General Information: Tegretol is an antiepileptic drug. Types of seizures treated with Tegretol include: grand mal, focal, psychomotor and mixed (seizures that include complex partial or grand mal seizures). Absence seizures (petit mal) do not respond to Tegretol.

Formulations: Tegretol is available in the following formulations:

• 100 mg/5 ml liquid suspension
• 100 mg chewable tablets
• 200 mg tablets
• 100, 200 and 400 mg extended-release tablets (Tegretol X-R)

Dosage: The usual dosage of Tegretol is 10 to 30 mg/kilogram of body weight per day. The total amount will usually be divided into two to three dosages. If your child is taking Tegretol three times a day, it is ok to take it upon awakening, after school and at bedtime. Tegretol suspension should not be taken along with other liquid medicine or diluted with other liquids.

Therapeutic Drug Levels: The blood level of Tegretol that is found to prevent seizures in most people is between 4-12 mcg/ml. With a blood level over 15 your child may experience "toxic" symptoms.

Side Effects: All drugs have side effects. Some children taking Tegretol may experience stomachache, vomiting, dizziness and/or drowsiness. These symptoms will usually disappear with a decrease of the dose.

Toxic symptoms are symptoms experienced when the blood Tegretol level is too high. Early toxic symptoms can include excessive drowsiness, staggering, slurred speech or vomiting.

Rarely, Tegretol can suppress the bone marrow function. The bone marrow is responsible for formation of blood components such as the white blood cells and platelets. These cells fight infections and help clot the blood. For this reason, children taking Tegretol should have periodic blood counts (CBC).

Common Labs: Scheduled monitoring of blood cell counts and the Tegretol level have increased the safety and efficacy of Tegretol. Children taking Tegretol will usually require a Tegretol level 4 weeks after reaching a therapeutic dose, and then every 4-12 months thereafter. We also check a complete blood count (CBC) before starting Tegretol and every 4-12 months thereafter.

Drug Interactions: Some drugs interact with Tegretol. Erythromycin, Clarithromycin (Biaxin), Cimetidine (Pepcid) and Ketoconazole can increase the blood level of Tegretol. Erythromycin and Biaxin are antibiotics frequently prescribed for children. You should remind your physician that your child is on Tegretol when antibiotics are prescribed. Other medications, such as Phenobarbital, Phenytoin (Dilantin), Felbamate (Felbatol) and Theophylline can decrease the blood levels of Tegretol. Other medications that can be affected by Tegretol include: oral contraceptives, Warfarin, Theophyline, Doxycycline, Felbatol and Lamictal. You should inform your neurologist if your child is taking any of these types of medications. Your local pharmacist can often be helpful in informing you of known drug interactions between the medications your child takes.

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