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Abnormalities in liver function testscholestatic and hepatocellular jaundicehepatitisvery rare cases of hepatic failure.
Hepatic effectsranging from slight elevations in liver enzymes to rare cases of hepatic failure have been reportedsee ADVERSE REACTIONS and PRECAUTIONSLaboratory TestsIn some caseshepatic effects may progress despite discontinuation of the drugIn addition rare instances of vanishing bile duct syndrome have been reportedThis syndrome consists of a cholestatic process with a variable clinical course ranging from fulminant to indolentinvolving the destruction and disappearance of the intrahepatic bile ductsSomebut not allcases are associated with features that overlap with other immunoallergenic syndromes such as multiorgan hypersensitivityDRESS syndromeand serious dermatologic reactionsAs an example there has been a report of vanishing bile duct syndrome associated with Stevens-Johnson syndrome and in another case an association with fever and eosinophilia.
Tegretol suspension in combination with liquid chlorpromazine or thioridazine results in precipitate formationandin the case of chlorpromazinethere has been a report of a patient passing an orange rubbery precipitate in the stool following coadministration of the two drugssee PRECAUTIONSDRUG INTERACTIONSBecause the extent to which this occurs with other liquid medications is not knownTegretol suspension should not be administered simultaneously with other liquid medications or diluents.
Concomitant administration of carbamazepine and lithium may increase the risk of neurotoxic side effectsConcomitant use of carbamazepine and isoniazid has been reported to increase isoniazid-induced hepatotoxicityAlterations of thyroid function have been reported in combination therapy with other anticonvulsant medicationsConcomitant use of Tegretol with hormonal contraceptive productse.goraland levonorgestrel subdermal implant contraceptivesmay render the contraceptives less effective because the plasma concentrations of the hormones may be decreasedBreakthrough bleeding and unintended pregnancies have been reportedAlternative or back-up methods of contraception should be consideredResistance to the neuromuscular blocking action of the nondepolarizing neuromuscular blocking agents pancuroniumvecuroniumrocuronium and cisatracurium has occurred in patients chronically administered carbamazepineWhether or not carbamazepine has the same effect on other nondepolarizing agents is unknownPatients should be monitored closely for more rapid recovery from neuromuscular blockade than expectedand infusion rate requirements may be higher.
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be sure to mention any of the following certain medications for seizures such as carbamazepine carbatrol, equetro, tegretol , phenytoin dilantin, phenytek , and phenobarbital; clarithromycin biaxin, in prevpac ; cyclosporine neoral, sandimmune ; efavirenz sustiva ; indinavir crixivan ; itraconazole onmel, sporanox ; ketoconazole nizoral ; lovastatin altoprev, in advicor ; nefazodone;nelfinavir viracept ; nevirapine viramune ; rifabutin mycobutin ; rifampin rifadin, rimactane, in rifamate , ritonavir norvir, in kaletra , simvastatin zocor, in simcor, in vytorin , and tacrolimus astragraf sl, prograf .
