Teril Retard

What is it?

An antipsychotic, anticonvulsant preparation and dibenzazepine, available as scored, capsule-shaped, white tablets in 2 strengths containing 200mg and 400mg of carbamazepine, marked T12 and T17.

Medical Uses

Prevention of manic-depression in patients who do not respond to lithium, generalised, tonic clonic and partial seizures, trigeminal neuralgia.

Dosage

Adults, manic depression, 400mg each day at first in divided doses, then increase slowly to 400 to 600mg each day in divided doses with a daily maximum of 1.6g. Seizures, 100 to 200mg 1 to 2 times each day at first, then increase gradually to most effective dose, usually in the order of 800mg to 1.2g in divided doses. The daily maximum is 2g each day in divided doses. Trigeminal neuralgia, 100mg twice each day to start, then slwly increased to 600 to 800mg each day in divided doses to a daily divided maximum of 1600mg. Children, seizures only, aged 5 to 10 years, 400 to 600mg each day; aged 10 to 15 years, 600 to 1000mg each day. Both in divided doses.

Special Care

Pregnancy, breastfeeding, liver, heart and kidney disease, previous psychotic illness, glaucoma. Analysis of urine, BUN (blood/urea/ nitrogen), blood counts and liver function tests must all be carried out before treatment starts and then at regular intervals.

Avoid Use

Children under 5 years, porphyria (inherited metabolic disorder involving porphyrins), depression of bone marrow, abnormalities of atrioventricular heart conduction.

Possible Drug and Food Interactions

Combined oral contraceptives, acetazolamide, benzodiazepines, fluoxetine, haloperidol, calcium antagonists, oral anticoagulants, cimetidine, MAOIs, danazol, viloxazine, frusemide, methadone, non-depolarising muscle relaxants, erythromycin, isoniazid, dextropropoxyphene, steroids, felodipine, alcohol, doxycycline, cyclosporin, imipramine, digoxin, thioridazine, hydrochlorothiazide, anticonvulsants.

Known Side Effects

Allergic skin effects, lack of coordination, gastrointestinal upset, dizziness, fluid retention, sleepiness, low blood sodium levels, blood changes, raised liver function tests. In rare cases, heart conduction disturbances, hepatitis, toxic skin effects, jaundice, multi-organ hypersensitivity disorder, Stevens-Johnson syndrome.