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What Are The Side Effects Of Carbamazepine?

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Posted on Mon, 19 Oct 2015
Question: I read this information online regarding one of the drugs I take for epilepsy. Is this a confirmed side effect of taking Carbamazepine? If so, how much can I expect it to impact my BG level? My daily fasting number averages around 155.

"High blood sugar is found among people who take Carbamazepine, especially for people who are female, 60+ old, have been taking the drug for < 1 month, also take medication Zyprexa, and have Bipolar disorder. We study 15,485 people who have side effects while taking Carbamazepine from FDA and social media. Among them, 68 have High blood sugar." (http://www.ehealthme.com/ds/carbamazepine/high+blood+sugar)
doctor
Answered by Dr. Panagiotis Zografakis (22 minutes later)
Brief Answer:
no connection, read the drug's SPC

Detailed Answer:
Hello,

I've answered your other question about this too. I would have answered to your doubts also! ehealthme is not a trusted source of medical information...

If you want to get trustworthy information about drugs, you should read their Summary of Product Characteristics (SPC) which is included in every package.

I'll also provide a couple of trustworthy links for you to check.

https://www.medicines.org.uk/emc/medicine/25929
https://www.medicines.org.uk/emc/medicine/24201

With a little search you'll find out that depakote may only cause false positive glucose readings in the urine (not in the blood) and tegretol may cause hyperglycemia only when taken in very high doses (overdose), for example when committing a suicide attempt.

Simvastatin does cause hyperglycemia (most statins do). If your current regimen is not sufficient to keep your blood glucose within the desired limits then a careful review of your diet would be required before changing your dosage or drugs.

I hope this is more clear this time!
Please contact me again, if you still have questions or doubts about it.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (40 minutes later)
I apologize for seeming unappreciative of your previous response. This response was what I was looking for when I asked the question initially. One more question if I may.

I was recently diagnosed with diabetes, but was diagnosed with pre-diabetes for about a year. I just had my first A1C test done a few days ago, and am waiting to hear back on the results. I am anticipating it will be high, in which case my doctor and I will discuss other options to lower my BG. Diet and exercise have been working reasonably well to control spikes in my BG, but after my doctor added Gilipizide a few weeks ago to the Metformin I was already taking my BG has gone down significantly.

Since Gilipizide focuses on the amount of sugar created in the liver (or at least recognized by insulin), and at 2.5mg, is it a reasonable step to look at increasing that dosage, and could I expect a further drop in my BG doing that? Or is there another drug or combo I should discuss with my doctor?

I realize those are "loaded" questions because there are many variables. I just want to have as many talking points prepared for my visit with my doctor.

Thank you
doctor
Answered by Dr. Panagiotis Zografakis (13 minutes later)
Brief Answer:
increasing the dosage or adding a new drug would help

Detailed Answer:
You're welcome!

First of all, let me correct a typo. Regaring depakote, I meant urine ketones (not glucose). It has to do with the drug metabolism and excretion. I can't edit my answer once they're submitted... Sorry about that!

On to your new question now. Increasing the dose of glipizide will decrease your blood sugar, although not as much as adding another drug. Glipizide may cause hypoglycemia if the dosage is too high for you. Please note that 2.5mg is a very low dosage.

There are other drugs which may reduce blood glucose without significant risk for hypoglycemia. DPP4 inhibitors do that. GLP-1 agonists do that too and they also reduce the patient's appetite, causing weight loss and a better glucose control. They can only be injected though, which is a big downside.

Your diet has to be reviewed in detail. If you're overweight or obese you'll see great improvement by loosing weight.

Wait for the glucosylated hemoglobin before trying any change. If your HbA1c is close to the target then the readings you've mentioned could only had been transient for some reason. Certain conditions may affect the blood sugar, like an infection (even a local one, a toothache or a furuncle).

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (20 minutes later)
It seems that the best course of action to discuss with my doctor is to increase gilipizide incrementally. My BG is high enough right now where it seems we could get away with increasing it a little bit.

A curiousity question for you. I am 48 and 6'4" and have always been active and followed a decent diet with a fast metabolism never weighing more than 205 and currently 185 (normal BMI). My mother was diagnosed with type II diabetes in her late 40's. I assume my condition is hereditary since everything else seems to be within reason. Is there anything else outside of what I mentioned that I can source it to?
doctor
Answered by Dr. Panagiotis Zografakis (6 hours later)
Brief Answer:
your mother's diabetes is the most important factor

Detailed Answer:
First of all I agree that you could increase glipizide dosage but adding a DPP4 or piogritazone would be an even better (but more costly) choice. You mentioned increased fasting blood glucose. Pioglitzone would increase the sensitivity of certain tissues to glucose and reduce fasting hyperglycemia. Glipizide helps to increase insulin excretion from the pancreas but it doesn't do any good to insulin resistance, which is your main problem right now. I can't argue against increasing the dosage of glipizide though because it's a good strategy to first increase the dosage enough (not maximize it) before adding new drugs, in order to take the most out of a drug without too many side effects. There are no guidelines about it either, so it's a matter of opinion and experience.

Regarding your other question, type 2 diabetes has a lot to do with genes. If both parents have type 2 diabetes then the children have an almost 50% chance of type 2 diabetes. Since your body weight is OK, there is no much you can do besides keeping your diet healthy, exercising and taking your medication.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3816 Questions

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What Are The Side Effects Of Carbamazepine?

Brief Answer: no connection, read the drug's SPC Detailed Answer: Hello, I've answered your other question about this too. I would have answered to your doubts also! ehealthme is not a trusted source of medical information... If you want to get trustworthy information about drugs, you should read their Summary of Product Characteristics (SPC) which is included in every package. I'll also provide a couple of trustworthy links for you to check. https://www.medicines.org.uk/emc/medicine/25929 https://www.medicines.org.uk/emc/medicine/24201 With a little search you'll find out that depakote may only cause false positive glucose readings in the urine (not in the blood) and tegretol may cause hyperglycemia only when taken in very high doses (overdose), for example when committing a suicide attempt. Simvastatin does cause hyperglycemia (most statins do). If your current regimen is not sufficient to keep your blood glucose within the desired limits then a careful review of your diet would be required before changing your dosage or drugs. I hope this is more clear this time! Please contact me again, if you still have questions or doubts about it. Kind Regards!