LYCOS RETRIEVER 
Carbamazepine: Drugs
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Carbamazepine has been reported to cause aplastic anemia. This is a form of anemia that is generally does not respond to treatment. The bone marrow of persons with aplastic anemia does not produce adequate amounts of red blood cells, white blood cells, and platelets. Blood counts should be monitored for individuals using this drug. Some people with previously diagnosed depression of the bone marrow should not take carbamazepine.
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Carbamazepine is 76% bound to plasma proteins. It is rapidly and uniformly distributed throughout the body. Carbamazepine epoxide, the principal active metabolite, is 50% bound to plasma proteins (Rane et al., 1976). It is probably subject to enterohepatic circulation (Laffey & Guzzardi, 1983). Carbamazepine crosses the blood-brain barrier and the placenta, accumulates in fetal tissues, and is distributed into breast milk at concentrations about 60% those of maternal plasma. The drug has been detected in cerebrospinal fluid in concentrations approximately 15% those of serum.
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Carbamazepine is a mood stabilizing and anticonvulsant drug. Anticonvulsant drugs can be prescribed during prostate cancer chemotherapy to combat the effects of neuropathic pain. Chemotherapy can cause neuropathic pain which is not easily treated with even the strongest pain killers. Carbamazepine has shown effectiveness in decreasing neuropathic pain in prostate cancer patients who are undergoing chemotherapy. No one knows... exactly how carbamazepine decreases neuropathic pain.
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Carbamazepine is an inducer of several potential pathways of drug elimination, including CYPs 1A2, 2C9, and 3A4, as well as the active transporter P-glycoprotein. Any drug that undergoes metabolism via CYP1A2, CYP2C9, or CYP3A4 or is a substrate for the P-glycoprotein transporter, is likely to be affected by carbamazepine administration.... The list of drugs that may potentially interact with carbamazepine is very large.1
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Carbamazepine is a complex drug that has both anticonvulsant properties in therapeutic doses and a proconvulsant property in overdose situations with supratherapeutic serum levels. Carbamazepine is chemically and stereospatially related to the tricyclic antidepressant (TCA) imipramine; it is spatially similar to phenytoin. The therapeutic anticonvulsant mechanism of carbamazepine is similar to phenytoin and is believed to be primarily related to the blockade of presynaptic voltage-gated sodium channels.
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Carbamazepine represents a drug with very complex drug interaction potential. Its narrow therapeutic range and potency as an inducer make it imperative to carefully monitor patients receiving carbamazepine with other drugs. It is likely to affect the elimination of a wide range of drugs and to be affected by many common therapeutic agents. Carefully review the drug profile of any patient receiving carbamazepine for potential drug interactions.
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