Carbamazepina
Carbamazepine
5H-Dibenz[b,f]azepine-5-carboxamide
También conocido como: Tegretol · Carbatrol · Epitol · Equetro · G-32883 · carbamazepinum · karbamatsepiini · karbamazepinas
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a psychotherapeutic agent | 4-8 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
- As a psychotherapeutic agent: Not commonly used, but may have some utility in dogs that seem to have amygdalar hyperactivity; sometimes used in conjunction with SSRIs to control explosive aggression.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For photic head shaking | 10 mg/kg PO q6h or 29 mg/kg PO q12h | PO | q6h or q12h | — | 🌎 NA |
- For photic head shaking: May be helpful in some horses that do not respond to cyproheptadine.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La carbamazepina es un derivado del dibenzoazepina iminoestilbeno que está químicamente relacionado con el antidepresivo tricíclico imipramina.
Perla clínica: Aunque se utiliza ampliamente en medicina humana como anticonvulsivo primario y estabilizador del estado de ánimo, su utilidad en medicina veterinaria (particularmente en perros) está severamente limitada por su rápida autoinducción hepática. Los perros metabolizan el fármaco tan rápidamente después de unos pocos días de terapia que mantener niveles séricos terapéuticos se vuelve extremadamente difícil.
Debido a esta limitación farmacocinética, rara vez se utiliza para el control de convulsiones en animales. En su lugar, en medicina veterinaria, se reserva principalmente para:
- Medicina del comportamiento en perros (p. ej., manejo de la hiperactividad amigdalina o agresividad explosiva, a menudo junto con ISRS).
- Dolor neuropático o condiciones neurológicas específicas como el sacudido de cabeza fotico (photic head shaking) en caballos que son refractarios a otros tratamientos como la ciproheptadina.
Mecanismo de acción
Carbamazepine primarily acts by blocking voltage-gated sodium channels in neuronal membranes.
- Mechanism: Binds preferentially to the inactive state of sodium channels → delays their recovery → inhibits repetitive neuronal firing and stabilizes hyperexcited neural membranes.
- It also decreases the synaptic transmission of excitatory impulses and may reduce the release of the excitatory neurotransmitter glutamate.
- Structurally related to tricyclic antidepressants, it also possesses mild anticholinergic, antidiuretic, and muscle relaxant properties.
Seguridad y advertencias
Contraindicaciones
- Patients receiving MAO Inhibitors (e.g., selegiline) within the past 14 days
- Patients with a history of bone marrow depression
- Known hypersensitivity to carbamazepine or tricyclic antidepressants
Efectos adversos
- Sedation and lethargy
- Ataxia (unsteadiness)
- Gastrointestinal upset (vomiting, anorexia)
- Hepatotoxicity (elevated liver enzymes)
- Blood dyscrasias (rare but possible bone marrow suppression)
Precauciones
Use with extreme caution due to extensive drug interactions (it is a potent inducer of hepatic enzymes). In dogs, it rapidly induces its own metabolism (autoinduction), making long-term therapeutic dosing difficult. May interfere with thyroid function tests (decreased values) and some pregnancy tests, though veterinary significance is unclear.
Interacciones farmacológicas
May increase plasma levels or effects of carbamazepine
May increase plasma levels or effects of carbamazepine; Carbamazepine may also decrease their effects
May increase plasma levels or effects of carbamazepine
May increase plasma levels or effects of carbamazepine
May increase plasma levels or effects of carbamazepine
May increase plasma levels or effects of carbamazepine; Carbamazepine may also increase effects of Isoniazid
May increase plasma levels or effects of carbamazepine
Contraindicated; discontinue MAOI at least 14 days prior to carbamazepine
May increase plasma levels or effects of carbamazepine
May increase plasma levels or effects of carbamazepine
May increase plasma levels or effects of carbamazepine; Carbamazepine may also decrease their effects, though it can increase Clomipramine levels
May increase plasma levels or effects of carbamazepine; Carbamazepine may decrease its effects and increase risk for phenobarbital toxicity
May decrease plasma levels or effects of carbamazepine
May decrease plasma levels or effects of carbamazepine
May decrease plasma levels or effects of carbamazepine
May decrease plasma levels or effects of carbamazepine
May decrease plasma levels or effects of carbamazepine
May decrease plasma levels or effects of carbamazepine
May decrease plasma levels or effects of carbamazepine
May decrease plasma levels or effects of carbamazepine
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Carbamazepine may decrease its effect by lowering serum concentrations
Monitorización
- Complete Blood Count (CBC)
- Liver function tests
- Clinical efficacy and behavioral changes
Farmacocinética
Vida media
Absorción
Variable and relatively slow oral absorption.
Distribución
Widely distributed into tissues; highly protein-bound.
Metabolismo
Extensively metabolized in the liver. In dogs, it is a potent inducer of hepatic microsomal enzymes and rapidly induces its own metabolism (autoinduction) within days of starting therapy.
Eliminación
Excreted primarily in the urine as metabolites.
Sobredosis
Overdose can lead to significant CNS depression, severe ataxia, tremors, seizures, respiratory depression, and cardiovascular abnormalities (tachycardia, hypotension). Treatment is primarily supportive and symptomatic, including gastric decontamination if caught early, IV fluids, and respiratory support. Seizures should be treated with standard anticonvulsants (e.g., diazepam, phenobarbital).
Productos disponibles
Formulaciones
- Oral Tablets
- Oral Chewable Tablets
- Extended-Release Tablets/Capsules
- Oral Suspension
Etiquetado para humanos
- Carbamazepine Oral Tablets: 100 mg (regular and chewable), & 200 mg (Tegretol, Epitol, generic)
- Carbamazepine Oral Tablets or Capsules Extended-Release (12-hour) (Tegretol XR, Carbatrol, Equetro, generic)
- Carbamazepine Oral Suspension (Tegretol, generic)
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store below 30°C (86°F) in airtight containers, as humid conditions can reduce potency by up to one-third. Protect from light. Compounded oral suspension (40 mg/mL in simple syrup) retains >90% potency for 90 days stored at both 5°C and 25°C, but must be protected from light and shaken vigorously before use.
Información para el cliente
Su veterinario ha recetado carbamazepina para su mascota. Por favor, lea lo siguiente cuidadosamente:
- Uso fuera de etiqueta (Off-Label): Este medicamento se utiliza "fuera de etiqueta" en medicina veterinaria. Se usa con poca frecuencia y su veterinario lo ha recetado basándose en las necesidades conductuales o neurológicas específicas de su mascota.
- Horario estricto: Es crucial administrar este medicamento exactamente como se prescribe. Debido a que los animales procesan este fármaco muy rápidamente, omitir una dosis puede llevar a una pérdida de eficacia. A menudo requiere una administración frecuente.
- Qué observar: Monitoree a su mascota en busca de signos de letargo, inestabilidad (ataxia) o malestar gastrointestinal (vómitos, pérdida de apetito).
Importante: Informe a su veterinario de inmediato si observa cualquier comportamiento inusual, vómitos severos o coloración amarillenta en los ojos/encías (ictericia), ya que estos podrían ser signos de estrés hepático o reacciones adversas.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.