Clinical Information

Carbamazepine (Tegretol) is an effective treatment for complex partial seizures, with or without generalization to tonic-clonic seizures. It is frequently administered in conjunction with other antiepileptic agents, such as phenytoin and valproic acid. Under normal circumstances, the carbamazepine that circulates in blood is 75% protein-bound. In severe uremia, carbamazepine may be displaced from protein resulting in a higher free (unbound) fraction of the drug circulating in blood. Since neurologic activity and toxicity of carbamazepine are directly related to the circulating free fraction of drug, adjustment of dosage based on knowledge of the free carbamazepine level may be useful in patients with severe uremia.