This section gives an overview of the commonly used drugs (excluding opioids) to manage symptoms in patients with terminal illnesses. The information includes basic dosage information as well as indications for use and potential side effects. Please note that non-opioid drugs commonly used in palliative care in Singapore are shown here but the list is NOT exhaustive and neither are the side effects nor indications. Doses are for adults only. Please check with pharmacy colleagues for dose adjustments (if any) in renal or liver impairment. Unless otherwise indicated, use water for injection for dilution in continuous subcutaneous infusions.
*For information on opioids, please search and refer to the drugs with their given context.
Carbamazepine
Route, Dosage and Frequency
ROUTE
|
DOSAGE AND FREQUENCY
|
| PO |
50-100mg b.d. Increase by 50-100mg every 1-2 weeks as needed (max dose 2g/day but usually requires ≤800mg/day) |
Other Information
Indications
Neuropathic pain, Seizures.
Side-Effects
Ataxia, Dizziness, Fatigue, Nausea, Mild liver impairment, Urticaria, Leukopenia.
Remarks
Anti-epileptic, adjuvant analgesic. Need to check HLA allele B*1502 – avoid if this genotype is present (risk of Steven Johnson Syndrome and Toxic Epidermal Necrolysis). Hepatic enzyme inducer, hence numerous drug interactions.
Reference
- Watson M. Oxford Handbook of Palliative Care. Oxford, NY: Oxford University Press; 2009.