Overview
Carbamazepine for facial pain
If you have chronic face pain, we might prescribe you a medicine called carbamazepine. Chronic pain (also called persistent pain) is long-term pain that lasts for more than 3 months.
Carbamazepine is a medicine used to treat epilepsy. It can also be taken for nerve pain caused by diabetes (peripheral neuropathy) or if you have a painful condition of the face called trigeminal neuralgia.
This medicine is only available on prescription. Always follow the amount prescribed (dose) by your doctor, and read the leaflet that comes with your medicine.
Carbamazepine is also known by the brand names Curatil® and Tegretol®.
Taking an unlicensed medicine
The use of carbamazepine for treating chronic facial pain is unlicensed. This means that the manufacturer of the medicine has not specified it can be used in this way, but there is evidence that it works to treat this particular condition.
Read more about unlicensed medicines or contact our pharmacy medicines helpline if you have any questions or concerns.
Taking carbamazepine
Most people take carbamazepine up to 4 times each day. Your doctor will tell you when you need to take it.
- Try to space your doses of carbamazepine evenly through the day. For example, first thing in the morning, lunchtime, late afternoon and in the evening before bed.
- You can take carbamazepine with or without food.
Do not drink grapefruit juice while taking carbamazepine. It increases the amount of carbamazepine in your body, and increases the risk of side effects.
To prevent the chance of side effects, your doctor will start you on a low dose of carbamazepine. They will increase it gradually over a few days or weeks.
When you find a dose that suits you, it will usually stay the same (unless your condition changes, or your doctor starts you on a new medicine that might affect carbamazepine).
Not everyone needs to have the maximum dose, which is 1,600mg a day for facial pain. Your doctor will tell you what dose you need to take.
It usually takes a couple of weeks for carbamazepine to work.
Example schedule
Your doctor will tell you which dose to take, and when to take it. Always follow the advice given by your doctor, even if it is different from this example.
| Day | Morning | Lunchtime | Late afternoon | Evening |
|---|---|---|---|---|
| 1 to 3 | 100mg | -- | -- | 100mg |
| 4 to 6 | 100mg | 100mg | -- | 100mg |
| 7 to 9 | 100mg | 100mg | 100mg | 100mg |
| 10 to 12 | 200mg | 100mg | 100mg | 100mg |
| 13 to 15 | 200mg | 100mg | 100mg | 200mg |
| 16 to 18 | 200mg | 200mg | 100mg | 200mg |
| 19 to 21 | 200mg | 200mg | 200mg | 200mg |
| 22 to 24 | 200mg | 200mg | 200mg | 400mg |
| 25 and onwards | 400mg | 200mg | 200mg | 400mg |
If you forget to take the medicine
If you miss a dose of carbamazepine, take the missed dose as soon as you remember unless the next dose is nearly due. In this case, it's better to leave out the missed dose and take your next dose at the usual time.
Do not take 2 doses at the same time to make up for a forgotten dose.
If you often forget doses, it might help to set an alarm to remind you. You can ask your pharmacist for advice on other ways to help you remember to take your medicine.
Side effects
Like all medicines, carbamazepine can cause side effects. But lots of people have no side effects or only minor ones.
The NHS website has more information about the side effects of carbamazepine.
Common side effects
Common side effects of carbamazepine include:
- feeling dizzy, sleepy or tired
- feeling sick (nausea) or being sick (vomiting)
- headaches
- dry mouth
- putting on weight
These side effects happen in more than 1 in 100 people. They're usually mild and go away by themselves.
Skin rashes
It's common to get a skin rash with carbamazepine. Most skin rashes are not serious.
Call 999 or go to your nearest A&E now if:
- you notice flu-like symptoms, followed by a severe red or purple rash that spreads and forms blisters which peel off.
This can develop into a life-threatening skin condition called a severe cutaneous adverse reaction or Stevens-Johnson syndrome.
These reactions are a rare side effect of carbamazepine. It's more likely to happen in the first 8 weeks of using carbamazepine, or when the dose is increased too quickly. It can also happen if carbamazepine is stopped suddenly for a few days and restarted at the same dose as before, without reducing the dose and increasing it slowly again.
To help prevent the chance of you getting a rash that could be confused with a severe cutaneous adverse reaction, try not start any new medicines, foods or products during the first 3 months of treatment with carbamazepine.
Do not start taking carbamazepine within 2 weeks of a viral infection, vaccination, or rash caused by something else.
Serious side effects
It's unusual to have serious side effects after taking carbamazepine.
Ask for an urgent GP appointment or call 111 if you have:
- unusual bleeding or bruising, mouth sores, infections, a high temperature or sore throat (these can be signs of a blood disorder)
- yellowing of skin or whites of eyes (these can be signs of a liver problem)
- pain in your joints and muscles, a rash across the bridge of your nose and cheeks, and problems breathing (these are signs of lupus)
Call 999 or go to your nearest A&E now if:
- you have thoughts of harming yourself or ending your life (a few people taking carbamazepine have had suicidal thoughts)
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to carbamazepine.
Call 999 or go to your nearest A&E now if:
- you get a skin rash that might include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
These are not all the side effects of carbamazepine. For a full list see the leaflet inside your medicine packet.
Pregnancy and breastfeeding
Speak to your doctor about taking carbamazepine during pregnancy or if you are breastfeeding. They can talk to you about the benefits and risks and help you decide on the best treatment for you and your baby.
Your doctor will only prescribe carbamazepine if the benefits of taking the medicine are greater than the risks.
Carbamazepine does pass into breast milk. There have been some reports of side effects in breastfed babies, including sleeping more and not feeding well.
More information about pregnancy and breastfeeding while taking carbamazepine can be found on the NHS website.
Carbamazepine and contraception
Carbamazepine can make many hormonal contraceptives less effective. This includes combined pills, contraception patches, vaginal rings, and progestogen-only methods such as the implant and progestogen-only pill (POP). This can increase the risk of an unplanned pregnancy.
If you are taking carbamazepine and need contraception, speak to your doctor or healthcare professional about the best options for you.
Taking carbamazepine with other medicines
Lots of medicines and carbamazepine can interfere with each other and increase the chances of side effects. Make sure that your doctor and pharmacist know you're taking carbamazepine before starting or stopping any other medicine, including medicines you buy from a pharmacy, or shop, or online and any herbal remedies.
Do not take St John's wort, the herbal remedy for depression, while you are being treated with carbamazepine. This is because St John's wort can make carbamazepine less effective.
More information about taking carbamazepine with other medicines and herbal remedies can be found on the NHS website.
Repeat prescriptions
Your GP gives you a repeat prescription for carbamazepine. You can take this to your local pharmacy.
Make sure you ask for your repeat prescription early to make sure that you do not run of medicine or miss any doses.
Resource number: 4830/VER3
Last reviewed: June 2026
Next review: June 2029
