Carnexiv (carbamazepine)

The following drug information is obtained from various newswires, published medical journal articles, and medical conference presentations.


Approval Status:

Approved October 2016

Specific Treatments:


Therapeutic Areas

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General Information

Carnexiv (carbamazepine) is a sodium channel blocker.

Carnexiv is specifically indicated as replacement therapy for oral carbamazepine formulations, when oral administration is temporarily not feasible, in adults with the following seizure types:

  • Partial seizures with complex symptomatology
  • Generalized tonic-clonic seizures
  • Mixed seizure patterns which include the above, or other partial or generalized seizures 

Carnevix is supplied as an injection for intravenous administration. The recommended total daily dose is 70% of the total daily dose of oral carbamazepine from which patients are being switched; divide the total daily dose of Carnexiv equally in four infusions separated by 6 hours; dilute each dose of Carnexiv in 100 mL of diluent and infuse intravenously over 30 minutes. Use of Carnexiv is not recommended for periods longer than 7 days.

Clinical Results

FDA Approval

The FDA approval of Carnexiv was based on  bioavailability studies comparing oral carbamazepine to Carnexiv.  Following adjustment of the intravenous dose by the 70% conversion factor, daily plasma exposures of carbamazepine following 15-minute or 30-minute infusions every 6 hours were comparable to those observed following oral dosing. The pharmacokinetics of carbamazepine-10,11-epoxide were similar following both intravenous and oral dosing.

Side Effects

Adverse effects associated with the use of Carnexiv may include, but are not limited to, the following:

  • dizziness
  • somnolence
  • blurred vision
  • diplopia
  • headache
  • infusion-related reaction
  • infusion site pain
  • anemia

Carnexiv comes with a black box warning of serious and sometimes fatal dermatologic reactions, including toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) and the risk of aplastic anemia and agranulocytosis, following the use of Carnexiv.

Mechanism of Action

Carnexiv (carbamazepine) is a sodium channel blocker. The mechanism by which carbamazepine exerts its anticonvulsant activity is unknown. The principal metabolite of carbamazepine, carbamazepine-10,11-epoxide, has demonstrated anticonvulsant activity in in vivo animal models of seizures. However, its contribution to the therapeutic effect of carbamazepine is unknown.

Additional Information

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