Zeptol Cr 200Mg Strip Of 10 Tablets

• Zeptol CR 200 Tablet is used to control epileptic seizures, including seizures that begin in one part of the brain and generalised tonic-clonic seizures.
• Zeptol CR 200 Tablet is also used to relieve the severe facial pain of trigeminal neuralgia, to help prevent recurrent mood swings in bipolar disorder, and in the management of alcohol withdrawal.

• If you are allergic to carbamazepine or any other ingredient of Zeptol CR 200 tablet.
• If you are allergic to tricyclic antidepressants such as clomipramine, imipramine, amitriptyline, nortriptyline, doxepin. Ask your doctor what these medicines are if you are not sure.
• If you have a type of heart block known as an atrioventricular block (AV block).
• If you have had a history of bone marrow depression (decreased number of those cells in the bone marrow that can develop into all types of blood cells).
• If you have a history of hepatic porphyrias (acute intermittent porphyria, variegate porphyria, porphyria, cutanea tarda).
• If you are on monoamine oxidase inhibitors medicine (MAO's like selegiline, rasagiline, phenelzine, tranylcypromine). If you are not sure, carry the prescription or packet along with you.

• Nausea
• Vomiting
• Red itchy skin bumps
• Dizziness
• Swelling

Other General Warnings

• You have a history of bone marrow depression.
• You have or have a history of any kind of liver or kidney disease.
• You have any kind of heart disease.
• You have thyroid disorders and take medicines for them.
• You have taken medicines called monoamine oxidase inhibitors (MAOIs) within the last 14 days.
• You develop symptoms like skin rashes, itchy bumps, mouth sores, blistering or peeling of the skin, yellowing of the skin and eyes, severe weakness, severe muscle pain, unusual bruising or bleeding, frequent infections that do not go away, fever, trouble swallowing or breathing, tiny pinpoint red to purple spots on your skin. These may indicate serious problems in your liver or blood cells.
• You develop signs and symptoms of an allergic reaction to the medicine (fever, rashes, weakness, red itchy skin bumps, nausea, vomiting, dizziness, sleepiness, impaired coordination, swelling, decrease in white blood cells count).
• You are pregnant or planning on becoming pregnant soon.
• You are a woman and do not use an effective method of contraception or use oral hormonal contraceptives.
• You experience an increase in the frequency of seizures after taking Zeptol CR 200 tablet.

• Take this medicine as a whole with sufficient water.
• Always take this medicine exactly as prescribed by your doctor.

• Store in a cool and dry place below 30°C away from direct sunlight.
• Keep it out of reach of children and pets.

• Zeptol CR 200 Tablet calms overactive nerve firing, which is why it works for seizures and for the stabbing pain of trigeminal neuralgia.
• Swallow the controlled release tablet whole with food; crushing it releases the dose too quickly.
• Stay on the same brand of carbamazepine and ask your pharmacist not to substitute it.
• Stop the medicine and seek immediate help for any rash, especially with fever, mouth ulcers or blistering.
• Never stop this medicine suddenly, as prolonged and dangerous seizures can follow.
• Hormonal contraception becomes unreliable on this medicine; arrange an alternative with your doctor.
• Avoid grapefruit juice completely, and avoid alcohol.
• Report confusion, persistent headache, drowsiness or muscle cramps, which may indicate low blood sodium.
• Report fever, sore throat, mouth ulcers, unusual bruising or bleeding without delay.
• Attend your blood tests for blood counts, liver function and sodium.
• Tell every doctor, dentist and pharmacist that you take carbamazepine before starting any new medicine.
• Plan any pregnancy with your doctor well in advance rather than stopping the medicine yourself.

Overdose

Missed a Dose

• Zeptol CR 200 Tablet contains carbamazepine, which acts on the voltage-gated sodium channels that nerve cells use to generate electrical impulses. After a nerve fires, these channels normally reset quickly and become ready to fire again.
• Carbamazepine binds preferentially to channels that are firing rapidly and holds them in their inactive state for longer. Nerve cells that are behaving normally are largely unaffected, but those firing in rapid, repetitive bursts are selectively quietened.
• In epilepsy this prevents the runaway synchronised discharge that produces a seizure and stops it spreading. In trigeminal neuralgia it silences the abnormal spontaneous firing of a damaged facial nerve, which is what produces the sudden stabbing pain. In bipolar disorder the same stabilising effect on nerve excitability helps limit swings in mood.

Interactions with other medicines

• Carbamazepine strongly speeds up several liver enzymes, so it lowers the level and effectiveness of a wide range of other medicines. Other medicines can in turn raise carbamazepine to toxic levels.
• This is one of the most interaction-prone medicines in common use. Tell every doctor, dentist and pharmacist that you take it, and check before starting anything new, including herbal products.
• Life-threatening: Monoamine oxidase inhibitors must not be taken with carbamazepine, and at least fourteen days should separate the two, as the combination can cause a severe and potentially fatal reaction with high fever, agitation and unstable blood pressure.
• Severe: Warfarin, acenocoumarol and the newer oral anticoagulants are broken down much faster when carbamazepine is added, so blood becomes less effectively thinned and the risk of a dangerous clot or stroke rises. Anticoagulation needs close monitoring and dose adjustment.
• Severe: Hormonal contraceptives, including the pill, patch, ring and implant, are made significantly less effective, and unintended pregnancy is a well-documented consequence. Alternative or additional contraception should be arranged before starting.
• Severe: Clarithromycin, erythromycin, fluconazole, ketoconazole, itraconazole, verapamil, diltiazem and some HIV medicines block the breakdown of carbamazepine, causing levels to rise sharply with severe dizziness, vomiting, unsteadiness, drowsiness and heart rhythm disturbance.
• Severe: Sodium valproate raises the level of an active breakdown product of carbamazepine, which can cause toxicity even when the carbamazepine level itself looks normal.
• Severe: Immunosuppressants such as tacrolimus and ciclosporin, and many cancer medicines, are cleared far more quickly with carbamazepine, risking transplant rejection or treatment failure.
• Moderate: Lithium combined with carbamazepine can cause confusion, tremor and unsteadiness even when lithium levels appear acceptable.
• Moderate: Diuretics and some antidepressants add to the risk of low blood sodium.
• Moderate: Paracetamol is cleared faster and may work less well, while the risk of liver injury from large doses increases.

Interactions with food items

• Take Zeptol CR 200 Tablet with or just after food, which reduces nausea and stomach discomfort and helps keep absorption consistent.
• Avoid grapefruit and grapefruit juice entirely. Grapefruit blocks the enzyme that breaks carbamazepine down, and levels can rise enough to cause dizziness, double vision, vomiting and marked unsteadiness. Other citrus fruits are safe.
• Avoid alcohol, which adds to drowsiness and unsteadiness, burdens the liver and can provoke seizures.
• Maintain a steady fluid intake but avoid drinking excessive amounts of water, since carbamazepine already promotes water retention and very high intake can worsen low blood sodium.
• Keep meals and sleep regular. Skipped meals and sleep deprivation lower the seizure threshold regardless of medication.