Vision problems with Tegretol?

Hi all,

Took my Tegretol and my tramadol and there is heaviness but no pain. As I might have mentioned, I have MS and the trigeminal nerve (V2 branch, right side) pain comes from whatever myelin-dissolving is going on in my nervous system. The Tegretol makes it very difficult for me to walk. I am aware of that; it is why I don't like to take it.

►Something I started noticing last night, maybe some of you have had this same side effect: I have vision problems after I swallow that tablet. It is a really strange vision problem. Patches of my vision disappear like someone has pulled a shade down. Then I blink and just like someone has made the shade go up, the vision returns. Maybe that's not so strange. I guess the strange part is that it only happens in patches in my field of vision, patches like on a black-and-white cow. It doesn't worry me too much because it goes away when the medication wears off. But have any of you experienced anything like that?

It's unusual that you experienced the vision problems right after swallowing the tablet, since it usually takes about 1 hour for the tablet to be absorbed. Depending on the formulation, the peak drug concentration is usually 2 or more hours after the dose. One of the common side effects of Tegretol is diplopia (double vision), but that doesn't sound like what you're having.

What dose of Tegretol and which formulation are you on? It would be worthwhile mentioning this to your physician. There is a blood test that your doctor can order to check if the dose that you're on is too high. I've had a it done a couple of times.

I am so sorry I left the impression the trouble started immediately after taking the medicine. I guess I should have said it happens at some time after I have taken the medicine. No, it is not double vision. It is more like floaters that get in the way and disappear with a blink, but I don't have floaters that big in my vitreous, and it happens and has happened only after (some time after) taking Tegretol. I'm not worried about it, just curious.

I've never heard of anyone experiencing that particular side effect, but I think it's worth mentioning to your doctor. Have you ever gotten a blood test for your tegretol level? Here's an excerpt from the Compendium of Pharmaceuticals and Specialties (CPS).

"The reactions which have been most commonly reported with carbamazepine are CNS disturbances (e.g., drowsiness, headache, unsteadiness on the feet, diplopia, dizziness), gastrointestinal disturbances (nausea, vomiting), and allergic skin reactions. These reactions usually occur only during the initial phase of therapy, if the initial dose is too high, or when treating elderly patients. They have rarely necessitated discontinuing carbamazepine therapy and can be minimized by initiating treatment at a low dosage.

The occurrence of CNS adverse reactions may be a manifestation of relative overdosage or significant fluctuation in plasma levels. In such cases it is advisable to monitor the plasma levels.

...Within each system organ class, the adverse drug reactions are ranked by frequency, with the most frequent reactions first. Within each frequency grouping, adverse drug reactions are presented in order of decreasing seriousness. In addition, the corresponding frequency category for each adverse drug reaction is based on the following convention (CIOMS III): very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1000 to <1/100); rare (≥1/10 000 to <1/1000); very rare (<1/10 000); frequency unknown:

...

Eye Disorders

Common: accommodation disorders (e.g. blurred vision); Very rare: lenticular opacities, conjunctivitis, retinal changes."

It sounds like you might be experiencing a very rare side effect, and it's definitely worth mentioning to your prescriber.



ShowMe_from_MO said:

I am so sorry I left the impression the trouble started immediately after taking the medicine. I guess I should have said it happens at some time after I have taken the medicine. No, it is not double vision. It is more like floaters that get in the way and disappear with a blink, but I don't have floaters that big in my vitreous, and it happens and has happened only after (some time after) taking Tegretol. I'm not worried about it, just curious.

I take 800 mg of Tegretol a day. 400 mg in the morning and 400 mg at night. So far the only vision problem I'm having is a little fuzziness when I try to read which is fixed when I wear some reading glasses I picked up at Walgreens. If the letters are big enough they don't look fuzzy. This only started with the Tegretol. I was nauseous for a couple of days just slightly, and that went away pretty quick. So far no major side effects. It seems to be helping too, it has greatly reduced my pain. Two teeth don't hurt at all anymore and one is getting better. I still have to wait a week to see the full effects of this last dose increase. The crunching, burning stabbing pains are gone. Now I just have a slight ache in one tooth which is better in the first few hours after taking the medicine, but gradually shows up once it's closer to my next dose. Could your side effect be the mixture of the two medications?