Carbamazepine and oxcarbazine are medications used initially as anti-epileptic drugs that have been used successfully for chronic pain - and in particular neuropathic or nerve type pain. Carbamazepine is the first line medication for Trigeminal Neuralgia.
Carbamazepine should be started at low doses and increased slowly. Doses should be reduced in the elderly. A maximum daily dose of 1200mg/d is recommended in divided doses BD or TDS.
Oxcarbazine Used as a second line treatment to carbamazepine or when there is sensitivity to CBZ. Start at low doses and increase to a max of 1200mg/d at BD dosing. Initially commence at 75mg BD. Important side effects include low sodium and depression.
Patients should be warned about important side effects
- sore throat
- mouth ulcers
- liver problems
All patients need initial FBC, electrolytes (Na) and Liver Function Tests at regular intervals.
Carbamazepine patient information sheet-Carbamazepine.pdf
Oxcarbazine patient information sheet - oxcarbazine.pdf