Carbamazepine

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Date: May 2025, Version 4.0

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Carbamazepine can be used in pregnancy if recommended by a specialist.

What is it?  

Carbamazepine (Tegretol, Curatil®) is used to treat epilepsy, bipolar disorder, and some types of nerve pain. Carbamazepine is also used to help with alcohol withdrawal symptoms in people who drink heavily and want to stop, although this type of use is rare during pregnancy.

Benefits

What are the benefits of taking carbamazepine in pregnancy?

Carbamazepine prevents seizures, which can be dangerous or life-threatening and can lead to pregnancy complications. Carbamazepine can help control bipolar disorder which can get worse during pregnancy and after your baby is born if not properly treated. Carbamazepine can also improve nerve pain which might severely affect quality of life.

Risks

Are there any risks of taking carbamazepine during pregnancy?

There may be a slightly increased chance of some birth defects in the baby following use of carbamazepine in early pregnancy. However, most pregnant women using carbamazepine will have a healthy baby. 

As a precaution, carbamazepine is only prescribed in pregnancy when there is no other safer treatment, and the benefits outweigh the possible risks. Your doctor will help you decide whether carbamazepine treatment should be continued in pregnancy.

Babies exposed to carbamazepine around the time of delivery might have some withdrawal symptoms after birth. These can be treated if necessary and usually pass quickly.

Carbamazepine can affect folic acid levels. If you are taking carbamazepine while trying to conceive and during pregnancy, your doctor will prescribe you a high dose folic acid supplement (5 mg/day).

Alternatives

Are there any alternatives to taking carbamazepine?

Possibly. Other medicines can be used to treat epilepsy, bipolar disorder, and nerve pain. However, if your medical condition is well-controlled with carbamazepine, staying on it may be the safest option to keep you well and avoid pregnancy complications.

If you are planning a pregnancy, please speak to your GP or specialist to determine whether carbamazepine is still the best medicine. If you have an unplanned pregnancy while taking carbamazepine, you should be reviewed at the earliest opportunity by your GP or specialist.

No treatment

What if I prefer not to take medicines during pregnancy?

It is very important to take any medicines prescribed to treat epilepsy. Uncontrolled seizures can be serious and can lead to pregnancy complications. It is also very important that bipolar disorder and nerve pain are controlled so that you are as well as possible during pregnancy and while looking after your baby.

Your doctor will only prescribe medicines when necessary and will be happy to talk to you about any concerns that you might have.

Do not stop carbamazepine without speaking to your GP or specialist.

Will I or my baby need extra monitoring?

All pregnant women in the UK will be offered a very detailed anomaly scan, usually at around 20 weeks of pregnancy, as part of their routine antenatal care. If you have taken carbamazepine in the first trimester you may be offered this scan slightly earlier than usual. 

Carbamazepine levels in your body might get lower during later pregnancy due to normal changes to your body. Your doctor might offer you a blood test and/or regular review of your symptoms to make sure the dose you are taking is still right for you.

Are there any risks to my baby if the father has taken carbamazepine?


We do not expect any increased risk to your baby if the father takes carbamazepine.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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