Epilepsy drug could increase risk of Stevens-Johnson Syndrome

Austin Kirk

By Austin Kirk
Posted December 14, 2007

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The FDA announced this week that they are strengthening the warnings about certain epilepsy drug side effects which could lead to severe skin reactions, especially for those with Asian ancestry.  Carbamazepin, which is sold as a generic and under the brand names Carbatrol, Tegretol and Equetro, has been associated with an increased risk of developing Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN), which are life-threatening conditions.

>>INFORMATION: Stevens-Johnson Syndrome Lawsuits

Carbamazepin therapies are approved to treat epilepsy, as well as bipolar disorder and nerve pain.  The drugs already carry a warning which applies to all patients about the rare but severe skin reactions.  However, the new warnings will be featured more prominently on the label and include specific information about an increased risk for those with Asian ancestry.

Steven-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) cause the skin to literally burn from the inside out.  The conditions could be caused by a side effect of several different medications, including the epilepsy drugs.

Symptoms of SJS and TENS include the development of skin blisters, rashes, lesions, fever and itching.  Blisters could also develop in the mouth, eyes, nose or genitals.  In many cases, individuals who experience the skin reaction require treatment in a hospital burn care unit, and the condition can be fatal in approximately 5% to 15% of the severe occurrences.

The information about the risk of Stevens-Johnson syndrome associated with Carbamazepine, Carbatrol, Equetro and Tegretol side effects will be moved to a “black box” warning which is more prominently displayed at the top of the labels.  The warning will also indicate that individuals with an Asian ancestry should receive a genetic test before starting treatment.

While the Stevens Johnson Syndrome risk exists for all new users of the epilepsy drugs, among Asian populations the risk is estimated to be about 10 times higher.  There is a strong association between the development of the skin reaction and an inherited variant gene, HLA-B* 1502, which is found in some people of Asian ancestry. 

The presence of the gene can be identified by a blood test, so the FDA is recommending that doctors give patients with Asian ancestry a genetic test before starting treatment.  According to the FDA, the following figures should be considered:

  • Approximately 10-15% of individuals from China, Thailand, Malaysia, Indonesia, the Philippines and Taiwan may carry the gene
  • Approximately 2% to 4% of individuals from South Asia, including India, could have the gene
  • Less than 1% of individuals from Japan and Korea appear to carry the gene.

EPILEPSY DRUG STEVENS JOHNSON SYNDROME LAWSUITS

The Stevens Johnson Syndrome lawyers at Saiontz & Kirk, P.A. investigate potential lawsuits for any individuals who have been diagnosed with SJS or TENS.  The epilepsy drugs marketed as generic carbamaepine, Carbatrol, Tegretol and Equetro have been directly associated with an increased risk of the serious skin reaction, and the manufacturers have failed to adequately warn about the problem, especially for those with Asian ancestry. 

If you, a friend or family member have experienced symptoms of Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis, request a free lawsuit consultation and claim evaluation.

11 Comments • Add Your Comments

  • CAMilke says:

    Gentlemen,
    Can the epilepsy drug tegretol increase the risk of suicide as was reported by the FDA on January 31 2008.? If so, I need be referred to an attorney in the Joplin MO area. My wife has been on tegretol for 25 years and has tried suicide several times almost succeeding once. She still has a few extreme mood swings. She also went through some skin broozing for no apparent reason several years ago before dose reduction took place.She is not of asian decent.Thank you

    Posted on February 1, 2008 at 10:27 pm

  • griselda mosqueda says:

    my sister 39 years old was diagnosed epileptic since she was 6. for many years she took valproato sodic and carbamazepine, then she changed to valproato sodic and lamotrigine 3 months later she got an infection and took sulfa, 3 days later Stevens Johnson war diagnosed. After 2 weeks at the burned patients she got a little better. Please pay attention to this combination, aks your doctor.

    Posted on August 22, 2008 at 10:24 pm

  • Troy says:

    I heard somewhere that there is 1- investigations, 2- lawsuits involving persons who committed sucide or attempted sucide while taking eplipsey medications, Well I did in mid 90’s and was lucky to survive. However i am in canada.

    Posted on August 27, 2008 at 9:32 am

  • christine says:

    one of my clsm8 has a SJS and i heard that 30% that you can survive…..wat ever i hope that he can survive…….fight..fight..fight

    Posted on September 11, 2008 at 6:01 am

  • telly says:

    I was on tegratol for epilepsy for 18 years. 3 years ago I started develiping hives. I have adusted my diet and I am on several antihistamines that don’t alwys help. They may go away for a few weeks but return again. during these times I have flu-like symptoms. The tegratol toped working in 2007. I began having seizures again. My doctor switched me to keppra. The hives continue. Is this a symptom of SJS . Even if you stop use of the drug will you continue to have symptoms?? Could my hive issues be related to the 18 years a used tegratol? I would like to know more.

    Posted on October 11, 2009 at 2:24 pm

  • patricia says:

    I have been on tegretol for 25 years for epilepsy. For the past 2 yrs. I have been experiencing what I have assumed where some kind of bug bites, similar to a mosquito bite, yet the bites appears right before my very eyes and itches much worse, until the bite is bleeding and even after that, they still itch. My house is extremely clean and no one else in my household has these bites except me. They actually leave scars on my skin from scratching them. I’ve just learned about SJS, and I’m wondering if this is one of the symptoms of SJS? I am not Asian. I am mostly white, with some Hebrew ancesetory.

    Posted on October 29, 2009 at 12:39 pm

  • christina says:

    my son has been on tegertol since he was 10 months and has gone thru several times of skin rashes , skin sensitivity, hip problems mood swings and brusing from nothing. as far as i know we are not of asian ancestry.

    Posted on December 15, 2009 at 8:19 pm

  • John says:

    I’ve been taking tegertol since 2000 when I was in a serious car accident that put me through a coma for 3 weeks. I would like to take this opportunity to address a few issues.

    1. CAMilke, NO… tegertol is a mood stabilizer. It has no effect on either extreme except to lessen them. However, if your wife has attempted suicide on multiple occasions it is likely due to a combination of seasonal depression(that previously existed and is genetically effected), and she wasn’t taking all of her meds. I have personally done these precise things and know that it effects me the most during winter, so I’m extra careful. If something seems off, get her lvl tested and keep a close watch on her.

    5. Telly, yes. You become more susceptible to many things once you’re on these medications. Find an environment that you can survive in and try to avoid those things that you are allergic to… maybe carry some strong anti-histamine drugs with you that do NOT conflict with your medication like benedryll conflicts with tegertol.

    6. Patricia… I’m sorry, that sounds horribly devastating…. actually on second thought, that sounds like a version of hives. This is merely my oppinion because you say you live in a clean house and I accept that. I just think that you may have developed an allergy to something in your house. It’s the only probability I can think of.

    7. Christina… I think that eventually the skin rashes will fade away, just tell him to make a conscious effort not to provoke(scratch) them. I think the hip thing would be due to joint failure in that sector similar to my knees becoming weaker… but that is also a genetically inherited issue. On the topic of mood swings, he’s not taking the right dosage. In the event that he is, then he must be missing doses. Tegertol is a mood stabilizer… the only way for his mood to swing was if he wasn’t taking it consistently. As for the Bruising, that may be attributed to his mood swings… such as rampage like feelings and restricting himself from hitting another. I am suggesting that he hits himself and doesn’t know how to present it to you. That would just be an anger control mechanism. For example when I feel that way I usually make myself alone and roar, or failing to make myself alone, I growl. Sure it’s accepting animal like characteristics for a while, but it sure beats turning your frustration on someone else… especially someone who doesn’t deserve it.

    Posted on January 26, 2010 at 1:31 am

  • Ashley says:

    I have had two confirmed cases of Stevens-Johnson Syndrome. The first was within eight weeks of starting Lamictal (used as a mood stablizer for PPD). My psychiatrist started me on 25 mg of Lamictal once a day for seven days, then upped my dose to 50 mg once a day for two weeks, then the very day I was supposed to increase my dose to 100 mg once a day I woke up with these terribly itchy hive looking places from my head all the way to my toes. These sores blistered within a couple of days, they were in my eyes, nose, mouth, genital area, EVERYWHERE. I also had a high fever. I was treated with steroids, two different anti-histamines, and an H2 blocker. I currently have SJS again, after being on Tegretol (once again, as a mood stablizer for PPD) since August 12th (it is now September 8th). I am going through the same treatments as before.

    Posted on September 8, 2010 at 10:10 pm

  • Chris says:

    My wife is a 41 yr old Hispanic from Panama with epilepsy in her family. She herself does not suffer from this disorder but has lost her mother and 2 siblings to siezures (drownings). Our daughter (age 24) was diagnosed with siezures (at age 15) is doing well with medication. My wife however was prescribed Tegretol for a nonpainful facial twitch of the left eye area and caught Stevens Johnson Syndrome. Is there anything we as a consumer can do to hold these Physicians and drug companies resonsible for their lack of knowledge? A simple blood test would have omitted her from takeing this potentially deadly medicine. She (we) will be affected by this the rest of her (OUR) live(s)!

    Posted on October 16, 2011 at 11:40 am

  • Linda says:

    I have taken dilantin when I was two years of age. Later when I was eight years of age I took tegretol200mg dailyfor over thirty years. I’ve. Struggled with depression suicide thoughts and attempts . I was currently told that my lab work is showing that I have drug induced lupus my doctors have gone back n forth between tegretol n keppra because of low white blood cell counts and anemia. I’ve. Also had a mass removed from my overlie they had to move the ovaries and my uterus. I have barrettes esophagus diseasebut I’ve also been on psych. Mess like axle prozact.

    Posted on September 12, 2015 at 9:18 pm

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