Finlepsin retard - instructions for use, 200 mg and 400 mg, reviews, price

Release form and composition

Finlepsin retard is produced in the form of tablets of prolonged action: from white with a yellow tint to white, flat, rounded, the edges of the tablets are beveled, on each side there is a cross-shaped dividing line, on the side surface - 4 notches (10 pieces each in blisters, in a cardboard pack of 3, 4 or 5 blisters).

1 tablet contains:

active ingredient: carbamazepine – 200 or 400 mg;
auxiliary components: triacetin, Eudragit RS30D copolymer [methyl methacrylate, ethyl acrylate and trimethylammonioethyl methacrylate (1:2:0.1)], Eudragit L30D-55 copolymer (ethyl acrylate, methacrylic acid), crospovidone, colloidal silicon dioxide, microcrystalline cellulose, magnesium stearate, talc .

Analogues of the drug according to ATC codes:

ZEPTOL CARBAMAZEPINE TEGRETOL TEGRETOL CR FINLEPSIN FINLEPSIN RETARD

Before using the drug FINLEPSIN RETARD, you should consult your doctor. These instructions for use are for informational purposes only. For more complete information, please refer to the manufacturer's instructions.

Pharmacological properties

Pharmacodynamics

Carbamazepine, the active substance of Finlepsin retard, is a derivative of dibenzazepine. Providing an antiepileptic effect, it exhibits antipsychotic, antidepressant and antidiuretic activity, and provides an analgesic effect in patients with neuralgia.

The mechanism of action of carbamazepine is due to the blockade of voltage-dependent sodium channels, causing stabilization of the membrane of overexcited neurons, inhibition of the appearance of serial neuronal discharges and a decrease in synaptic conduction of impulses. Prevents the re-formation of sodium-dependent action potentials in depolarized neurons. The likelihood of developing an epileptic seizure is reduced due to an increase in the seizure threshold caused by a decrease in the release of monosodium glutamate, an increase in the transport of potassium ions and modulation of voltage-gated calcium channels.

The use of carbamazepine is effective in the treatment of the following types of epilepsy: simple and complex partial (focal) epileptic seizures, which are accompanied or not accompanied by secondary generalization, generalized tonic-clonic epileptic seizures, and a combination of these two types of seizures. Finlepsin retard is ineffective for minor seizures of epilepsy, absence seizures, and myoclonic seizures.

In patients with epilepsy, Finlepsin retard has a positive effect on symptoms of anxiety and depression, especially in children and adolescents, and a decrease in the incidence of aggression and irritability. The degree of effect on psychomotor performance and cognitive function depends on the dose of carbamazepine.

The period before the onset of the anticonvulsant effect can range from several hours to several days.

With trigeminal neuralgia, it often prevents painful attacks; the existing pain syndrome can be relieved within 1/3–3 days.

In alcohol withdrawal syndrome, it helps to increase the reduced threshold of convulsive readiness and reduce the severity of its clinical signs (including increased excitability, tremor, gait disturbances).

For psychotic (manic) disorders, the therapeutic effect is achieved after 7–10 days.

The prolonged action of the tablets maintains a more stable concentration of carbamazepine in the blood when using a daily dose divided into 1-2 doses.

Pharmacokinetics

After taking the tablet, carbamazepine is slowly but almost completely absorbed from the gastrointestinal tract. Food intake does not have a significant effect on the speed and degree of its absorption.

The maximum concentration (Cmax) of the active substance in the blood plasma is achieved 32 hours after a single dose. The average Cmax of unchanged carbamazepine when taking Finlepsin retard 400 mg is approximately 0.0025 mg/ml.

Css (equilibrium plasma concentration) is achieved after 7–14 days of regular use of the drug. The rate at which Css is achieved is influenced by individual metabolic characteristics: the patient’s condition, the dose and duration of drug use, autoinduction of liver enzyme systems, heteroinduction by other means of concomitant therapy. In the therapeutic range, the Css value can fluctuate in most patients from 0.004 to 0.012 mg/ml (17–50 µmol/l). The pharmacologically active metabolite of carbamazepine is carbamazepine-10,11-epoxide, its concentration is approximately 30% of the level of carbamazepine.

Binding to blood plasma proteins: adults – 70–80%, children – 55–59%.

The estimated Vd (volume of distribution) is 0.8–1.9 L/kg. The concentration level of the active substance in saliva and cerebrospinal fluid is 20–30% of the dose taken, it corresponds to the amount of carbamazepine not bound to plasma proteins.

Carbamazepine crosses the placental barrier, its concentration in breast milk reaches 60% of its total level in blood plasma.

In the liver, it is metabolized via the epoxide pathway (mainly), with the formation of an active metabolite - carbamazepine-10,11-epoxide - and an inactive compound with glucuronic acid. The biotransformation of carbamazepine into carbamazepine-10,11-epoxide is ensured by the CYP3A4 isoenzyme. The metabolite 9-hydroxy-methyl-10-carbamoylacridan formed as a result of metabolic reactions has insignificant pharmacological activity. Carbamazepine tends to induce its own metabolism.

After oral administration of a single dose, T1/2 (half-life) ranges from 60 to 100 hours. Autoinduction of liver enzyme systems during long-term therapy leads to a decrease in T1/2.

72% of the dose taken is excreted through the kidneys (of which about 2% unchanged and about 1% as an active metabolite), through the intestines - 28%.

There is no information confirming changes in the pharmacokinetics of carbamazepine in elderly patients.

pharmachologic effect

Anticonvulsant (dibenzazepine derivative). It also has antidepressant, antipsychotic, antimanic and antidiuretic effects, and has an analgesic effect in patients with neuralgia. The mechanism of action is associated with the blockade of voltage-dependent sodium channels, which leads to stabilization of the membrane of overexcited neurons, inhibition of the occurrence of serial neuronal discharges and a decrease in synaptic conduction of impulses. Prevents the repeated formation of Na+-dependent action potentials in depolarized neurons. Reduces the release of glutamate (an amino acid with excitatory neurotransmitter properties), increases the reduced threshold of convulsive readiness and, thus, reduces the risk of developing an epileptic attack. Increases the transport of potassium ions, modulates voltage-dependent calcium channels, which may also contribute to the anticonvulsant effect of the drug.

Effective for focal (partial) epileptic seizures (simple and complex), accompanied or not accompanied by secondary generalization, for generalized tonic-clonic epileptic seizures, as well as for a combination of these types of seizures (usually ineffective for petit mal, absence seizures and myoclonic seizures).

In patients with epilepsy (especially children and adolescents), a positive effect on symptoms of anxiety and depression, as well as a decrease in irritability and aggressiveness, was noted. The effect on cognitive function and psychomotor performance is dose dependent.

The onset of the anticonvulsant effect varies from several hours to several days (sometimes up to 1 month due to autoinduction of metabolism).

In case of essential and secondary neuralgia of the trigeminal nerve, in most cases it prevents the occurrence of painful attacks. Pain relief from trigeminal neuralgia is observed after 8-72 hours.

In alcohol withdrawal syndrome, it increases the threshold of convulsive readiness (which is usually reduced in this condition) and reduces the severity of the clinical manifestations of the syndrome (increased excitability, tremor, gait disturbances).

The antipsychotic (antimanic) effect develops after 7-10 days, which may be due to inhibition of the metabolism of dopamine and norepinephrine.

Indications for use

primary generalized (except absence seizures) and secondary generalized epileptic seizures;
simple and complex types of seizures in partial form of epilepsy;
epileptiform seizures in multiple sclerosis;
paroxysmal paresthesia and attacks of pain;
tonic convulsions;
idiopathic glossopharyngeal neuralgia;
trigeminal neuralgia;
spasms of the facial muscles with trigeminal neuralgia;
paroxysmal dysarthria and ataxia;
pain due to damage to peripheral nerves caused by diabetes mellitus;
pain syndrome in diabetic neuropathy;
alcohol withdrawal syndrome, accompanied by increased excitability, anxiety, convulsions, and sleep disturbances;
psychoses, affective and schizoaffective disorders, functional disorders of the limbic system.

Contraindications

AV (atrioventricular) block;
acute intermittent porphyria (including medical history);
disorders of bone marrow hematopoiesis (leukopenia, anemia);
combination with monoamine oxidase inhibitors (MAO) and lithium preparations;
age up to 6 years;
hypersensitivity to tricyclic antidepressants;
individual intolerance to the components of the drug.

Finlepsin retard should be prescribed with caution in case of decompensated chronic heart failure, impaired renal and/or liver function, prostatic hyperplasia, increased intraocular pressure, chronic alcoholism, dilution hyponatremia (hypothyroidism, antidiuretic hormone hypersecretion syndrome, adrenal insufficiency, hypopituitarism), combinations with sedatives and hypnotics, treatment of elderly patients, in case of suppression of bone marrow hematopoiesis when taking medications (history), during pregnancy and lactation.

Contraindications to the use of the drug Finlepsin retard

bone marrow damage, suppression of bone marrow function in the patient's medical history;
AV block;
known hypersensitivity to carbamazepine, tricyclic antidepressants or other components of the drug;
acute intermittent porphyria;
concomitant treatment with an MAO inhibitor;
concomitant treatment with voriconazole, as it may cause treatment failure;
children under 6 years of age.

In the following cases, Finlepsin retard should be prescribed only after a thorough study of the potential benefits of using the drug compared to the likely risks:

any current or past diseases of the hematopoietic system, any reactions from the blood system to other medications in the patient’s history;
disturbance of sodium metabolism;
serious functional disorders of the heart, liver and kidneys;
myotonic dystrophy, since with this disorder there is often a disturbance in cardiac conduction.

Instructions for use of Finlepsin retard: method and dosage

Finlepsin retard tablets 200 mg or 400 mg are taken orally during or after meals and washed down with a sufficient amount of water, juice or other liquid.

If necessary, preliminary dissolution of the dose of the drug in liquid is allowed; its pharmacological properties are not affected.

The daily dose is divided into 1–2 doses. The maximum daily dose is 1.6 g.

Recommended daily dosage:

treatment of epilepsy. Adults: the initial dose (single dose in the evening) is 0.2–0.4 g, the dose should be gradually increased until a dose is reached that provides the optimal therapeutic effect in the patient. The maintenance dose range is 0.8–1.2 g. It is divided into 2 doses: in the morning – 0.2–0.6 g, in the evening – 0.4–0.6 g. Children: initial dose for children 6–15 years (once, in the evening) – 0.2 g, the dose is gradually increased (0.1 g per day) until the optimal effect is achieved. The maintenance dose for children 6–10 years old is 0.4–0.6 g, divided into 2 doses in the following proportion: in the morning – 0.2 g and in the evening – 0.2–0.4 g. Maintenance dose for children aged 11–15 years is 0.6–1 g: in the morning – 0.2–0.4 g, in the evening – 0.4–0.6 g. The duration of therapy depends on the clinical condition of the patient and individual tolerability of the drug . It is preferable to prescribe Finlepsin retard in the form of monotherapy. The drug should be introduced gradually into existing antiepileptic therapy, adjusting the dose of concomitant drugs if necessary. If you miss the next dose, you can take it if this does not correspond to the simultaneous administration of a double dose of the drug. The doctor makes the decision to transfer the patient to treatment with Finlepsin retard, duration of use or discontinuation of therapy with the drug individually. The dose can be reduced or discontinued only if there is complete absence of seizures for 2–3 years. Treatment is stopped for 1–2 years, gradually reducing the dose under the control of electroencephalography. In children, when reducing the daily dose, it is necessary to take into account the age-related increase in body weight;
epileptiform seizures in multiple sclerosis: 0.2–0.4 g;
Trigeminal neuralgia and idiopathic glossopharyngeal neuralgia: the initial dose is 0.2–0.4 g, its increase is indicated until the pain completely disappears. The maximum daily dose is 0.8 g. The maintenance dose is usually 0.4 g. The initial dose in elderly patients or with individual sensitivity to the effects of carbamazepine should be 0.2 g 1 time per day;
pain syndrome in diabetic neuropathy: 0.2 g in the morning and 0.4 g in the evening. In exceptional cases, to achieve a therapeutic effect, the administration of Finlepsin retard in the morning and evening at a dose of 0.6 g is indicated;
treatment of alcohol withdrawal syndrome in a hospital setting: usually - 0.6 g (0.2 g in the morning and 0.4 g in the evening), in severe cases - 1.2 g during the first few days. The drug can be combined with other drugs used to treat alcohol withdrawal. Finlepsin retard should not be combined with sedatives and hypnotics. Careful monitoring of the patient's mental state should be ensured. Treatment must be accompanied by regular monitoring of the level of carbamazepine in the blood plasma;
psychoses (treatment and prevention): initial and maintenance dose – 0.2–0.4 g. Maximum daily dose – 0.8 g.

Finlepsin price, where to buy

The price of Finlepsin tablets in different regions of Russia differs slightly. At the same time, you can buy Finlepsin 200 mg, 50 pieces each, for 215-270 rubles. The price of Finlepsin retard (400 mg, etc.) varies between 260-330 rubles.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

ZdravCity

Finlepsin Retard tablets 200 mg 50 pcs. Teva Operations Poland Sp.z.
o.o. 171 rub. order
Finlepsin tablets 200 mg 50 pcs. Teva Operations Poland Sp.z. o.o
RUB 198 order

Pharmacy Dialogue

Finlepsin tablets 200 mg No. 50Teva
RUB 229 order
Finlepsin retard tablets 200 mg No. 50Teva
186 RUR order
Finlepsin retard tablets 400 mg No. 50Teva
RUB 287 order

Pharmacy24

Finlepsin retard 200 mg No. 50 tablets TOV Teva Operations Poland, Poland
416 UAH. order
Finlepsin 200 mg No. 50 tablets TOV Teva Operations Poland, Poland
370 UAH. order
Finlepsin 400 mg N50 tablets TOV Teva Operations Poland, Poland
528 UAH order

PaniPharmacy

Finlepsin retard tablets Finlepsin retard tablets 200 mg No. 50 Poland, Pliva Krakow
363 UAH. order
Finlepsin tablets Finlepsin tablets 200 mg No. 50 Poland, Teva Operations Poland
270 UAH. order

Side effects

from the immune system: often – urticaria; sometimes - angioedema, various combinations of manifestations of multiorgan delayed-type hypersensitivity reactions (fever, skin rashes, vasculitis, erythema nodosum, erythroderma, lymphadenopathy, signs of lymphoma, arthralgia, leukopenia, eosinophilia, hepatosplenomegaly, changes in indicators of liver, kidney, lung, pancreas function , myocardium and/or colon, aseptic meningitis with myoclonus and peripheral eosinophilia, allergic pneumonitis (eosinophilic pneumonia), anaphylactoid reaction; rarely - skin itching, lupus-like syndrome, photosensitivity, exudative erythema multiforme (including Stevens-Johnson syndrome), Lyell's syndrome ( toxic epidermal necrolysis);
from the nervous system: often - drowsiness, dizziness, general weakness, headache, accommodation paresis, ataxia; sometimes – abnormal involuntary movements (including tics, dystonia, tremor, fluttering tremor), nystagmus; rarely - decreased appetite, visual or auditory hallucinations, anxiety, disorientation, aggressive behavior, orofacial dyskinesia, psychomotor agitation, depression, activation of psychosis, eye movement disorders, speech disorders (including dysarthria, slurred speech), peripheral neuritis, choreoathetoid disorders, paresthesias, muscle weakness, paresis;
from the hematopoietic system: often – thrombocytopenia, leukopenia, eosinophilia; rarely - folic acid deficiency, leukocytosis, lymphadenopathy, agranulocytosis, true erythrocyte aplasia, aplastic anemia, megaloblastic anemia, reticulocytosis, acute intermittent porphyria, splenomegaly, hemolytic anemia;
from the cardiovascular system: rarely - impaired blood pressure, bradycardia, arrhythmias, intracardiac conduction disorders, AV block with fainting, exacerbation or development of chronic heart failure, collapse, development or increased frequency of angina attacks, exacerbation of coronary heart disease, thromboembolic syndrome, thrombophlebitis ;
from the digestive system: often - dry mouth, nausea, vomiting, increased activity of gamma-glutamyltransferase, increased activity of alkaline phosphatase; sometimes – abdominal pain, diarrhea or constipation, increased activity of liver enzymes; rarely - stomatitis, glossitis, gingivitis, pancreatitis, jaundice, hepatitis (granulomatous, cholestatic, parenchymal), liver failure;
from the metabolism and endocrine system: often - fluid retention, edema, weight gain, hyponatremia; rarely - dilution hyponatremia (accompanied by vomiting, headache, neurological disorders, lethargy, disorientation), increased prolactin levels, galactorrhea, gynecomastia, decreased levels of levothyroxine sodium (L-thyroxine), increased concentrations of thyroid-stimulating hormone (usually without clinical manifestations), hirsutism, disturbance of calcium-phosphorus metabolism in bone tissue (osteomalacia, enlarged lymph nodes, hypertriglyceridemia, hypercholesterolemia, including high-density lipoprotein cholesterol);
from the musculoskeletal system: rarely - convulsions, arthralgia, myalgia;
from the genitourinary system: rarely - decreased potency, frequent urination, interstitial nephritis, albuminuria, hematuria, oliguria, increased urea concentration (azotemia), other kidney pathologies, renal failure, urinary retention;
from the senses: rarely - disturbance of taste, increased intraocular pressure, clouding of the lens, conjunctivitis, hearing impairment (including tinnitus, changes in the perception of pitch, hyperacusis, hypoacusia);
dermatological reactions: sweating, acne, skin pigmentation disorders, alopecia, purpura.

Side effects of the drug Finlepsin retard

The side effects that were observed occurred more frequently with combination treatment than with monotherapy. Depending on the dose and mainly at the beginning of treatment, certain side effects may occur. In general, they disappear on their own after 8–14 days or after a temporary dose reduction. From the central nervous system and psyche Confusion, drowsiness, dizziness, fatigue, impaired coordination of movements (cerebellar ataxia) and headache may often occur. Elderly patients may experience confusion and restlessness. In isolated cases, depressive mood, aggressive behavior, slowness of thinking, decreased motivation, as well as perception disorders (hallucinations) and tinnitus are noted. When treated with Finlepsin retard, latent psychoses may become more active. Rarely, involuntary movements such as large-scale tremors, muscle contractions, or nystagmus occur. In addition, in elderly patients with brain damage, involuntary movements in the maxillofacial area may occur in the form of grimacing (maxillofacial dyskinesia), rotational movements (choreoathetosis), neuroleptic malignant syndrome, and polyneuropathy. Isolated cases of speech impairment, false sensations, muscle weakness, neuritis (peripheral neuritis), as well as paralysis of the lower limbs (paresis) and taste disturbances have been reported. On the part of the organ of vision In some cases, inflammation of the mucous membrane of the eye (conjunctivitis) occurs, sometimes developing into visual disturbances (impaired accommodation, double vision, blurred images), increased intraocular pressure. There have been reports of cases of lens opacity. Retinotoxicity was detected in 2 patients after prolonged therapy with carbamazepine. After stopping carbamazepine, the severity of these phenomena decreased significantly. From the organ of hearing: Decreased hearing, increased auditory perception, impaired perception of pitch. From the musculoskeletal system In isolated cases, arthralgia, myalgia, and muscle spasms were noted. These phenomena disappeared after stopping the drug. On the skin There have been reports of cases of allergic reactions from the skin with or without fever, for example, urticaria, pruritus, sometimes large lamellar or scaly inflammation of the skin (exfoliative dermatitis, erythroderma), Lyell's syndrome, photosensitivity, exudative erythema multiforme, erythema nodosum, Stevens syndrome - Johnson), petechial hemorrhages in the skin and disseminated lupus erythematosus). In isolated cases, hair loss (alopecia) and sweating (diaphoresis), changes in skin pigmentation, acne, hirsutism and vasculitis were noted. From the circulatory and lymphatic system When treated with Finlepsin retard, hemogram disorders may occur: leukocytosis, eosinophilia or leukopenia, thrombocytopenia. According to the literature, the most common form of leukopenia occurs benign (transient in approximately 10% of cases, and permanent in 2% of cases). There are isolated cases of blood diseases, sometimes life-threatening, such as agranulocytosis, aplastic anemia along with other forms of anemia (hemolytic, megaloblastic), reticulocytosis, pancytopenia, erythrocyte aplasia, as well as enlargement of the spleen and lymph nodes. As a rule, this occurs in the first 4 months of treatment. From the gastrointestinal tract Sometimes - loss of appetite, dry mouth, nausea and vomiting, rarely diarrhea or constipation. Isolated cases of abdominal pain and inflammation of the mucous membrane of the nasopharynx (stomatitis, gingivitis, glossitis) are known. There are indications in the literature that carbamazepine can sometimes cause pancreatitis. From the liver and gallbladder Sometimes changes in liver function test parameters are noted, in some cases jaundice occurs, in isolated cases - various forms of hepatitis (cholestatic, hepatocellular, granulomatous, mixed). In isolated cases, acute hepatitis with liver failure developed in the first few months against the background of allergic manifestations. Hormonal and water-salt metabolism Individual cases of enlarged mammary glands in men (gynecomastia) and spontaneous leakage of milk from the mammary glands in women (galactorrhea) have been reported. Finlepsin retard can affect indicators of thyroid function (triiodothyronine, thyroxine, thyroid-stimulating hormone and free thyroxine), especially when combined with other antiepileptic drugs. The most common side effect was hyponatremia, sometimes accompanied by fluid retention, weight gain, and decreased plasma osmotic concentration. In very rare cases, this has resulted in water intoxication with vomiting, headache, confusion, drowsiness and other neurological disorders. Individual cases of edema and weight gain have been observed. Finlepsin retard may reduce serum calcium levels. In isolated cases, this leads to softening of the bones (osteomalacia). In extremely rare cases, cholesterol levels may increase, including HDL cholesterol and TG, as well as free cortisol in the blood serum. Carbamazepine may reduce serum folate levels. A decrease in serum vitamin B12 levels and an increase in homocysteine levels have also been reported under the influence of carbamazepine. In two cases, acute intermittent porphyria occurred. On the part of the respiratory system, isolated disorders have been described, which were accompanied by fever, shortness of breath (dyspnea), inflammation and the development of pulmonary fibrosis. From the genitourinary system Rarely, renal dysfunction occurs, which is manifested by proteinuria, hematuria, oliguria, interstitial nephritis, in isolated cases they develop into renal failure. Perhaps these disorders are due to the drug's own antidiuretic effect. Sometimes dysuria, polakiuria and urinary retention occur. In addition, there are known cases of sexual disorders, such as impotence, decreased libido, and impaired spermatogenesis. From the cardiovascular system Very rarely, mainly in elderly people or in patients with impaired heart function, bradycardia, cardiac arrhythmias, congestive heart failure, circulatory collapse, as well as worsening of coronary heart disease may occur. Disturbances in the conduction of excitation in the myocardium (AV blockade) are rarely observed, which is occasionally accompanied by fainting conditions. In addition, in some cases, significant fluctuations in blood pressure are detected. A drop in blood pressure mainly occurs when the drug is used in high doses. Vasculitis, thrombophlebitis and thromboembolism were also observed. Hypersensitivity reactions Rarely, delayed-type hypersensitivity reactions to the drug develop, accompanied by fever, skin rash, swollen lymph nodes, joint pain, leukocytosis, enlarged liver and spleen, changes in liver function tests, with involvement of other organs, such as the lungs, kidneys, pancreas and myocardium. In isolated cases, an acute generalized reaction and aseptic meningitis with manifestations of myoclonus, eosinophilia, anaphylactic reactions and angioedema were observed.

Overdose

Symptoms: nausea, vomiting, slower evacuation of stomach contents, decreased colonic motility; depression of the function of the central nervous system, drowsiness, agitation, disorientation, hallucinations, coma; hypothermia, blurred vision, slurred speech, nystagmus, dysarthria, ataxia, dyskinesia, hyperreflexia alternating with hyporeflexia, psychomotor disorders, convulsions, myoclonus, mydriasis; decrease (less often - increase) in blood pressure, tachycardia, fainting, intraventricular conduction disturbances with widening of the QRS complex, cardiac arrest, respiratory depression, pulmonary edema, fluid retention in the body, rare urination, oliguria or anuria. Changes in laboratory parameters: decrease or increase in the number of leukocytes in the blood, hyponatremia, possibly metabolic acidosis, increased muscle fraction of creatine phosphokinase, hyperglycemia, glucosuria.

Treatment: there is no specific antidote, therefore it is necessary to prescribe symptomatic supportive therapy in the intensive care unit - immediate gastric lavage, administration of activated charcoal, determination of the level of carbamazepine concentration in the blood plasma (in order to confirm drug poisoning and assess the degree of overdose); monitoring heart function, body temperature, kidney and bladder function, corneal reflexes, correction of electrolyte disorders. Delayed absorption with delayed evacuation of gastric contents can cause re-occurrence of symptoms of intoxication.

The use of hemodialysis, peritoneal dialysis or forced diuresis for the purpose of detoxification is ineffective. Dialysis is indicated for patients with renal failure. In children, blood transfusion may be used to treat an overdose.

Overdose of the drug Finlepsin retard, symptoms and treatment

An overdose of the drug requires urgent medical intervention. The picture of an overdose of the drug Finlepsin retard is characterized by an increase in side effects such as trembling (tremor), convulsive seizures that occur when the brain is excited (tonic-clonic seizures), agitation, as well as impaired breathing and function of the cardiovascular system with often reduced (sometimes also elevated) blood pressure, tachycardia and conduction dysfunction (AV block, ECG changes), cardiac arrest, accompanied by loss of consciousness and respiratory depression. The following may occur: dizziness, ataxia, drowsiness, stupor, nausea, vomiting, agitation, confusion, involuntary movements, dilated pupils, nystagmus, flushing, urinary retention, cyanosis, opisthotonus, abnormal reflexes (weakening or strengthening of reflexes). In isolated cases, leukocytosis, leukopenia, neutropenia, glucosuria or acetonuria were observed. When assessing intoxication, it is necessary to take into account the possibility of multiple intoxication with other pharmacological drugs that could be used for suicidal purposes. Intoxication with carbamazepine occurs mainly when taken in very high doses from 4 to 10 g. The level of the drug in the blood plasma is more than 20 mcg/ml. People have survived after intentionally or accidentally taking high doses of carbamazepine that produced plasma concentrations of 38 mcg/mL. There is no specific antidote for the treatment of acute poisoning with Finlepsin retard. Treatment for overdose with Finlepsin retard is usually carried out depending on the severity of poisoning in a hospital setting. In case of overdose, treatment is symptomatic: if possible, quickly remove the toxic substance from the stomach by inducing vomiting and/or gastric lavage, as well as using activated charcoal and laxatives. For convulsive attacks, anticonvulsants may be used. It is not recommended to prescribe barbiturates due to respiratory depression, especially in children. Due to the high binding of carbamazepine to blood proteins, forced diuresis, as well as hemodialysis or peritoneal dialysis are ineffective

special instructions

The degree of influence of carbamazepine on the development of neuroleptic malignant syndrome, especially when combined with antipsychotics, has not been established.

The development of side effects from the central nervous system can be caused by a relative overdose of the drug or significant fluctuations in the level of carbamazepine concentration in the blood plasma.

Finlepsin retard can be prescribed only if a doctor regularly monitors the patient’s condition.

While using the drug, there is a risk of suicidal attempts or intentions, the mechanism of which is unknown. Patients, their loved ones and staff should be informed of this and that if symptoms of suicidal behavior occur, they should immediately seek medical help.

To select an individual initial and maintenance dose that provides the optimal effect, it is advisable to determine the level of carbamazepine in the blood plasma, especially when prescribing Finlepsin retard as part of combination therapy, since with accelerated metabolism caused by the induction of microsomal liver enzymes or the interaction of concomitantly used drugs, the patient may require a dose significantly different from the recommended dose.

Sudden withdrawal of Finlepsin retard can cause an epileptic attack, therefore, if it is necessary to abruptly interrupt therapy, the patient should be transferred to another antiepileptic drug under the cover of intravenous (IV) or rectal administration of diazepam, phenytoin (IV) or another drug indicated in such cases.

Alcohol consumption is contraindicated while using the drug.

The transition to carbamazepine treatment is made by gradually reducing the dose of the previously taken antiepileptic drug.

Women of reproductive age should not use hormonal oral contraceptives as they do not provide reliable contraception and may cause intermenstrual bleeding.

Taking tablets must be accompanied by regular monitoring of liver function indicators, especially in elderly people and patients with a history of liver disease. If severe liver disease develops, Finlepsin retard should be discontinued immediately.

When prescribing the drug, during the first 4 weeks of treatment, weekly and then once every 4 weeks, it is necessary to conduct a blood test to determine the number of platelets, reticulocytes, iron levels, urea and electrolyte concentrations in the blood serum. In addition, a general urine test and electroencephalography are required.

Treatment should be discontinued in case of leukopenia with clinical symptoms of infectious pathology or progressive leukopenia.

The appearance of mild skin reactions in the form of an isolated macular or maculopapular rash usually does not require discontinuation of Finlepsin retard; the symptoms go away on their own, including after lowering the dose of the drug. During this period, the patient needs medical supervision. If a hypersensitivity reaction or symptoms of Stevens-Johnson syndrome or Lyell's syndrome occur, taking the tablets should be stopped.

The physician should inform the patient about the possible development of toxic reactions, the manifestation of which early signs may include fever, rash, sore throat, ulceration of the oral mucosa, bruising, hemorrhage or purpura. For timely diagnosis of these symptoms, you must consult a doctor.

Before starting treatment, the patient is recommended to undergo an ophthalmological examination, including measurement of intraocular pressure and fundus examination. If intraocular pressure is elevated, it must be constantly monitored when taking carbamazepine.

For severe diseases of the cardiovascular system, liver and (or) kidney damage, as well as for elderly people, it is recommended to use Finlepsin retard in reduced doses.

Regular determination of the level of carbamazepine in plasma is advisable if there is a suspicion of impaired absorption, to monitor the patient’s regularity of taking the drug, with a sharp increase in attacks, during pregnancy, when treating children, or if signs of toxic reactions appear.

Special instructions for the use of the drug Finlepsin retard

Since Finlepsin retard can provoke new or intensify existing special forms of seizures (so-called absence seizures), it is not recommended for use in patients with such forms of seizures. Finlepsin retard should not be used simultaneously with MAO inhibitors. Therapy with MAO inhibitors is stopped no later than 14 days before starting treatment with Finlepsin retard. For elderly patients, Finlepsin retard is prescribed in lower doses. Due to the possible occurrence of side effects, as well as hypersensitivity reactions to the drug, it is recommended (especially with prolonged use) to periodically monitor the hemogram and check the function of the liver and kidneys. This is done before the start of treatment, then during the 1st month of treatment - once a week, and after that - once a month. After the first 6 months of therapy, this control is carried out 2–4 times a year. In the following cases, careful monitoring of the patient's condition is necessary: fever, infections, skin rash, general weakness, sore throat, ulcers on the oral mucosa, easy appearance of hematomas, increased levels of liver transaminases, decreased leukocytes 3000/mm3 and granulocytes below 1500/mm3, decreased platelets below 125,000/mm3, an increase in the level of iron in the blood serum over 150 mcg%, a decrease in reticulocytes below 0.3% = 20,000/mm. Carbamazepine should be discontinued if the red blood cell count decreases below 4 million/mm3, with petechial or purpuric hemorrhages, hematocrit decreases below 32%, hemoglobin decreases below 11 g%, leukocytes decreases below 2000/mm3, granulocytes below 1000/mm3 and platelets below 80 000 mm3, for symptomatic hematopoietic disorders. You should also regularly monitor the concentration of the drug Finlepsin retard and other antiepileptic drugs in the blood plasma during combination therapy and, if necessary, reduce the daily dose. Termination of therapy with Finlepsin retard in patients with epilepsy and transferring them to other antiepileptic drugs is not carried out suddenly, but by gradually reducing its dose. In patients with glaucoma, intraocular pressure is regularly monitored. It is necessary to take into account that the side effects of the drug Finlepsin retard can be similar to withdrawal symptoms in alcoholism. If, in exceptional cases, for the prevention of manic-depressive phases when only lithium preparations are insufficiently effective, Finlepsin retard is prescribed in combination with them, in order to prevent unwanted interactions, it is necessary to ensure that a certain concentration of carbamazepine in the blood plasma (8 mcg/ml) is not exceeded, the lithium content is maintained in the low therapeutic range (0.3–0.8 mEq/L), treatment with antipsychotics was carried out more than 8 weeks ago, and do not allow it to be carried out simultaneously. If a patient develops symptoms such as fever, sore throat or allergic skin reactions in the form of a skin rash with swollen lymph nodes or flu-like symptoms during treatment with Finlepsin retard, a blood test is necessary. If serious allergic reactions are detected, the use of Finlepsin retard should be stopped immediately. Finlepsin retard should not be combined with sedative-hypnotics. However, according to clinical requirements, if necessary, Finlepsin retard can be combined with other substances used to treat alcohol withdrawal. During therapy, it is necessary to regularly monitor the content of the drug Finlepsin retard in the blood plasma. Due to the development of side effects from the central nervous system and the autonomic nervous system, patients are carefully monitored. During treatment with carbamazepine, patients should avoid exposure to the sun to prevent the risk of photosensitivity. When switching from the immediate release dosage form to Finlepsin retard extended release tablets, ensure that an equivalent serum level of carbamazepine is achieved. Simultaneous administration of carbamazepine with grapefruit juice leads to an increase in the level of carbamazepine in the blood plasma, therefore Finlepsin retard should not be taken with grapefruit juice. Use during pregnancy and lactation The use of the drug during pregnancy in patients with epilepsy requires special attention. If a woman receiving Finlepsin retard has established or is planning a pregnancy, or during pregnancy there is a need to use the drug, the potential benefits of using the drug should be carefully weighed against the potential risk (especially in the first trimester of pregnancy). If possible, Finlepsin retard should be prescribed to women of reproductive age as monotherapy, since the incidence of congenital malformations in children whose mothers received combination therapy with antiepileptic drugs is higher than in children whose mothers received monotherapy. It is recommended to prescribe the drug in the minimum effective doses and monitor the level of carbamazepine in the blood plasma. Patients should be informed of the possible increased risk of developing birth defects and should be given the opportunity for antenatal screening. It is known that folic acid deficiency may develop during pregnancy. Antiepileptic drugs may increase folic acid deficiency. This may lead to an increased incidence of birth defects in children whose mothers receive antiepileptic therapy. Therefore, supplemental use of folic acid before and during pregnancy is recommended. Carbamazepine passes into breast milk. The benefits of breastfeeding against the potential for long-term side effects in infants must be carefully weighed. Women receiving Finlepsin retard can breastfeed, provided that the baby is monitored for the development of possible adverse reactions (for example, excessive drowsiness, allergic skin reactions). Children. Due to the high content of active substance and insufficient experience with the use of extended-release tablets, Finlepsin retard should not be prescribed to children under 6 years of age. The ability to influence the reaction rate when driving vehicles or working with other mechanisms Due to side effects on the central nervous system, in particular dizziness, drowsiness and fatigue that occur at the beginning of treatment, after increasing the dose or when using a combination with other drugs acting on the central nervous system, Finlepsin retard, even when used correctly, can affect the response of patients (regardless of the effect on the underlying disease), significantly impairing the ability to drive vehicles and operate complex machinery. This effect is enhanced when combined with alcohol. While using the drug, you should not drive vehicles or operate other machinery.

Use during pregnancy and lactation

Caution should be exercised when prescribing Finlepsin retard during pregnancy and lactation.

It is preferable to prescribe the use of carbamazepine in women of reproductive age in the minimum effective dose as monotherapy, since the incidence of congenital pathologies in newborns is higher during combined antiepileptic treatment.

In the first trimester of pregnancy, the risk of intrauterine development disorders when taking Finlepsin retard is especially high, therefore, when confirming conception, it is necessary to assess the ratio of the benefits of therapy for the mother and the risk of possible diseases and malformations of the fetus, including spina bifida.

Carbamazepine increases folic acid deficiency, so its use should be started when planning pregnancy and continued throughout the entire period of gestation. This will reduce the risk of birth defects in children.

To prevent hemorrhagic complications in the fetus, it is necessary to take vitamin K in the last weeks of pregnancy, and after childbirth it is recommended to administer it to newborns.

Finlepsin retard passes into breast milk and can cause severe drowsiness, skin rashes of allergic etiology and other negative reactions in the child. Therefore, in the context of ongoing therapy, the safety of breastfeeding should be assessed and a decision made on its advisability.

Pharmacokinetics

Suction

When taking the drug orally, carbamazepine is slowly but almost completely absorbed from the gastrointestinal tract (food intake does not significantly affect the rate and extent of absorption).

After a single dose of 400 mg, Cmax is reached after 32 hours and averages about 2.5 mcg/ml.

Distribution

Css in plasma is achieved after 1-2 weeks of constant use (the rate of achievement depends on the individual characteristics of metabolism: autoinduction of liver enzyme systems, heteroinduction by other concomitantly used drugs, as well as on the patient’s condition, the dose of the drug and the duration of treatment). There are significant interindividual differences in the value of equilibrium concentrations in the therapeutic range: in most patients these values range from 4 to 12 μg/ml (17-50 μmol/l). Concentrations of carbamazepine-10,11-epoxide (a pharmacologically active metabolite) are approximately 30% of those of carbamazepine.

Plasma protein binding in children is 55-59%, in adults - 70-80%. Apparent Vd - 0.8-1.9 l/kg. In the cerebrospinal fluid and saliva, concentrations are created proportional to the amount of active substance not bound to proteins (20-30%). Penetrates the placental barrier and is excreted in breast milk (the concentration is 25-60% of that in blood plasma).

Metabolism

Metabolized in the liver, mainly along the epoxide pathway, with the formation of the main metabolites: active - carbamazepine-10,11-epoxide and inactive conjugate with glucuronic acid. The main isoenzyme that ensures the biotransformation of carbamazepine into carbamazepine-10,11-epoxide is isoenzyme 3A4 of cytochrome P450. As a result of these metabolic reactions, a low-active metabolite, 9-hydroxy-methyl-10-carbamoylacridan, is also formed. Can induce its own metabolism.

Removal

T1/2 after a single oral dose is 60-100 hours (on average about 70 hours); with prolonged use, T1/2 decreases due to autoinduction of liver enzyme systems. After a single oral dose, 72% of the dose taken is excreted in the urine and 28% in feces; while about 2% are excreted in the urine in the form of unchanged carbamazepine, about 1% - in the form of a 10,11-epoxide metabolite.

Pharmacokinetics in special clinical situations

There is no evidence that the pharmacokinetics of carbamazepine changes in elderly patients.

Drug interactions

With simultaneous use of Finlepsin retard:

inhibitors of the CYP3A4 isoenzyme: may increase the level of carbamazepine in the blood plasma and the development of adverse reactions;
inducers of the CYP3A4 isoenzyme: may cause an acceleration of the metabolism of carbamazepine and a decrease in its concentration in the blood plasma and the therapeutic effect. However, when they are canceled, the concentration of carbamazepine increases, since the rate of its biotransformation decreases;
MAO inhibitors: can cause the development of hyperthermic and hypertensive crises, convulsions, and lead to death, therefore the interval between their use should be at least two weeks;
lithium preparations: cause an increase in the neurotoxic effect of each drug;
verapamil, nicotinamide, diltiazem, desipramine, felodipine, danazol, dextropropoxyphene, acetazolamide, viloxazine, cimetidine, fluoxetine, fluvoxamine, macrolides - clarithromycin, josamycin, troleandomycin, erythromycin, azoles - fluconazole, itraconazole and ketoconazole, ENT atadine, terfenadine, isoniazid, grapefruit juice , propoxyphene, ritonavir and other protease inhibitors for the treatment of human immunodeficiency virus infection: increase the concentration of carbamazepine in the blood plasma, therefore monitoring the level of carbamazepine in the plasma or adjusting its dosage regimen is required;
valproic acid, primidone: displacing carbamazepine from association with plasma proteins, can contribute to an increase in the concentration of the pharmacologically active metabolite (carbamazepine-10,11-epoxide) and the development of severe side effects;
phenobarbital, primidone, phenytoin, methsuximide, fensuximide, rifampicin, theophylline, cisplatin, doxorubicin, clonazepam, valpromide, oxcarbazepine, valproic acid, preparations containing St. John's wort: may help reduce drug concentrations;
felbamate: causes a decrease in the level of carbamazepine and an increase in the content of carbamazepine-10,11-epoxide in the blood plasma, a simultaneous decrease in the concentration in the blood serum and the effect of felbamate is possible;
isotretinoin: alters the bioavailability and (or) clearance of carbamazepine, carbamazepine-10,11-epoxide;
phenothiazine, pimozide, thioxanthenes (chlorprothixene), molindone, haloperidol, maprotiline, clozapine, tricyclic antidepressants: weaken the anticonvulsant effect of the drug, increasing the inhibitory effect on the central nervous system;
clobazam, clonazepam, prednisolone, digoxin, ethosuximide, prednisolone, valproic acid, prednisolone, alprazolam, dexamethasone, cyclosporine, methadone, doxycycline, haloperidol, theophylline, oral contraceptives with estrogen and (or) progesterone, oral anticoagulants (warfarin, dicumarol, fenproc mon ), topiramate, lamotrigine, tricyclic antidepressants (amitriptyline, imipramine, clomipramine, nortriptyline), clozapine, oxcarbazepine, tiagabine, protease inhibitors - indinavir, ritonavir and saquinavir, levothyroxine, calcium channel blockers dihydropyridine derivatives (felodipine), midazolam, olanzapine, tramadol, praziquantel, risperidone, ziprasidone, itraconazole: reduce their plasma levels and their therapeutic effect;
tetracyclines: may weaken the therapeutic effect of carbamazepine;
myelotoxic drugs: cause increased hematotoxic manifestations of carbamazepine;
indirect anticoagulants, hormonal contraceptives, folic acid, praziquantel: accelerate their metabolism;
paracetamol: accelerates its metabolism, which leads to an increased risk of toxic effects on the liver and a decrease in the therapeutic effectiveness of paracetamol;
hydrochlorothiazide, furosemide (diuretics): contribute to the development of hyponatremia with clinical manifestations;
pancuronium and other non-depolarizing muscle relaxants: weaken their effect, their dose adjustment is required;
Thyroid hormones: may enhance elimination;
enflurane, halothane, fluorothane (anesthetics): accelerate their metabolism, increasing the risk of hepatotoxic effects;
methoxyflurane: increases the formation of its nephrotoxic metabolites;
isoniazid: enhances its hepatotoxic effect;
ethanol: aggravates its effect.

Interactions of the drug Finlepsin retard

Cytochrome P450 ZA4 (CYP ZA4) is the main enzyme that catalyzes the formation of the active metabolite carbamazepine-10, 11-epoxide. The simultaneous use of CYP3A4 inhibitors may cause an increase in the concentration of carbamazepine in the blood plasma, which in turn can lead to the development of adverse reactions. Concomitant use of CYP3A4 inducers may increase the metabolism of carbamazepine, leading to a potential decrease in carbamazepine serum concentrations and its therapeutic effect. Similarly, discontinuation of the CYP3A4 inducer may decrease the rate of carbamazepine metabolism, resulting in increased plasma levels of carbamazepine. Carbamazepine is a powerful inducer of CYP3A4, and therefore can reduce the concentration of other drugs in the blood plasma, which are predominantly metabolized by inducing their metabolism. Drugs that increase the level of carbamazepine in the blood plasma. Since an increase in the level of carbamazenin in the blood plasma can lead to adverse reactions, the dosage of the drug must be adjusted and/or monitored its level in the blood plasma when used simultaneously with the following drugs:

macrolide antibiotics: erythromycin, troleandomycin, yosamycin, clarithromycin;
anti-tuberculosis drugs: isoniazid;
affecting the cardiovascular system: verapamil, diltiazem; - carbonic anhydrase inhibitors: acetazolamide;
antidepressants: viloxazine, fluoxetine, nefazodone, desipramine and fluvoxamine, trazodone;
antifungals: itraconazole, ketoconazole, fluconazole;
antihistamines: terfenadine, loratadine;
drugs for the treatment of gastrointestinal diseases: cimetidine;
antiviral drugs: ritonavir.

Other substances: nicotinamide (in adults and only in high doses). Elevated levels of carbamazepine-10, 11-epoxide in blood plasma can cause dizziness, fatigue, unsteadiness of gait, and diplopia. The dosage of carbamazepine in the event of these symptoms should be adjusted accordingly and/or the level of the drug in the blood plasma should be monitored if Finlepsin retard is taken simultaneously with the following drugs: loxapine, quetiapine, primedone, progabide, valproic acid, valpromide. Effect of the drug Finlepsin retard on plasma levels when used in combination with other drugs Carbamazepine can reduce the levels of certain drugs in the blood plasma and reduce or neutralize their effects. Therefore, their dose must be adjusted according to clinical need. This applies to the following drugs:

other anticonvulsants: for example, clonazepam, ethosuximide, felbamate, primidom, lamotrigine, oxcarbazepine, tiagabine, topiramate, valproic acid. Under the influence of carbamazepine, the concentration of phenytoin in the blood plasma may increase or decrease. In exceptional cases, this can cause confusion and even coma;
benzodiazepines: alprazolam, clobazam;
typical antipsychotics: (haloperidol, bromperidol) and atypical antipsychotics (clozapine, olanzapine, risperidone, quetiapine);
tricyclic antidepressants: for example imipramine, amitriptyline, nortriptyline, clomipramine;
tetracyclic drugs: for example doxycycline;
azole-type antifungals: for example, voriconazole, itraconazole, since antifungals may cause ineffective treatment;
anthelmintic drugs: praziquantel;
antiviral drugs: indinavir;
analgesics, anti-inflammatory drugs: methadone, paracetamol, tramadol;
antibiotics: doxycycline;
anxiolytics: midazolam, alprazolam;
GCS (for example, prednisolone, dexamethasone), cyclosporines, tacrolimus;
anticoagulants (eg warfarin, phenprocoumon, dicumarol);
hormonal contraceptives.

In patients taking hormonal contraceptives, the effectiveness of contraception may decrease and intermenstrual bleeding may suddenly begin. Therefore, it is necessary to take oral contraceptives containing more than 50 mg of estrogen, or the use of other, non-hormonal methods of contraception can be recommended. Drugs that reduce the level of carbamazepine in the blood plasma. It may be necessary to adjust the dose of the drug when used in combination with the following drugs: - other anticonvulsants: phenobarbital, phenytoin, primidone, felbamate, methsuximide; - anti-tuberculosis drugs: rifampicin; - bronchodilators or anti-asthma drugs: theophylline, aminophylline; — antitumor drugs: doxorubicin, cisplatin; - other: preparations containing St. John's wort (Hypericum perforatum). Combinations of drugs that require separate consideration The combined use of lithium with carbamazepine may enhance the neurotoxic effect of both drugs. Therefore, it is necessary to carefully monitor serum levels of both substances. Patients should not take concomitant antipsychotics during the 8-week run-in period before prescribing carbamazepine, nor during treatment with carbamazepine. The following symptoms of neurotoxicity should be observed: unsteadiness of gait, ataxia, horizontal nystagmus, increased muscle proprioceptive reflexes, muscle twitching (muscle fasciculation). Information has been published in the literature that in patients taking carbamazepine in combination with antipsychotics, the risk of neuroleptic malignant syndrome and erythema maligna was increased. The combined use of Finlepsin retard with most diuretics (hydrochlorothiazide, furosemide) can cause symptomatic hyponatremia. Under the influence of Finlepsin retard, the effectiveness of muscle relaxants (for example, pancuronium bromide) may decrease. Therefore, patients taking muscle relaxants should be monitored and, if necessary, the dose of these drugs should be increased. In cases where Finlepsin retard is taken in combination with isotretinoin (an anti-acne drug), it is necessary to monitor the level of carbamazepine in the blood plasma. Carbamazepine may increase the excretion of thyroid hormone, resulting in an increased need for this hormone in patients with hypothyroidism. Therefore, at the beginning and at the end of treatment with Finlepsin retard, it is necessary to determine indicators of thyroid function in patients receiving hormone replacement therapy. If necessary, adjust the dose of the thyroid hormone drug. Thyroid function may change, especially when carbamazepine is combined with other anticonvulsants (in particular phenobarbital). Carbamazepine appears to accelerate the metabolism of zotepine.

Reviews of Finlepsin retard

Reviews about Finlepsin retard are mostly positive. They indicate the effective effect of the drug in the treatment of epilepsy, inflammation of the trigeminal nerve, and attacks of depression. Patients with epilepsy note that regular use of the pills helps prevent seizures (there are practically no seizures) and stabilizes mood. When treating inflammation of the trigeminal nerve, it perfectly relieves pain and helps to survive severe exacerbations of back pain.

The advantages of tablets include ease of breaking and affordable price.

In some patients, Finlepsin retard causes undesirable effects (fluid retention in the body, effects on the heart, hearing impairment, compression of the temples, etc.), sometimes requiring its discontinuation.

Patients who have extensive experience using Finlepsin retard report frequent cases of purchasing counterfeit packages of tablets. The disadvantages of the drug include addiction, which causes the need to increase the maintenance dose if long-term use is necessary, as well as poor combination with other anticonvulsants.

Finlepsin's analogs

The drug can be replaced with other antiepileptic drugs that exhibit a similar effect and have a similar composition. These include:

Actinerval is a normomimetic and anticonvulsant drug in tablet format;
Apo-Carbamazepine, Carbamazepine, Oxcarbazepine - an analogue of Finlepsin, in tablet form;
Zagretol - antiepileptic tablets;
Zeptol - regular and delayed-release tablets;
Carbalepsin retard – long-acting tablets;
Mazepine – sedative tablets, treat neuralgia;
Stazepin – antiepileptic tablets;
Storilat - divisible tablets from the group of mood stabilizers;
Tegretol - anticonvulsant tablets and syrup.