Tegrital 100 mg pureskeltava (Karbamazepiini) — kolmoishermosärky ja kouristukset
✅ Controls seizures
✅ Hoitaa kaksisuuntaista mielialahäiriötä
✅ Relieves nerve pain
✅ Manages trigeminal neuralgia
✅ Stabilizes mood
Tegrital contains Carbamazepine.
✓ Lääketieteellinen tarkistus Morgan Ellis — Farmasian tutkija · 8 vuoden kokemus · Viimeisin arvio: toukokuu 2026
Pikavastaus
Tegrital 100 mg chewable tablets sisältää karbamasepiini, a sodium-channel-blocking anticonvulsant that has been first-line for trigeminal neuralgia since 1962 and remains a workhorse anti-epileptic for partial-onset seizures and bipolar mood stabilisation. The chewable formulation is well-suited to children, patients with swallowing difficulty, and adults who prefer not to swallow whole tablets. Treatment starts low (100 mg once or twice daily) and titrates up slowly because carbamazepine induces its own metabolism over 2–4 weeks. Asian-ancestry patients should be tested for HLA-B*1502 before starting — this allele identifies a high risk of Stevens-Johnson syndrome.
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What Is Tegrital?
Tegrital is an Indian-manufactured generic of karbamasepiini, available as a 100 mg chewable tablet. Carbamazepine is a tricyclic compound structurally related to imipramine but pharmacologically classified as an anti-epileptic. The chewable formulation can be chewed, broken, or swallowed whole with water — convenient for children and patients with dysphagia.
How Carbamazepine Works
Carbamazepine binds voltage-gated sodium channels in their inactivated state, preventing the channel from returning to its resting state and so blocking repetitive high-frequency neuronal firing while sparing normal physiological signalling. This mechanism explains its efficacy in:
- Focal (partial) seizures — sustained suppression of epileptogenic firing
- Trigeminaalinen neuralgia — blocks paroxysmal nerve discharges in the trigeminal ganglion
- Mood stabilisation — reduces neuronal excitability and limbic hyperactivity
Indikaatiot
- Trigeminaalinen neuralgia — first-line per NICE, EFNS, and AAN guidelines
- Partial-onset seizures with or without secondary generalisation
- Generalised tonic-clonic seizures — second-line
- Bipolar disorder — mood stabiliser, particularly mixed and rapid-cycling presentations
- Glossopharyngeal neuralgia — analogous use to trigeminal neuralgia
- Diabetic neuropathy — second-line option when gabapentinoids fail or are contraindicated
- Alcohol withdrawal — selected cases under specialist supervision
Annos ja käyttöohje
| Käyttöaihe | Aloitusannos | Titraus | Ylläpito |
|---|---|---|---|
| Trigeminaalinen neuralgia | 100 mg once or twice daily | +100–200 mg every 2 days | 200–400 mg three times daily |
| Partial seizures (adult) | 100–200 mg once or twice daily | +100–200 mg weekly | 800–1200 mg/day in 2–4 doses |
| Bipolar disorder | 200 mg kahdesti päivässä | +200 mg every 3–4 days | 400–1600 mg/day |
| Children (epilepsy) | 10–20 mg/kg/day | Erikoislääkärin ohjaus | 15–30 mg/kg/day in divided doses |
| Iäkkäät | 100 mg kahdesti päivässä | Cautious titration | Lower of typical adult range |
Yleisimmät haittavaikutukset
- Drowsiness, ataxia (especially during titration)
- Dizziness, blurred or double vision
- Pahoinvointi, oksentelu
- Päänsärky
- Mild rash (≈5–10% of patients)
- Dry mouth, mild fluid retention
- Hyponatraemia (mild, especially in elderly)
Serious Side Effects — Stop and Seek Care
- Severe rash, blistering, mouth ulcers — possible Stevens-Johnson syndrome / TEN
- Aplastic anaemia, agranulocytosis — full blood count monitoring during the first months
- Hyponatraemia <125 mmol/L — confusion, seizures
- Hepatiitti — jaundice, dark urine, abdominal pain
- DRESS syndrome — fever, lymphadenopathy, eosinophilia, multi-organ involvement
- Heart block (rare)
- Suicidal ideation (anti-epileptic class warning)
Käyttökiellot
- Known hypersensitivity to carbamazepine, oxcarbazepine, or tricyclic antidepressants
- Atrioventricular block (especially second- or third-degree)
- History of bone-marrow depression or acute intermittent porphyria
- Use of MAO inhibitors within the previous 14 days
- HLA-B*1502 positive (relative — alternative agent preferred)
Lääkeaineenvaihdunta
Carbamazepine is a powerful inducer of CYP3A4 and many other CYP enzymes. It accelerates the metabolism (and so reduces the plasma level and clinical effect) of:
- Combined oral contraceptives — alternative contraception is essential
- Warfarin and direct oral anticoagulants
- Many other anti-epileptics (lamotrigine, valproate, phenytoin)
- Antiretrovirals, immunosuppressants, calcium-channel blockers
- Statins (especially simvastatin), corticosteroids
And its own level is raised dangerously by:
- Makrolidi-antibiootit (erytromysiini, klaritromysiini)
- Diltiazem, verapamil, isoniazid, fluconazole, ketoconazole
- Greippimehu
Säilytys
Store below 25 °C in a dry place. Protect from moisture (carbamazepine tablets can degrade in damp conditions). Keep in original blister packaging. Keep out of reach of children.
Usein Kysytyt Kysymykset
Is Tegrital the same as Tegretol?
Yes — both are brand names for carbamazepine. Tegrital is the Indian generic version; Tegretol is the original Novartis brand. Mechanism, dosing, and effect are identical at the same dose.
How fast does carbamazepine work for trigeminal neuralgia?
Most patients experience meaningful pain relief within 24–72 hours of reaching an effective dose. The challenge is reaching that dose — slow titration is required to limit dizziness and ataxia. About 70% of trigeminal neuralgia patients respond at carbamazepine doses of 200–800 mg/day.
Why does the dose need to go up over time?
Carbamazepine induces its own hepatic metabolism — autoinduction. Over the first 2–4 weeks the liver produces more CYP3A4 enzyme, accelerating drug clearance. Daily requirements typically rise 30–60% before plateauing.
What is HLA-B*1502 testing and do I need it?
HLA-B*1502 is a genetic marker strongly associated with Stevens-Johnson syndrome on carbamazepine. The FDA recommends pre-treatment testing for patients of Han Chinese, Thai, Malay, South Indian, Filipino, Indonesian, and Vietnamese ancestry. If positive, an alternative anticonvulsant should be used.
Can carbamazepine be used in pregnancy?
Carbamazepine is associated with neural tube defects (1% risk vs. 0.06% baseline) and other malformations. It is generally avoided in pregnancy when alternatives exist. If continued, high-dose folic acid (5 mg daily) is recommended before conception and through the first trimester.
Does Tegrital interact with the contraceptive pill?
Yes — strongly. Carbamazepine reduces oestrogen and progestogen levels via CYP3A4 induction, leading to contraceptive failure. Use a copper IUD, levonorgestrel IUD, or progestogen-only injection during treatment.
How long until I can come off carbamazepine?
For trigeminal neuralgia, many patients trial dose reduction every 6–12 months once pain is controlled. For epilepsy, withdrawal is considered only after 2–3 years seizure-free. Always taper — abrupt stop can precipitate seizures even in patients without epilepsy.
Mitä verikokeita tarvitaan?
Baseline full blood count, liver function, urea and electrolytes, and pregnancy test where relevant. Repeat FBC and LFTs at 4 weeks, 3 months, then every 6–12 months. Carbamazepine plasma level 5–7 days after each dose change.
Can I drink alcohol on Tegrital?
Avoid or strictly limit alcohol. Both carbamazepine and alcohol depress the central nervous system; combining them increases sedation, falls risk, and raises seizure threshold variability.
Why is Tegrital chewable?
The chewable format makes the tablet easy to take for children, elderly patients, and anyone with swallowing difficulty. The bioavailability is comparable to standard tablets.
Is Tegrital effective for fibromyalgia?
Carbamazepine is not first-line for fibromyalgia — pregabalin, duloxetine, and amitriptyline are. Carbamazepine has a defined role in trigeminal neuralgia and partial seizures; for general nerve pain it is a later-line option.
For trigeminal neuralgia patients who do not respond to or tolerate carbamazepine, Gabasign (gabapentin 100/300/400/600/800 mg) is the standard second-line option per AAN/EFNS guidelines and covers the broader range of neuropathic-pain indications.
Katso myös: the gabapentin brand we stock — Ciplan gabapentiinin geneerinen versio — sama FDA-hyväksytty molekyyli, täysi annosvaihtelu 300 mg:n aloitusannoksesta 600 mg:n ylläpitoon.
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| Vahvuus | 100 mg |
|---|---|
| Määrä | 30 tablettia, 60 tablettia, 90 tablettia, 180 tablettia |
Tegrital 100 mg purettava (Karbamatsepiini) — Kolmoishermosärky ja kouristukset
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Tegrital 100 mg purettava (Karbamatsepiini) — Kolmoishermosärky ja kouristukset
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