Posted by Sunnely on December 2, 2000, at 19:10:16
In reply to Tegretol.. Aplastic Anemia Stories??!!!! PLEEEZ, posted by KarenK on December 2, 2000, at 10:46:09
> My 17 yr old bp son is going to start tegretol next week as soon as the pdoc can wean him off the depakote. How big a risk is the aplastic anemia? Does it sneak up on you so you stand a chance or do you take a pill and die? Sorry but I'm freaking out about this and I don't want my anxiety to jeopardize what might be a successful trial for him.
>
> Any information would be appreciated. Thanks in advance.
>
> Love,
> KarenK++++++++++++++++++++++++
Hi Karen,
The bad news: Aplastic anemia is a serious and potentially fatal adverse effect of carbamazepine (Tegretol).
The good news: Tegretol produces aplastic anemia in less than 0.002% of patients, calculated at 2 per million). This is 5-8 times more than the spontaneous rate in the general population.
Another serious blood disorder but fortunately rare that Tegretol causes is agranulocytosis (critically low white blood cell or WBC count). The person becomes defenseless against infection and may succumb to severe infection if the offending drug is not stopped and the condition not treated immediately. Tegretol produces agranulocytosis an estimate of 6 per million.
A mild drop in WBC occurs in about 7-10% initially in patients on Tegretol, but this decrease is usually transitory and without adverse effects.
Patients on Tegretol who develop signs and symptoms of infection such as fever, sore throat, mouth ulcerations, weakness, and/or bleeding tendencies such as easy bruising, purpura, should notify their doctor, stop the drug immediately, and a complete blood count (and coagulation panel) done STAT.
I agree with Chris A. Why not ask the doctor about oxcarbazepine (Trileptal)? It was recently approved by the US FDA as anticonvulsant (for epilepsy) but has shown mood-stabilizing effects (at least in European clinical trials). It has some chemical similarity to Tegretol without its excess "baggage." Compared to Tegretol, Trileptal: 1) has few drug-drug interactions because of its minimal interaction with the CYP450 enzyme system (liver enzymes); 2) does not induce its own metabolism; 3) has no "black box warning;" monitoring of liver enzymes and blood parameters are not required; 4) is quickly and easily titrated (dose increase); 5) generally well tolerated; and 6) can be taken with or without food.
Since 1990, Trileptal has been approved in over 50 countries. It is manufactured by Novartis Pharmaceuticals Corporation.
poster:Sunnely
thread:49806
URL: http://www.dr-bob.org/babble/20001130/msgs/49819.html