
Store below 30°C in a dry place, away from direct sunlight and out of reach of children.
Side Effects
- Dizziness or drowsiness
- Nausea or vomiting
- Blurred or double vision
- Skin rash or allergic reactions
- Swelling of face or lips (seek medical attention)
- Low sodium levels (may cause confusion or seizures)
- Tiredness or weakness
- Coordination problems
Contraindications
- Known hypersensitivity to carbamazepine or chemically related medicines (e.g. tricyclic antidepressants)
- History of bone marrow suppression or blood disorders
- AV conduction abnormalities (heart block) unless a pacemaker is fitted
- Concomitant use with monoamine oxidase inhibitors (MAOIs)
- History of acute intermittent porphyria
Drug / Food Interactions
- Hormonal contraceptives: carbamazepine is a strong enzyme inducer and can significantly reduce their effectiveness, so alternative or additional contraception should be discussed with your doctor
- Warfarin and many other medicines metabolised by the liver: carbamazepine can reduce their blood levels and effectiveness
- Grapefruit juice can increase carbamazepine blood levels and the risk of side effects
- Other antiepileptic medicines: complex interactions can occur in either direction, so combination therapy requires specialist monitoring
Quick Tips
- Never switch between different brands or generic versions of carbamazepine without your doctor’s explicit instruction, due to its narrow therapeutic index
- Attend all scheduled blood tests to monitor carbamazepine levels, blood counts, and liver function
- Seek immediate medical attention for any new widespread skin rash, especially with fever or mouth sores, as this can be a serious, potentially life-threatening reaction
- Ask your doctor about genetic testing (HLA-B*1502) if you are of Southeast Asian or Chinese ancestry, as this genetic marker is more common in these populations and is associated with a higher risk of severe skin reactions to carbamazepine
Frequently Asked Questions
What is Tegretol CR 400mg Tablet used for?
Tegretol CR 400mg Tablet is used to treat certain types of epileptic seizures, trigeminal neuralgia (severe facial nerve pain), and some mood disorders such as bipolar disorder. Your doctor will confirm the specific reason it has been prescribed for you.
Why can’t I switch to a different brand of carbamazepine without asking my doctor?
Carbamazepine has a narrow therapeutic index, meaning small differences in how much of the drug is absorbed between different brands or formulations can meaningfully affect seizure control or increase side effects. Any switch should only be made under your doctor’s supervision, usually with closer monitoring.
What is this genetic test my doctor mentioned before starting this medicine?
Carbamazepine carries a risk of causing severe skin reactions (Stevens-Johnson syndrome/toxic epidermal necrolysis), and a genetic marker called HLA-B*1502, which is more common in people of Southeast Asian and Chinese ancestry, is associated with a substantially higher risk. Your doctor may recommend testing for this marker before starting treatment, particularly relevant for many patients in Malaysia.
Why do I need regular blood tests while taking this medicine?
Regular blood tests check your carbamazepine level (to ensure it is in the effective and safe range), your blood cell counts (as this medicine can rarely affect bone marrow function), and your liver function, allowing your doctor to catch any problems early.
Can I stop taking this medicine if I feel well?
No, do not stop without consulting your doctor. Stopping an antiepileptic medicine suddenly can trigger seizures to return or worsen, and any change to your treatment should be done gradually under medical supervision.
What should I do if I miss a dose of Tegretol CR 400mg Tablet?
Take the missed dose as soon as you remember, unless it is almost time for your next dose – in that case, skip the missed dose and continue your regular schedule. Do not double the dose, and contact your doctor if you miss doses frequently.
Can I buy Tegretol CR 400mg Tablet from DoctorOnCall?
Yes, Tegretol CR 400mg Tablet is available through DoctorOnCall, a licensed online pharmacy serving our Malaysian and Singaporean customers. As this is a prescription medicine, you will need to complete an online consultation so a doctor can assess your suitability and issue a valid prescription before the order is processed. This ensures the medicine is appropriate for your condition and used under proper medical supervision, whether you are ordering from Malaysia or Singapore.
Is the medication provided by DoctorOnCall genuine and safe to use?
DoctorOnCall sources its medicines through appropriate licensed pharmacy supply channels for our Malaysian and Singaporean customers. All orders are dispensed and checked by a registered pharmacist before delivery. Always use Tegretol CR 400mg Tablet according to your doctor’s instructions and the information provided with the product.
What payment methods does DoctorOnCall accept?
We accept payment via Online Banking, Credit Card, and e-Wallets (Boost, GrabPay) for our Malaysian and Singaporean customers, so you can choose whichever method is most convenient for you at checkout.
Does DoctorOnCall provide an installment payment plan for Tegretol CR 400mg Tablet?
DoctorOnCall provides an installment payment plan for eligible Malaysian and Singaporean customers, where applicable. Available plans, eligibility, and terms can vary by market, so please contact DoctorOnCall Customer Service for the latest information on installment options for your order.
Is delivery free, and how much does shipping for Tegretol CR 400mg Tablet cost?
Delivery charges may vary for our Malaysian and Singaporean customers depending on your delivery location and the applicable order terms at the time of purchase. For the most accurate and up-to-date delivery fee information, please contact DoctorOnCall Customer Service before placing your order.
How long does delivery take for Tegretol CR 400mg Tablet?
Our Malaysian customers can generally expect delivery within 3-5 working days, while our Singaporean customers generally receive their orders within 5-7 working days. These are expected timeframes rather than guarantees, and actual delivery time may vary depending on your delivery location, order processing time, courier operations, and whether the order falls on a weekend or public holiday.
What is DoctorOnCall’s shipping, return, or cancellation policy for Tegretol CR 400mg Tablet?
Shipping, return, and cancellation terms may vary for our Malaysian and Singaporean customers depending on the product and your order details. Please refer to DoctorOnCall’s Shipping & Delivery Policy and Return, Refund & Exchange Policy, or contact Customer Service, for the specific terms that apply to your order.
Ingredients / Active Ingredients
- Carbamazepine 400mg (controlled-release)
Safety Advice
Pregnancy
This medicine should be used cautiously during pregnancy. Monitoring may be required.
Breastfeeding
Use with caution. Monitor infant for potential adverse reactions.
Kidney
Use cautiously. Dose adjustment or monitoring may be required.
Liver
Use cautiously. Liver function monitoring may be required.
Alcohol
Caution is advised when consuming alcohol with this medicine.
Driving
Use caution while driving until you know how this medicine affects you.
Medical Review
