Carbamazepine (CZ) is an anticonvulsant drug is used for management of seizure disorders. It is
a mood stabilizer to treat combined episodes, manic episodes, and bipolar disorder. It is also
recommended for use in treatment trigeminal neuralgia, generalized tonic-clonic attacks, temporal
lobe seizures, and multiple psychiatric problems. CZ gets broken down in the liver by the enzyme
CYP450 3A4. Carbamazepine epoxide is the most essential metabolite. The metabolic routes of CZ
include oxidation, hydroxylation, deamination, and esterification with glucuronic acid. CZ has a 75–
80% high affinity for plasma proteins. The bioavailability can vary from 75 to 85%. Consuming food
did not seem to have any effect on the rate or degree of absorption. It exhibits its effects via
decreasing dopamine turnover, raising brain levels of -aminobutyric acid (GABA) through several
kinds of synthesis and degradation processes, and altering a series of neurotransmitters, extra
hypothalamic neuropeptides, voltage-sensitive Na+ channels, secondary messenger systems, and neuro
protection. Despite triacetyloleandomycin, erythromycin, propoxyphene, isoniazid, and cimetidine
minimize the metabolism of CZ, it facilitates the metabolism of phenytoin, primidone, valproic acid,
phenobarbital, and warfarin. The most common adverse reactions include ataxia, nausea, vomiting,
constipation, diarrhea, a lack of appetite, and sleepiness. Skin rashes, weakened bone marrow
function, and confusion are the main negative consequences.
Keywords: Carbamazepine, Seizure disorders, Metabolism, Liver, Bioavailability, Ataxia
Publication date: 01/03/2025
https://ijbpas.com/pdf/2025/March/MS_IJBPAS_2025_8813.pdf
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https://doi.org/10.31032/IJBPAS/2025/14.3.8813
