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Health Agencies Update
January 30, 2008

Carbamazepine Prescribing

JAMA. 2008;299(4):399. doi:10.1001/jama.2008.6

A genetic test should be used to identify patients of Asian ancestry who may be at a higher risk of rare but serious skin reactions when taking medications containing carbamazepine, according to updated product labeling announced by the US Food and Drug Administration.

Carbamazepine, which is used in the treatment of epilepsy, bipolar disorder, and neuropathic pain, has been associated with severe and sometimes life-threatening skin conditions such as toxic epidermal necrolysis and Stevens-Johnson syndrome. The risk of such reactions in predominantly white populations is small, with about 1 to 6 in 10 000 new users experiencing a serious skin reaction. Previous labels of the drug have warned of this risk.