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Control of pain can be maintained in most patients with 400 to 800 mg dailyHoweversome patients may be maintained on as little as 200 mg dailywhile others may require as much as 1200 mg dailyAt least once every 3 months throughout the treatment periodattempts should be made to reduce the dose to the minimum effective level or even to discontinue the drug.<\/p>\n
There have been reports of associated paralysis and other symptoms of cerebral arterial insufficiencybut the exact relationship of these reactions to the drug has not been established.<\/p>\n
Treatment of Blood Count AbnormalitiesIf evidence of significant bone marrow depression developsthe following recommendations are suggested1stop the drug2perform daily CBCplateletand reticulocyte counts3do a bone marrow aspiration and trephine biopsy immediately and repeat with sufficient frequency to monitor recovery.<\/p>\n
Human microsomal epoxide hydrolase has been identified as the enzyme responsible for the formation of the 10,11-transdiol derivative from carbamazepine-10,11 epoxideCoadministration of inhibitors of human microsomal epoxide hydrolase may result in increased carbamazepine-10,11 epoxide plasma concentrationsAccordinglythe dosage of Tegretol should be adjusted and\/or the plasma levels monitored when used concomitantly with loxapinequetiapineor valproic acid.<\/p>\n
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