Rectal Administration of Carbamazepine Suspension
DOI:
https://doi.org/10.4212/cjhp.v57i2.485Abstract
INTRODUCTION
Clinicians sometimes face a situation in which a patient requires anticonvulsant medication but is unable to take medication orally. The parenteral route may be a suitable alternative for the delivery of many medications, but may not be appropriate in other cases, for example, because of lack of IV access or patient discomfort. Furthermore, not all anticonvulsant medications are available in parenteral form. The rectal route has been used for interim or long-term administration of anticonvulsants such as diazepam,1 valproate,2,3 phenobarbital,4 carbamazepine,5-9 and (with less success) phenytoin.10-12 The clinical usefulness and bioavailability of rectally administered carbamazepine (in suspension, suppository, or gel form) has been previously described.5-9 However, very little, if any, information has been published regarding the rectal use of the commercially available Tegretol suspension, which has been available on the Canadian market since 1995. This case report describes the successful use of Tegretol suspension, administered rectally in a patient with an uncontrolled seizure disorder.
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