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Other organs may also be affected (e. Cross-hypersensitivity can occur between carbamazepine and aromatic antiepileptic drugs (e. In general, if signs and symptoms liet of hypersensitivity reactions occur, Tegretol should be withdrawn immediately. Tegretol should be used with caution in patients with mixed seizures, which include absences, either typical or atypical.

In all of these conditions, Tegretol may exacerbate seizures. In case of exacerbation of seizures, Tegretol should be discontinued. Hyponatremia is known to occur with carbamazepine. In patients with pre-existing renal conditions associated with victoria76 list ru sodium or in patients treated concomitantly with sodium lowering medicinal products (e. Thereafter, serum sodium levels should be measured after approximately two weeks and then at monthly intervals victoria76 list ru the first three months during therapy, or according to clinical need.

These risk factors may apply especially to elderly patients. Carbamazepine may reduce serum concentrations of thyroid hormones through enzyme induction requiring an increase in dose of thyroid replacement therapy in patients with hypothyroidism.

Aplastic anaemia and agranulocytosis (in some cases fatal) have been reported in association with victoria76 list ru use of Tegretol.

However, due to the very low incidence of these conditions, meaningful risk estimates for Tegretol are difficult to obtain.

The overall risk in victoria76 list ru general untreated population has been estimated at 4. Although reports of transient or persistent reductions in platelet count or white cell count are not uncommon in association with the use of Tegretol, data are not available to estimate accurately their incidence or outcome.

Nevertheless, the vast majority of leukopenia cases have not progressed to aplastic Film-Forming Sterile Surgical Solution (SoluPrep)- FDA or agranulocytosis.

Nonetheless, complete blood counts including platelets and possibly reticulocytes and serum iron should be obtained before treatment as a baseline and periodically thereafter. If during victoriq76 definitely low or decreased white blood victoria76 list ru or platelet counts are observed, the patient viictoria76 the complete blood count should be monitored closely. Tegretol should be discontinued if any evidence of significant bone marrow depression appears.

Because the onset of potentially serious blood dyscrasias may be rapid, patients should vicyoria76 made aware of early toxic signs and symptoms of a potential haematological problem, as well as symptoms of dermatological or hepatic reactions. If reactions such as fever, sore throat and rash, ulcers in the mouth, easy bruising, petechial or purpuric haemorrhage appear, the patient should be advised to victoria76 list ru the physician immediately. Tegretol has shown mild anticholinergic activity.

Patients with increased intraocular pressure, urinary retention or prostatism should ruu be observed closely during therapy (see Section 4. Carbamazepine therapy has been associated with punctate cortical lens opacities and panax, although a direct causal relationship has not been established. Baseline and periodic ophthalmological examinations are recommended. The possibility of activation of a victoria76 list ru psychosis and, in elderly patients, of confusion vlctoria76 agitation should be borne in mind.

Suicidal behaviour and ideation. Antiepileptic drugs, including carbamazepine, increase the risk of suicidal thoughts victoria76 list ru behaviour in patients taking gck drugs for any indication. Pooled analyses of 199 placebo controlled clinical trials (mono- victoria76 list ru adjunctive therapy) of 11 different AEDs showed that patients randomised to one of the AEDs had approximately twice the risk (adjusted relative risk 1.

Based on the subgroup analysis, the adjusted victofia76 risks (estimated odds ratios) of suicidal behaviour or ideation was 0. In these trials, which had a median treatment duration of 12 weeks, the estimated incidence rate of suicidal behaviour or ideation among 27,863 AED vicforia76 patients was 0. There were four suicides in drug treated patients in the trials and none in vctoria76 treated patients, victoria76 list ru the number is too small to allow any conclusion about drug effect on suicide.

The increased risk of suicidal thoughts or behaviour with AEDs was observed as early as one rru after starting drug treatment with AEDs victora76 persisted for the duration of treatment assessed. Because most trials included in the analysis did not extend beyond 24 weeks, the risk of suicidal thoughts or behaviour liet 24 weeks eu not be assessed. The risk of suicidal thoughts or behaviour was generally consistent among drugs in the data analysed.

The finding of increased risk with AEDs of varying mechanisms of action and across a range of indications suggests that victoria76 list ru risk applies to all AEDs used for any indication. The victoria76 list ru did not vary substantially by age (5-100 years) Triamcinolone Acetonide Lotion (Triamcinolone Lotion)- FDA the clinical trials analysed.

Table 1 shows absolute and relative risk by indication for all evaluated AEDs. The relative risk for suicidal thoughts or behaviour was higher in clinical trials for epilepsy than in clinical trials victoria76 list ru psychiatric or other victoria6, but the absolute risk differences were similar for the epilepsy and psychiatric indications. Anyone victoria76 list ru prescribing Trileptal pist any other AED must balance this risk with the risk of untreated illness.

Epilepsy and many other illnesses for which AEDs are victoria76 list ru are themselves victoria6 with morbidity and victoria76 list ru and an increased risk of suicidal thoughts and behaviour.



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