Carbatrol is the brand name used for one form of extended-release carbamazepine available in the United States. Carbatrol was developed to provide more convenient dosing of carbamazepine and less fluctuation of blood levels. The Food and Drug Administration (FDA) approved Carbatrol in 1997.

Tegretol-XR is another extended-release form of carbamazepine sold in the United States. It uses a different drug delivery system than Carbatrol. Other extended-release forms of carbamazepine may be available in other countries. In the UK, for instance, Tegretol Retard, a tablet composed of coated pellets, is often used. Tegretol Retard tablets can be divided for flexible dosing, but they should not be chewed or crushed.

Forms Carbatrol is manufactured in the United States by Shire US Inc.. These are the forms of Carbatrol available in the U.S.:

100 milligrams (photo not available)
Bluish-green opaque two-piece capsule, printed with company logo in white ink.

		200 milligrams A two-piece capsule with a light gray body and bluish green cap.
		300 milligrams A two-piece capsule with a black body and bluish green cap.

Each Carbatrol capsule contains tiny beads of medication. These beads have three different types of coatings so that they dissolve at different times:

• 25% of the beads dissolve and release their medication almost immediately
• 40% dissolve gradually over 8 to 12 hours
• 35% dissolve only after the medication reaches the small intestine, where it is released slowly

How to take and store Carbatrol
Carbatrol capsules must not be crushed or chewed. The contents can be sprinkled over food, however, without affecting the extended-release qualities. Advise patients who are unable to swallow capsules to sprinkle the contents over a teaspoonful of applesauce, pudding, ice cream, oatmeal, yogurt, or other similar food and then swallow it immediately without chewing. Drinking a glass of water or another liquid may help with swallowing. Carbatrol also can be given through most feeding tubes.

Carbatrol can be taken either with or without meals. The extent of absorption and elimination half-life are the same, though the rate of absorption is faster when Carbatrol is given with a high-fat meal.

Advise patients to avoid grapefruit juice, which inhibits the hepatic metabolism of Carbatrol.

Store Carbatrol capsules at room temperature (below 77°F) and protect them from light and moisture.

Missed doses
Because Carbatrol is usually taken only twice daily, patients are less likely to miss doses than if they take many other forms of carbamazepine, which may require tid or qid dosing. Advise patients to take a forgotten dose immediately. If it is almost time for the next dose, they should delay the next dose rather than taking two doses very close together.

Patients who often forget doses may benefit from using a special pillbox or watch with an alarm.