Tegretol and the Liver

[grace.mackay]

Hi Guys,

I'm just wandering about tegretol and it's effects on the old liver, now I'm sure you've all seen the stag nights with a dozen men wearing t-shirts with the slogan " the liver is evil and must be punnished" with the usual fuzzy vision type face, but I'm a bit curious about how much this drug punnishes the liver.

Now I have no intentions of stopping it, it's a god send for all it's taken a lot of adjusting to, the directions state when taking it to take with food, or at least around the same time , the packet isn't handy so I don't have the exact wording.

I have taken it on a mostly empty stomach ( I know, my bad!) with no ill effects, other than a little nausea, and I thought it may have been so it didn't hit you too hard and make you all space monkeyish, and I found that that wasn't the case and there was no monkey effects with it that way, so I'm wandering if it's for liver protection that you're to take it with food?

In the same vein I wander if that, that's why it was prescribed for me to take only twice a day rather than all through the day? Maybe others do take it all through the day ( and I tried that but the break through on day 3 wasn't worth it, but going back onto the 200 twice a day afterwards was better because I was less out of it then but maybe it's just my system being used to it now anyway, but I am getting more break through again with it now even this way so I might ave to speak to the doc about upping it again ) but I was just wandering if the twice a day prescription was so your liver only has it hitting it twice rather than constantly though the day?

There have been liver issues in my family with reduced functionality ( not to severe levels, but levels to take note of) due to various medication cocktails and as that's affected other family members I'd rather err on the side of caution where possible, just wandering what the general consensus was.

Hope you're all doing well and you're all having pain free ( or as close to it as possible) days.

Love

Grace

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[baywatcher]

Oh, our poor livers. They have to clean up after all the insults we give it. Even those of us on nice clean meds instead of overwhelming amounts of alcohol.

I have always taken my tegretol - and now my trileptal - with food. In the evening, I take it with milk, just before I go to bed. I don't know what it will do to your liver if you take it without food but I do know that I have increased side effects if I skip a little food midday. It's awfully easy to work through lunch, or to think that I'll grab a bite when I get home (always later than I expect) but I can feel the difference. It only takes a little milk or cottage cheese or maybe a banana to prevent any problem.

Where the recommendation is to take with food, I try to pay attention. After all, having a small amount of fruit or some kind of dairy product or even, I suppose, a couple of crackers is awfully easy to do. And some of the things I take are specific about taking on an empty stomach (even as much as 1/2 hour before eating) and I also pay attention to that.

For one thing, when the meds cost as much as they do, getting the most good possible makes sense. And in fact, I really, really want them to work. I wouldn't be taking them if I didn't need the help. About the only thing I can control in this whole area is following instructions. So I do.

I'm no expert on the liver. Maybe it matters and maybe it doesn't but I don't know. So I figure someone who does know is telling me something that I should pay attention to. As you know, a wrecked liver is a real life-changing event.

After you get your dose and timing settled you should have a much more even sort of life. Even if things are never what we used to call "normal", we learn to adjust and work around stuff. Good luck. Nancy

[grace.mackay]

Hi Nancy,

Thanks again for that, I have no plans of deliberatley taking it without food, I was just wandering about the implications that's all, am always curious about the effects of things, not that I'm a health freak by any means, but more so because I'm not!

Thanks again though, and no doubt I'll be in touch again soon.

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[mstw]

I've been taking the Tegretol XR for a couple of months now, getting blood work tests along the way. I always take my medicine (twice a day) right after my morning and evening meal. You may have seen my post that the test I had a couple of weeks ago showed my liver numbers to be a bit high, and white blood count a little down. Took a re-test last Friday, and they said it's a bit better so will keep me on the Tegretol XR and test me again in a month.

I thought to ask them what my baseline number was (the test they took before I started the meds), as well as what the numbers were when they were "off" and what the newest numbers are, so I could see for myself how much the meds are affecting things. Well, basically, my liver numbers have tripled since I started meds :( However, the last test showed it only about 7 points above the normal range, so I guess that's not toooo bad :confused:

One thing I changed before the last test was to stop having my evening ritual of one small mixed drink as well as started drinking more water through out the day. That may have been what helped decrease the liver number. So I will try to continue watching my diet, water intake, and limit or eliminate my evening cocktail and see where the numbers are in a month.

So I can attest for the fact that these meds do indeed affect our livers! It disturbs me that my number tripled, but I guess it's the price to pay for eleviating the pain of TN as long as I can stay close to the "normal" range.
My neuro said that if I don't have any symptoms after being on meds for a year, that we can try taking me off the meds and see what happens. So I'm keeping my fingers crossed!!

Marj

[RStapler]

Grace,

The 'take with food' warning is standard for this type of med and is not related to blood-cell count. The changes to blood and autoimmunity are long-term effects whereas taking meds with food is purely a matter of minimizing short-term side-effects (nausea, dizziness, high blood-pressure, &c).

- Bob S

[grace.mackay]

Thanks Bob, I was just curious. I also read recently that long term use of anti-seizure meds can cause osteoporosis, and that long term users should be taking calcuim supplements.
I know that a lot of medication can cause these effects but I was a little surprised and concerned that the insert with the tegretol medication shows no mention of this ( it mentions osteomalacia but not osteoporosis) the contraceptive pill gives mention of it in its insert and as such I have thought this should mention the same if there is evidence to support the claim?!

I don't know yet if I will have to be taking these pills long term ( I can but hope I wont!) but if I do, I will have to make enquiries as I'm already at an increased risk of osteoporosis, due to long term use of the pill, being a small framed female ( a smoker to boot, I know, I know filthy habbit!) and already being hyper mobile, so I may have to follow this one up, but again if anyone has any info it would be much appreciated!

Anyway, I will no doubt speak to you all soon, take care

Grace

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