Document Detail


A review of carbamazepine's hematologic reactions and monitoring recommendations.
MedLine Citation:
PMID:  2089834     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early case reports of fatal hematologic effects attributed to carbamazepine (CBZ) resulted in extensive monitoring recommendations by the manufacturer. The rarity of blood dyscrasias led many authors to question the manufacturer's guidelines. Thus the manufacturer removed specific monitoring guidelines, allowing physicians to monitor CBZ using their clinical judgment. This article reviews case reports and studies of CBZ's hematologic effects. Due to their rapid onset, daily laboratory checks would be necessary to monitor for aplastic anemia, agranulocytosis, and thrombocytopenia. These adverse effects are best monitored by informing patients and physicians to carefully watch for signs and symptoms. Leukopenia develops more slowly, occurring in approximately 12 percent of children and 7 percent of adults. Its onset is typically within the first three months of treatment, with patients at risk having a low or low-normal pretreatment white blood cell (WBC) count. Leukopenia often reverses, even if CBZ is continued. Based upon our review of the literature, we recommend monitoring of those high-risk patients during the first three months of treatment with the frequency being determined by results of each laboratory value. WBC counts less than 3000/mm3 or neutrophil counts below 1000/mm3 warrant a decrease in dose with frequent monitoring or CBZ discontinuation, if necessary.
Authors:
J L Sobotka; B Alexander; B L Cook
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Review    
Journal Detail:
Title:  DICP : the annals of pharmacotherapy     Volume:  24     ISSN:  1042-9611     ISO Abbreviation:  DICP     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-05-30     Completed Date:  1991-05-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8904338     Medline TA:  DICP     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1214-9     Citation Subset:  IM    
Affiliation:
University of Iowa, College of Pharmacy, Iowa City 52242.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Agranulocytosis / chemically induced*
Anemia, Aplastic / chemically induced*
Carbamazepine / adverse effects*
Child, Preschool
Female
Humans
Male
Middle Aged
Product Surveillance, Postmarketing*
Risk Factors
Thrombocytopenia / chemically induced
Chemical
Reg. No./Substance:
298-46-4/Carbamazepine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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