From the Guidelines
Carbamazepine should be dosed at 400-1200 mg per day, divided into 2-3 doses, for the treatment of Trigeminal Neuralgia.
Dosing Details
- The initial dose of Carbamazepine can be started at 200 mg at night and gradually increased by 200 mg every 7 days to achieve the desired dose 1.
- The dose can be further divided into 2-3 doses per day to minimize side effects and optimize pain relief 1.
- Once a response has been achieved and patients maintain pain relief, the dose can be tapered to a minimal effective dose to reduce the risk of side effects 1.
Efficacy and Safety
- Carbamazepine has been shown to be effective in 70% of patients with Trigeminal Neuralgia, with partial or complete pain relief 1.
- Common side effects of Carbamazepine include drowsiness, headache, and dizziness 1.
From the Research
Dosing of Carbamazepine for Trigeminal Neuralgia
- The dosing of Carbamazepine for Trigeminal Neuralgia has been studied in several research papers 2, 3, 4, 5, 6.
- According to a study published in 1980, the doses of Carbamazepine given ranged from 200 to 1,400 mg/day, with a mean of 733 mg/day 2.
- Another study published in 2014 found that the median dose of Carbamazepine was 600 mg (range 200-1200) 3.
- A study published in 1981 reviewed the results of treating 143 patients with trigeminal neuralgia with Carbamazepine over a 16-year period, but did not specify the exact dosing 4.
- A case report published in 2011 started with a dose of 200 mg every 12 hours and increased to 300 mg every 8 hours, then reduced to 200 mg every 8 hours with the addition of oxycodone 5.
- The efficacy of Carbamazepine in relieving pain was found to be an auxiliary indicator of trigeminal neuralgia, with 90% of patients with trigeminal neuralgia experiencing pain relief 6.
Plasma Concentration and Dosing
- A study published in 1980 found that complete or almost complete pain relief was achieved at Carbamazepine plasma concentrations of 24-43 μmol/l 2.
- The same study found that small adjustments of plasma concentration resulted in pronounced changes in pain score, and side effects were not reported below 34 μmol/l 2.
- Another study published in 2014 did not specify the plasma concentration of Carbamazepine, but found that the median dose was 600 mg (range 200-1200) 3.