CARBAMAZEPINE
Formoral.solid
Initial 200-400 mg daily, increased gradually until pain-free, usually 200 mg 3-4 times daily; up to 1200 mg daily may be needed in some cases, then tapered to the lowest possible dose that maintains control. Elderly: initial 100 mg twice daily. - As directed; long-term at the lowest effective maintenance dose once pain is controlled.
Trigeminal neuralgia is essentially an adult/older-adult condition; the formulary's paediatric carbamazepine dosing is for epilepsy, not facial pain, and is not reproduced here.
Egyptian National Drug Formulary - nervous-2025.pdf, Carbamazepine monograph (chapter PDF p27)
Carbamazepine is the guideline first-line drug specifically for trigeminal neuralgia, one of the recognised causes within the broad 'facial pain' symptom code; it is not appropriate for facial pain from other causes.
- Only appropriate for the specific pattern of trigeminal neuralgia (brief, electric-shock-like, touch-triggered unilateral facial pain) - not for facial pain from dental, sinus, or other causes.
- There is a rare but serious risk of Stevens-Johnson syndrome/toxic epidermal necrolysis and agranulocytosis - stop immediately and seek care if rash or fever develops.
- Many drug interactions (it is a strong enzyme inducer) - check other medications.
- Avoid in pregnancy where possible - associated with neural tube defects.
- Facial pain with jaw claudication or visual change in an older adult needs urgent referral for possible giant cell arteritis, not carbamazepine.
- Facial swelling or fever suggests a dental/sinus abscess needing antibiotics and dental/ENT referral, not carbamazepine.
| Egyptian brand | Manufacturer | Indicative price |
|---|---|---|
| CARBAMAZEPIN 200MG 10 TAB.U.S.P.33 | SEDICO | 3.00 EGP (0.30/unit) |
| CARBAMAZEPINE 200MG XR 10 TAB. | SIGMA | 4.00 EGP (0.40/unit) |
| TONOCLONE 200MG 30 TAB. | UP PHARMA | 13.50 EGP (0.45/unit) |
| TONOCLONE RETARD 400MG C.R. 10 F.C. TAB. | UP PHARMA | 8.50 EGP (0.85/unit) |
| CARBAPEX 200 MG CR 30 TABS. | MULTI-APEX | 81.00 EGP (2.70/unit) |
| EPIMAZEPINE CR 200 MG 10 CONTROLLED RELEASE F.C. TABS. | EIPICO | 6.00 EGP |
| NEUROTOP RETARD 300MG 100 S.R. TAB. | GEROT PHARMA > B.P PHARMA | 410.00 EGP |
| NEUROTOP RETARD 600MG 100 S.R. TAB. | GEROT PHARMA > B.P PHARMA | 720.00 EGP |
| ALEXTOL 100MG/5ML ORAL SUSP. 100ML? strength differs? different route - not oral solid | ALEXANDRIA | 7.50 EGP |
| ARBATEG 2% SUSP. 100 ML? strength differs? different route - not oral solid | MEDIZEN PHARMACEUTICAL INDUSTRIES | 35.00 EGP |