Zeptol
Generic Name
Carbamazepine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zeptol 200 mg tablet | ৳ 5.52 | ৳ 55.20 |
Description
Overview of the medicine
Zeptol 200 mg Tablet contains Carbamazepine, an anticonvulsant medicine used to treat various types of seizures (epilepsy), trigeminal neuralgia (a type of facial nerve pain), and bipolar disorder. It helps to stabilize electrical activity in the brain.
Uses & Indications
Dosage
Adults
Initial dose 100-200 mg once or twice daily, gradually increasing to 400-1200 mg/day in divided doses. Max 1600 mg/day.
Elderly
Lower initial doses are recommended, typically 100 mg twice daily, with gradual titration.
Renal_impairment
No specific dose adjustments for mild to moderate renal impairment; caution with severe impairment. Close monitoring is advised.
How to Take
Take Zeptol 200 mg Tablet orally, usually with food, to minimize gastrointestinal upset. Do not crush or chew the tablet unless it is a chewable formulation.
Mechanism of Action
Carbamazepine acts by stabilizing hyperexcited nerve membranes and blocking repetitive firing of action potentials. It appears to do this by inhibiting voltage-gated sodium channels, thereby reducing the influx of sodium ions and stabilizing neuronal membranes.
Pharmacokinetics
Onset
Anticonvulsant effect typically begins within several hours to a few days.
Excretion
Approximately 72% excreted in urine (mainly as metabolites) and 28% in faeces.
Half life
Initial single-dose half-life is 25-65 hours; with chronic administration, it decreases to 12-17 hours due to autoinduction of metabolism.
Absorption
Slow and variable absorption from the gastrointestinal tract, but usually complete. Peak plasma concentrations are reached 4-12 hours after oral administration.
Metabolism
Extensively metabolized in the liver, primarily by CYP3A4, to an active metabolite, carbamazepine-10,11-epoxide.
Side Effects
Contraindications
- Hypersensitivity to carbamazepine or tricyclic antidepressants
- History of bone marrow depression
- Concomitant use with MAO inhibitors (within 14 days)
Drug Interactions
Warfarin
May decrease warfarin's anticoagulant effect.
MAO Inhibitors
Contraindicated due to risk of hypertensive crisis.
Oral Contraceptives
May decrease efficacy of oral contraceptives.
Other Anticonvulsants
Potential for altered levels of both carbamazepine and co-administered anticonvulsants.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, drowsiness, nausea, vomiting, nystagmus, ataxia, tremor, convulsions, respiratory depression, coma. Treatment is symptomatic and supportive, including gastric lavage and activated charcoal.
Pregnancy & Lactation
Pregnancy Category D: Carbamazepine can cause fetal harm. Discuss risks and benefits with your doctor. It is excreted in breast milk; caution is advised during breastfeeding.
Side Effects
Contraindications
- Hypersensitivity to carbamazepine or tricyclic antidepressants
- History of bone marrow depression
- Concomitant use with MAO inhibitors (within 14 days)
Drug Interactions
Warfarin
May decrease warfarin's anticoagulant effect.
MAO Inhibitors
Contraindicated due to risk of hypertensive crisis.
Oral Contraceptives
May decrease efficacy of oral contraceptives.
Other Anticonvulsants
Potential for altered levels of both carbamazepine and co-administered anticonvulsants.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, drowsiness, nausea, vomiting, nystagmus, ataxia, tremor, convulsions, respiratory depression, coma. Treatment is symptomatic and supportive, including gastric lavage and activated charcoal.
Pregnancy & Lactation
Pregnancy Category D: Carbamazepine can cause fetal harm. Discuss risks and benefits with your doctor. It is excreted in breast milk; caution is advised during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Carbamazepine has been extensively studied in numerous clinical trials for its efficacy in epilepsy, trigeminal neuralgia, and bipolar disorder, establishing its role as a first-line or adjunct treatment.
Lab Monitoring
- Complete Blood Count (CBC) before and periodically during treatment
- Liver function tests (LFTs) before and periodically during treatment
- Serum carbamazepine levels (therapeutic drug monitoring)
- Electrolyte levels (especially sodium) due to risk of hyponatremia
Doctor Notes
- Emphasize the importance of patient adherence and not discontinuing abruptly.
- Monitor for signs of bone marrow suppression, dermatologic reactions, and hyponatremia.
- Advise patients about potential drug interactions, especially with hormonal contraceptives and grapefruit juice.
- Consider genetic testing (HLA-B*1502) in at-risk populations.
Patient Guidelines
- Do not stop taking this medicine suddenly without consulting your doctor, as it can worsen seizures.
- Report any skin rash, fever, sore throat, or unusual bruising/bleeding to your doctor immediately.
- Regular blood tests are necessary during treatment to monitor for serious side effects.
- Avoid grapefruit juice while on this medication.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
This medicine may cause dizziness, drowsiness, or blurred vision. Avoid driving or operating heavy machinery until you know how it affects you.
Lifestyle Advice
- Avoid alcohol consumption, as it can increase central nervous system depression.
- Maintain good hydration.
- Regular follow-ups with your doctor are crucial.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.