WARNING: SERIOUS DERMATOLOGIC ADVERSE REACTIONS and APLASTIC ANEMIA AND AGRANULOCYTOSIS
Serious Dermatologic Reactions and HLA-B*1502 Allelle
Serious and sometimes fatal dermatologic reactions, including toxic epidermal necrolysis (TEN) and Stevens-Johnson Syndrome (SJS), have occurred in patients treated with carbamazepine. These syndromes may be accompanied by mucous membrane ulcers, fever, or painful rash occur. These reactions are estimated to occur in 1 to 6 per 10,000 new users in countries with mainly Caucasian populations, but the risk in patients of Asian descent is estimated to be about 10 times higher. There is a strong association between the risk of developing SJS/TEN and the presence of HLA-B*1502, an inherited allelic variant of the HLA-B gene that is found almost exclusively in patients with Asian ancestry. Test for HLA-B*1502, prior to initiating EQUETRO in patients with an increased likelihood of carrying this allele. Avoid use of EQUETRO in patients testing positive for the allele unless the benefit clearly outweighs the risk. Discontinue EQUETRO if you suspect that the patient has a serious dermatologic reaction [see Warnings and Precautions ].
Aplastic Anemia and Agranulocytosis
Aplastic anemia and agranulocytosis can occur during treatment with EQUETRO. The risk of developing these reactions with EQUETRO is 5-8 times greater than in the general population. However, the overall risk in the general population is low (6 cases in a population of one million per year for agranulocytosis and two cases in a population of one million per year for aplastic anemia). Obtain a complete blood count before beginning treatment with EQUETRO, and monitor CBC periodically. Consider discontinuing if EQUETRO if significant bone marrow depression develops [see Warnings and Precautions].
EQUETRO (carbamazepine) is a mood stabilizer available for oral administration as 100 mg, 200 mg, and 300 mg extended-release capsules of carbamazepine, USP. Carbamazepine is a white to off-white powder, practically insoluble in water and soluble in alcohol and in acetone.
Acute Manic or Mixed Episodes associated with Bipolar I Disorder
EQUETRO is indicated for treatment of patients with acute manic or mixed episodes associated with bipolar I disorder.
The efficacy of EQUETRO in acute mania was established in 2 randomized, double-blind, placebo-controlled, 3-week studies in adult patients meeting DSM-IV criteria for bipolar I disorder who had an acute manic or mixed episode [see Clinical Studies]. The effectiveness of EQUETRO for longer-term use and for prophylactic use in mania has not been systematically evaluated in controlled clinical trials. Therefore, physicians who elect to use EQUETRO for extended periods should periodically re-evaluate the long-term risks and benefits of the drug for the individual patient.
Media Articles Related to Equetro (Carbamazepine)
Epilepsy: Vimpat EU positive monotherapy Phase 3 results
Source: Epilepsy News From Medical News Today [2015.10.08]
UCB has announced positive results of a Phase 3 non-inferiority study designed to compare efficacy and safety of lacosamide to carbamazepine-CR (controlled release; retard tablets) as monotherapy...
Published Studies Related to Equetro (Carbamazepine)
Evaluation of the efficacy and safety of pregabalin, venlafaxine, and
carbamazepine in patients with painful diabetic peripheral neuropathy. A
randomized, double-blind trial. 
venlafaxine in patients with painful diabetic neuropathy (PDN)... CONCLUSION: This study showed the efficacy of venlafaxine, pregabalin, and
Population pharmacokinetics of carbamazepine in elderly patients. 
these parameters... CONCLUSIONS: Carbamazepine clearance was not associated with body weight or any
The effect of levetiracetam monotherapy on subjective sleep quality and objective sleep parameters in patients with epilepsy: compared with the effect of carbamazepine-CR monotherapy. [2011.05]
PURPOSE: There is relatively little known about the effects of new antiepileptic drugs (AEDs) on sleep. This study was done to evaluate the effect of levetiracetam (LEV) on subjective sleep quality and sleep architecture in patients with epilepsy, and the results were compared with the effects of carbamazepine-CR (CBZ-CR)... CONCLUSION: LEV may increase sleep efficiency without major effects on sleep structure with an overall effect on sleep parameters comparable to CBZ-CR. Copyright (c) 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
Pregabalin effect on steady-state pharmacokinetics of carbamazepine, lamotrigine, phenobarbital, phenytoin, topiramate, valproate, and tiagabine. [2011.02]
By reducing neuronal excitability through selective binding to the alpha(2)delta subunit of voltage-dependent calcium channels, pregabalin effectively treats epilepsy, chronic pain, and anxiety disorders. To evaluate if pregabalin coadministration affects pharmacokinetics of other antiepileptic drugs, population pharmacokinetic analyses using NONMEM software were performed on data from three epilepsy trials involving seven antiepileptic drugs with pregabalin as add-on therapy...
Carbamazepine coadministration with an oral contraceptive: effects on steroid pharmacokinetics, ovulation, and bleeding. [2011.02]
PURPOSE: Antiepileptic drugs (AEDs) are widely used in reproductive-age women...
Clinical Trials Related to Equetro (Carbamazepine)
Carbamazepine in Severe Liver Disease Due to Alpha-1 Antitrypsin Deficiency [Recruiting]
The primary objective is to determine if the medication Carbamazepine, can be used as a
therapy for patients with severe liver disease due to Alpha-1-Antitrypsin Deficiency .
Carbamazepine Extended-Release for the Treatment of Bipolar Depression [Completed]
To study the efficacy and safety of beaded extended-release Carbamazepine (Equetro) in the
treatment of patients with Bipolar Disorder with a Major Depressive Episode.
A Study to Investigate the Potential Pharmacokinetic Interactions Between Phenytoin or Carbamazepine and Telaprevir [Completed]
The purpose of this study is to investigate the potential pharmacokinetic (what the body
does to the drug) interactions between multiple doses of phenytoin 200 mg every 12 hours or
carbamazepine 200 mg every 12 hours and telaprevir 750 mg every 8 hours at steady-state
(constant concentration of medication in the blood) in healthy participants.
Fed Bioequivalence Study of CBZ Formulations [Completed]
Controlled release Carbamazepine (CBZ) is a antiepileptic, antineuralgic and mood stabilizer
drug. The CR formulation of CBZ is slowly absorbed and the elimination half life varies
with time due to metabolism autoinduction.
The primary objective of this study is to estimate the bioequivalence of the new brand
generic product (Auration(R) CR) 400 mg manufactured in Uruguay vs. the innovative product
(Tegretol(R) CR) 400 mg manufactured in Brasil, under fed conditions. The secondary
objective will be evaluation of safety issues.
The study design will be randomized two sequences, two periods and crossover. For a power
of not less than 80% sample size was estimated to be 20 healthy male subjects. Products will
be administered with food (high calories/high fat breakfast) after an overnight fast.
Time vs. concentration curves will be built for each subject and formulation and Area Under
Curve (AUC0240) will be estimated using the trapezoid rule, the AUC 0-inf. (from time 0 to
infinity) will be estimated using the formula Cz/Ke, Cmax will be taken from the individual
This parameters will be statistically processed with the WinNonlin 6. 3
Pharmacokinetics/Statistic software in order to prove bioequivalence between the study
Equetro for the Treatment of Mania in Children Ages 6-12 With Bipolar Disorder [Completed]
This is an open-label pilot study of up to 1200 mg/day of carbamazepine ER (Equetro) in the
treatment of children who meet DSM-IV criteria for Bipolar I, Bipolar II, or Bipolar
Spectrum Disorder. The main goal of this study is to begin to address the void of
information on safety, tolerability and effectiveness of Equetro in the treatment of
Pediatric Bipolar Disorder.
Page last updated: 2015-10-08