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Tegretol suspension in combination with liquid chlorpromazine or thioridazine results in precipitate formationandin the case of chlorpromazinethere has been a report of a patient passing an orange rubbery precipitate in the stool following coadministration of the two drugssee PRECAUTIONSDRUG INTERACTIONSBecause the extent to which this occurs with other liquid medications is not knownTegretol suspension should not be administered simultaneously with otherliquid medications or diluents.

Tegretol is indicated for use as an anticonvulsant drugEvidence supporting efficacy of Tegretol as an anticonvulsant was derived from active drug-controlled studies that enrolled patients with the following seizure types:

Treatment of Blood Count AbnormalitiesIf evidence of significant bone marrow depression developsthe following recommendations are suggested1stop the drug2perform daily CBCplateletand reticulocyte counts3do a bone marrow aspiration and trephine biopsy immediately and repeat with sufficient frequency to monitor recovery.

Hepatic effectsranging from slight elevations in liver enzymes to rare cases of hepatic failure have been reportedsee ADVERSE REACTIONS and PRECAUTIONSLaboratory TestsIn some caseshepatic effects may progress despite discontinuation of the drugIn addition rare instances of vanishing bile duct syndrome have been reportedThis syndrome consists of a cholestatic process with a variable clinicalcourse ranging from fulminant to indolentinvolving the destruction and disappearance of the intrahepatic bile ductsSomebut not allcases are associated with features that overlap with other immunoallergenic syndromes such as multiorgan hypersensitivityDRESS syndromeand serious dermatologic reactionsAs an example there has been a report of vanishing bile duct syndrome associated with Stevens-Johnson syndrome and in another case an association with fever and eosinophilia.

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