Side Effect Of Carbamazepine

Dr. Rajesh B IyerDM - Neurology, Fellowship EpilepsyNeurologist

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Hi, the suffix xr, er, sr, od and cr all refer to drug formulations which help to pronlog the duration of action of the drug. These letters stand for extended release, sustained release, once daily and controlled release formulations. This is achieved by slowing down the release of the drug and its absorption from the intestine by various techniques. As far as treating epilepsy is concerned there are some advantages of using this kind of medications where the number of dosages per day can be reduced to almost once a day. This improves the compliance and reduces some of the side effects of the medications. Also the drug concentration in blood tends to remain more or less steady when compared to plain tablets which tend to cause peak and trough levels and fluctuations. Typically, most antiepileptic drugs have a standard or immediate release formulation and some have an once daily dose formulation. Except for carbamazepine controlled release tablets and sodium valporate chrono tablets which need to be used twice a day, most of the other extended release or xr, er, od tablets can be used once a day. These tablets should not be cut or powdered. Levetiracetam standard tablet or plain tablet needs to be taken twice daily. Levetiracetam xr (torleva xr) is for enabling administration of the medicine only once a day and to avoid fluctuations in the drug level in the body. 

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Dr. M S HaqueBUMSSexologist

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-pill tablet is a hormonal contraception, an effective contraceptive tablet widely used by women to avoid unwanted pregnancy about i-pill emergency contraceptive pill, 1 tablet i-pill emergency contraceptive pill, 1 tablet belongs to the class of medications called ‘contraceptives’ primarily used for birth control and treating dysmenorrhea (irregular and painful periods). Contraception is a procedure that aims to prevent pregnancy and is used in family planning. Dysmenorrhea is irregular and painful, leading to abdominal pain, digestion problems, fainting, vomiting, and nausea. I-pill emergency contraceptive pill, 1 tablet is a combination of three medicines: levonorgesterol, ethinylestradiol, and ferrous fumarate. I-pill emergency contraceptive pill, 1 tablet works by preventing the release of an egg from ovaries and making sperm entry difficult to enter in the uterus to fertilise sperm and egg. In addition to this, i-pill emergency contraceptive pill, 1 tablet prevents the thickening of the uterus's inner wall, required for an egg growth in the uterus. Ferrous fumarate is required to make up for the amount of iron in the women lost during their menstrual period. You should take this medicine as prescribed by your doctor. The common side effects are acne, amenorrhea (absence of menses), tenderness, pain, or swelling of the breasts, decrease in the secretion of breast milk after giving birth, dizziness, oedema (fluid retention), gastrointestinal symptoms such as abdominal pain, cramps, and bloating, unwanted hair growth, intolerance to contact lenses, changes in sexual desire, loss of scalp hair, change in menstrual flow, dark patches on the skin, mood changes, nausea, nervousness, vaginal discharge, vomiting, and loss or gain of appetite. If the side effects are persistent, reach out to your doctor. Do not take i-pill emergency contraceptive pill, 1 tablet if you are allergic to any contents of it. Please do not smoke while you are using i-pill emergency contraceptive pill, 1 tablet as it increases the risk of a blood clot. Inform your doctor before starting i-pill emergency contraceptive pill, 1 tablet if you are over 35 years, smoke, have or ever had a heart problem, uncontrolled hypertension (high blood pressure), cancer of breast, uterus, or vagina, liver diseases, diabetes that affect blood vessels, headache with disruption of the brain function, and prolonged immobilization due to a surgery. Do not take this medicine if you are pregnant or breastfeeding. Uses of i-pill emergency contraceptive pill, 1 tablet contraception, dysmennohrea (irregular menstrual cycle) medicinal benefits i-pill emergency contraceptive pill, 1 tablet is a combination of three medicines: levonorgestrel, ethinylestradiol, and ferrous fumarate. It is primarily used for contraception (prevent pregnancy). It increases menstrual cycle regularity and decreases blood loss. It decreases the incidence of iron-deficiency anemia, dysmenorrhea (irregular or painful periods), functional ovarian cysts, and ectopic pregnancies (pregnancy outside the womb). Long-term use may decrease the incidence of fibroadenomas and fibrocystic disease of the breast (lumps in the breast), acute pelvic inflammatory disease (inflammation of the pelvic organs), and cancer of the ovary and vagina. Directions for use tablet: swallow it as a whole with water; do not crush, break or chew it. Safety information keep in a cool and dry place, away from sunlight keep out of reach of children storage store in a cool and dry place away from sunlight key ingredients levonorgestrel. Side effects of i-pill emergency contraceptive pill, 1 tablet acne amenorrhea (absence of menses) tenderness, pain, or swelling of the breasts decrease in secretion of breast milk after giving birth dizziness edema (fluid retention) gastrointestinal symptoms such as abdominal pain, cramps, and bloating unwanted hair growth intolerance to contact lenses changes in sexual desire loss of scalp hair change in menstrual flow dark patches on the skin mood changes nausea nervousness vaginal discharge vomiting loss or gain of appetite in-depth precautions and warning drug warnings i-pill emergency contraceptive pill, 1 tablet increases the risk of blood clots, heart attacks, strokes, gallbladder disease, liver tumors, cancer of the ovary, breast, cervix, or vagina, and inflammation of the pancreas. Do not stop taking this medicine even if there is irregular menses or spotting. Missing pills can also cause spotting or light bleeding. Do not switch to another brand or another type of birth control without informing your doctor. Drug interactions drug-drug interactions: i-pill emergency contraceptive pill, 1 tablet may interact with an antitubercular drug (rifampicin), drugs used for epilepsy (phenobarbital, phenytoin, primidone, topiramate, carbamazepine, and phenylbutazone), drugs used for hiv (ritonavir and modafinil), antibiotics, penicillins, and tetracyclines, herbal products containing st. John’s wort (hypericum perforatum). Drug-food interactions: alcohol consumption should be avoided while taking i-pill emergency contraceptive pill, 1 tablet. Drug-disease interactions: i-pill emergency contraceptive pill, 1 tablet should not be used in patients with a history of heart attack or stroke, blood clots in the legs (thrombophlebitis), lungs (pulmonary embolism), or eyes, blood clots in the deep veins of your legs, known or suspected breast cancer or cancer of the lining of the uterus, cervix, or vagina, liver tumor (benign or cancerous), angina pectoris (chest pain), unexplained vaginal bleeding, jaundice (yellowing of the whites of the eyes or skin) during pregnancy or during previous use of the pill, heart rhythm disorders, diabetes affecting your circulation, headaches with neurological symptoms, uncontrolled high blood pressure, liver disease, and surgery with prolonged bed rest. 

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Dr. Chaitali ShahBHMS, Ozone Therapy, CCH, Certificate Course in Palliative CareHomeopath

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Hi, it's good your mri is clean. Alot of times such conditions can alter a person's emotional status. Also, the medicines taken for seizures for a long time can also shave such effects. You must consider seeing a psychologist / counsellor for help. If their opinion is that you may require medication, do consider Homoeopathic treatment as it will not affect you adversely and will help you get out of this situation. 

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Dr. Saranya DevanathanMBBS, DPMPsychiatrist

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Dear Harshit, It looks as though Kavita was given tablets for manic episode at present. There is no mood stabilizer in the list you have given. For 20 years, what are the medicines she was taking that kept her fine for many years. Lithium carbonate, divalproex or carbamazepine? At what dose and what blood level (lithium and divalproex). Probably the same drug, if it does not cause disturbance in her diabetes treatment, will be prescribed to her after controlling the present manic episode. Did she stop mood stabiliser, just because she was normal? Bipolar disorder is a lifelong illness. Recurrences are difficult to treat, more so with diabetes, so it is better to prevent the recurrences with proper dose of mood stabilizers. 

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Dr. Shubham JaiswalMBBS Bachelor of Medicine and Bachelor of SurgeryGeneral Physician

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Hello, thank you for informing me about your problem, Constipation is a condition of the digestive system where an individual has hard feces that are difficult to expel. In most cases, this occurs because the colon has absorbed too much water from the food that is in the colon. The slower the food moves through the digestive tract, the more water the colon will absorb from it. Consequently, the feces become dry and hard. When this happens, emptying the bowels can become very painful. This article will cover the main causes of constipation and how it can be treated and prevented. Fast facts on constipation Here are some key points about constipation. More detail and supporting information is in the main article. * Constipation generally occurs because too much water is absorbed from food * Causes of constipation include physical inactivity, certain medications, and aging * Some cases of constipation can be relieved by lifestyle changes * Laxatives should only be used as a last resort Symptoms A diet that contains a good quantity of fiber helps prevent constipation. The main symptoms of constipation are increased difficulty and straining when passing stools. Passing fewer stools than usual can be a sign of constipation. Other symptoms include: * stomach ache * stomach cramps * feeling bloated and nauseous * losing appetite Causes Constipation happens when the colon absorbs too much water. This can occur if the muscles in the colon are contracting slowly or poorly, causing the stool to move too slowly and lose more water. These are the most common causes of constipation: 1) Lack of fiber in the diet People whose diets include a good quantity of fiber are significantly less likely to suffer from constipation. It is important to consume foods rich in fiber such as fruits, vegetables, and whole grains. Fiber promotes bowel movements and prevents constipation. Foods that are low in fiber include high-fat foods, such as cheese, meat, and eggs. 2) Physical inactivity Constipation can occur if someone becomes too physically inactive. This is especially the case in older adults. For individuals who have been bedridden for a long time, perhaps for several days or weeks, their risk of having constipation is significantly increased. Experts are not sure why. Some believe that physical activity keeps the metabolism high, making the processes in the body happen more rapidly. Older adults tend to have a more sedentary life compared with younger people and are therefore at higher risk of constipation. Physically active people are much less likely to become constipated than inactive people. 3) Medications The most common medications to cause constipation are: * narcotic (opioid) pain drugs including codeine (Tylenol), oxycodone (Percocet), and hydromorphone (Dilaudid) * antidepressants including amitriptyline (Elavil) and imipramine (Tofranil) * anticonvulsants including phenytoin (Dilantin) and carbamazepine (Tegretol) iron supplements * calcium channel blocking drugs including diltiazem (Cardizem) and nifedipine (Procardia) * aluminum-containing antacids including Amphojel and Basaljel * diuretics including chlorothiazide (Diuril) 4) Milk Some people become constipated when they consume milk and dairy products. 5) Irritable bowel syndrome People who suffer from irritable bowel syndrome (IBS) get constipation much more frequently, compared with the rest of the population. 6) Pregnancy Pregnancy brings about hormonal changes that can make a woman more susceptible to constipation. Also, the uterus may compress the intestine, slowing down the passage of food. 7) Aging As a person gets older, the metabolism slows down, resulting in less intestinal activity. The muscles in the digestive tract do not work as well as they used to. 8) Changes in routine When a person travels, their normal routine changes. This can affect the digestive system, which sometimes results in constipation. Meals are eaten at different times, or a person might go to bed, get up, and go to the toilet at different times. All these changes can raise the risk of constipation. 9) Overuse of laxatives Some people believe a person should go to the toilet at least once a day - this is not true. However, to make sure this happens, some people self-medicate with laxatives. Laxatives are effective at helping bowel movements. However, using them regularly allows the body to get used to their action and gradually the dose needs to increase to get the same effect. Laxatives can be habit-forming. When a person becomes dependent on them, there is a significant risk of constipation when they are stopped. 10) Not going to the toilet when needed If individuals ignore the urge to have a bowel movement, the urge can gradually go away until the individual no longer feels the need to go. The longer it is delayed, the drier and harder the stool will become. 11) Not drinking enough water If constipation is already present, drinking more liquids might not relieve it. However, regularly drinking plenty of water reduces the risk of constipation. Many sodas and drinks contain caffeine which can cause dehydration and worsen constipation. Alcohol also dehydrates the body and should be avoided by individuals who are constipated or very susceptible to constipation. 12) Problems with the colon or rectum Tumors can compress or restrict the passages and cause constipation. Also, scar tissue, diverticulosis, and abnormal narrowing of the colon or rectum, known as colorectal stricture. People with Hirschsprung disease are susceptible to constipation (a birth defect in which some nerve cells are absent in the large intestine). 13) Some diseases and conditions Diseases that tend to slow down the movement of feces through the colon, rectum, or anus can cause constipation. These include the following: * Neurological disorders: Multiple Sclerosis (MS), Parkinson's disease, stroke, spinal cord injuries, and chronic idiopathic intestinal pseudo-obstruction can lead to constipation. * Endocrine and metabolic conditions: Uremia, diabetes, hypercalcemia, poor glycemic control, and hypothyroidism. * Systemic diseases: These are diseases that affect a number of organs and tissues, or affect the body as a whole, they include lupus, scleroderma, amyloidosis. * Cancer: Constipation occurs in people with cancer, mainly due to pain medications and chemotherapy. Also, if a tumor blocks or squeezes the digestive system. Treatment In the majority of cases, constipation resolves itself without any treatment or risk to health. The treatment of recurring constipation can include lifestyle changes such as doing more exercise, eating more fiber, and drinking more water. Usually, laxatives will successfully treat most cases of constipation - but should be used with care and only when necessary. In more difficult cases, the person may need a prescription medication. It is important to understand the cause of constipation - there could be an underlying illness or condition. Some people with recurring constipation use a daily diary where they record their bowel movements, stool characteristics, and other factors that may help both the doctor and patient devise the best treatment. Some gastroenterologists comment that there are people who do not allocate enough time for their defecation. Set aside enough time to allow your toilet visit to be unstressed and uninterrupted, and do not ignore an urge to have a bowel movement. OTC laxatives Only use these laxatives as a last resort: * Stimulants: These make the muscles in the intestines contract rhythmically. These include Correctol, Dulcolax, and Senokot. * Lubricants: These help the stool move down the colon more easily. These include mineral oil and Fleet. * Stool softeners: These moisten the stool. Stool softeners include Colace and Surfak. * Fiber supplements: These are perhaps the safest laxatives. They are also called bulk laxatives. They include FiberCon, Metamucil, Konsyl, Serutan, and Citrucel and should be taken with plenty of water. If you want to buy bulk laxatives, then there is an excellent selection online with thousands of customer reviews. * Osmotics: These facilitate the movement of fluids through the colon. These include Cephulac, Sorbitol, and Miralax. * Saline laxatives: These draw water into the colon and include milk of magnesia. * Chloride channel activators: These require a prescription and include lubiprostone (Amitiza). * 5-HT-4 agonists: They increase the secretion of fluid in the intestines and speed up the rate at which food passes through the colon. They include Prucalopride. If the constipation does not respond to any treatment, as a last resort, surgery to remove part of the colon may be undertaken. In the procedure, the segment of the anal sphincter or rectum that causes the constipation is removed. Natural remedies There are a few ways to ease the symptoms of constipation without using medication. These include: * Increasing fiber intake: People with constipation should eat between 18 and 30 grams (g) of fiber every day. Fresh fruits and vegetables and fortified cereals have high fiber content. * Drinking water: Consuming lots of water can help to rehydrate the body. * Bulking agents: Adding these to your diet can help soften stools and make them easier to pass. Examples of bulking agents include wheat bran. * Regular exercise: This can help to make bodily processes more regular, including the passing of stools. * Routine: Having a place and time of day where you can put aside time to visit the bathroom without forcing a stool. * Avoiding holding in stools: Responding to your body's natural urges to pass stools when they happen is key to reducing the impact of constipation. * Elevate your feet: Place your feet short platform, such as a step, and make sure the knees are above hip-level while passing stools. This can reduce constipation. * Homeopathic remedies: While their effectiveness is disputed, some studies have suggested that treatments for constipation offered by homeopathic doctors can be successful. These include calcarea carbonica, nux vomica, silica, bryonia, and lycopodium. Speak with your doctor about the best course of action if symptoms are not responding to natural or home remedies. Complications Constipation on its own can be uncomfortable but not life-threatening. However, severe constipation can develop into more serious conditions, including: * rectal bleeding after continually straining to pass stools * anal fissure, or a small tear around the anus * hemorrhoids, or swollen, inflamed blood vessels of veins in the rectum * faecal impaction, in which dried stools collect in the anus and rectum, leading to an obstruction in the path stool would take to leave the body Dealing with constipation before it becomes one of these conditions can prevent further discomfort. Feel free to get connected and clarify your queries in the private section. Wish you best of health! 

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Dr. Manvinder KaurPGDHHM, MBBSGeneral Physician

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Difference between oxcarbazepine (ox mazetol) and carbamazepine (mazetol) are in terms of efficacy, tolerability and fewer side effects. Used in the various medical problems as advised by treating physician. 

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Dr. M ReyazMD - PsychiatryPsychiatrist

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BMD is relapsing and remitting type of illness. Symptoms are controlled with drugs. Patient leads a normal life except in episodes. 

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Dr. Jayvirsinh ChauhanMD - Homeopathy, BHMSHomeopath

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Hi Xyz.... this kind of problems... respond to homoeopathic treatment well... And as far as I know it is the only permanent solution without any side effects... You can consult to a good homoeopath nearby or me through lybrate.. 

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Dr. Indranil SahaMBBS, MD Psychiatry, DPM Psychological MedicinePsychiatrist

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Hi lybrate-user, I would like to say that the symptoms of slowness of movement what you have mentioned in a patient who is on Rispeidone and aripiprazole is most probably EPS (extra pyramidal Side effects) unless proved otherwise. There may be underlying or Co morbid Parkinsons disease. But in this position its difficult to diagnose as the Pt is on antipsychotic. Gabapentin has no role in decreasing antipsychotic induced slowness in movements. But its often used as a treatment of Akathesia which is also a kind of EPS. So indirectly gabapentin may decrease Slowness of gaits by working through GABA neurotransmitter system. I would suggest to change the antipsychotics if possible after discussing with your doctor. Preferably Quitiapine may be a good choice. Or anticholinergic medicine can be added to alleviate the side effects. Thanks. 

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Dr. R.S. SainiMBBS, MD - Internal MedicineInternal Medicine Specialist

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Hi, Good Foods For Hypothyroidism Foods that are rich in iodine are highly recommended in the struggle to ward off hypothyroidism. Below is a categorized list of good food sources. Iodine-Rich Foods For Hypothyroidism •Iodized Salt •Seaweeds and Seafoods •Salt Water Fish •Sushi •Nori Rolls •Celtic Sea Salt Selenium-Rich Foods For Hypothyroidism •Meat •Chicken •Salmon •Tuna •Whole Unrefined Grains •Brazil Nuts •Dairy Products •Garlic •Onions Iodine For Hypothyroidism The thyroid gland needs iodine, therefore if you have an underactive thyroid gland you should increase the iodine intake in your diet. A well-balanced diet that includes iodine can help in alleviating the symptoms that you encounter with your condition. With the simplest intake of the foods mentioned above, you can greatly assist your thyroid in keeping up with your body's metabolism. Foods To Avoid For Hypothyroidism These foods must be avoided in order to prevent recurrence of hypothyroidism symptoms. Avoiding them will also prevent aggravating the already aggravated thyroid glands. Here is a list of foods to be avoided: •Cassava •Linseed •Kohlrabi •Peanuts •Kale •Turnips •Mustard Greens •Mustard •Millet •Cauliflower •Rutabagas •Peaches •Coffee •Spinach Goitrogenic Foods To Avoid For Hypothyroidism The food items listed below can impede your body's ability to absorb iodine. And when your body can't absorb iodine, your thyroid gland will swell and you will eventually develop goiter. Some of the food listed above can also be goitrogenic. P.T.O •Bamboo shoots •Soybeans and related products •Canola Oil •Horseradish •Bok Choy •Foods with Gluten •Garden Kres •Tempeh •Babassu •Sweet Potato Goitrogenic Chemicals These chemicals, when ingested through processed food or medications can cause goiter: •Amiodarone •Lithium •Oxazolidines •Iopanoic acid •Minocycline (MN) •Propylthiouracil •Thioureylene •Sulfadimethoxine •Carbamazepine •Phenobarbitone as per Lybrate policy you have to paid consultation for prescription or visit clinic (1). 

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