Dr James Schaller
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One government agency seems to suggest only 25% of patients get any information about their medications. In the world of rushed insurance plan medicine doctors fly from appointment to appointment trying to pay massive overhead and malpractice premiums. So lets talk about what you might not have been told about this medication.

Side Effects

I will not split out the rare from the common ones since you should know them all. If it were only causing bad reactions with no benefit it would not be on the market and being repeatedly used.

  • Sleepiness–the most common side effect.
  • Double vision
  • Fatigue
  • Nausea or vomiting
  • Dizziness/vertigo
  • Trouble walking normally/falls
  • Other types of vision changes
  • Belly pain
  • Tremor
  • Indigestion
  • About 1/100 patients has trouble with blood sodium levels going too low
  • Rash
  • Headache
  • Fever
  • Bloating or edema
  • Allergy
  • Chest pain
  • Increased upper respiratory symptoms
  • Low blood sodium
  • Anxiety
  • Confusion
  • Coughing
  • Sore throat
  • Eccentric taste sensations
  • Urinary tract infections
  • Constipation
  • Sweats
  • Weight loss
  • Heart rate changes, high or low blood pressure
  • Cerebral hemorrhage
  • Blood in stool
  • Gallstones that may require surgery
  • Low white infection fighting cells
  • Low platelets used for clotting
  • Lab changes include liver GGT and ALT increases, high or low blood sugar, low calcium, low potassium which can cause fatal heart arrhythmias, and a low sodium.
  • Stiff muscles
  • Agitation
  • Speech changes
  • Worse seizures
  • Delirium,
  • Muscle spasms
  • Abnormal reflexes
  • Psychosis
  • Eye muscle dysfunction
  • Paranoid
  • Asthma
  • Shortness of breath
  • Hair loss
  • Cataracts
  • Bleeding in the eye
  • Eye swelling
  • Dangerous constant erection
  • Kidney stones
  • Lupus
  • Deadly skin rashes such as Stevens-Johnson syndrome and Toxic epidermal necrolysis

Drug Interactions

Trileptal inhibit the liver removal of carbamazepine, erythromycin, cimetidine, and propoxyphene. For simplicity, it should be assumed that this medication changes the levels in the blood of ALL other seizure medications. So doses should be re evaluated. Dihydropyridine calcium antagonists and some oral contraceptives can decrease with this medication, for example, ethinylestradiol and levonorgestrel concentrations. Therefore, this medication may make your oral birth control fail, and you should consider at least one other highly effective back upon option. Phenytoin concentrations with this medication can increase up to 40%.

Trileptal can inhibit CYP2C19

Trileptal can induce CYP3A4/5

So your doctor's should look up all of your medications and see if they use either of these metabolism enzyme paths.

To your health,

Dr. J

Bank Towers, Tamiami Trail, Naples, FL
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