Volume : 12, Issue : 08, August- 2025
Title:
CARBAMAZEPINE-INDUCED HYPONATREMIA: A CLINICAL PHARMACIST INTERVENTION
Authors :
Dr.Challa Srilekha , R.Roshinee , MD Akhter Uzzaman , Bodhanampati Monish Venkat , Dr.Mohammed Misbahuddin , Shaik Shaheera , Dr. Chanchal Gawande , Premraj Subhash Chaudhari , Rakshith Gowda E S , Nalajala Akash
Abstract :
Background: Background: Carbamazepine is an effective antiepileptic drug but is associated with rare adverse effects such as hyponatremia, particularly due to its role in potentiating antidiuretic hormone release, leading to water retention and dilutional hyponatremia.
Case Presentation: A 58-year-old man with a history of long-standing carbamazepine therapy for seizure disorder had presented to hospital with a symptom complex of confusion, drowsiness, and fatigue. Laboratory investigations revealed severe hyponatremia (serum sodium, 118 mEq/L) in keeping with Syndrome of inappropriate antidiuretic hormone secretion (SIADH). The clinical pharmacist considered carbamazepine to be the inciting agent and recommended its stopping, along with fluid restriction and correction with hypertonic saline. Subsequently, the patient stabilized and was put on levetiracetam.
Intervention: Clinical pharmacists were instrumental in detection of the adverse drug reaction, in optimizing the therapy, and in continuous monitoring leading to resolution of symptoms and normalization of the electrolyte profile.
Outcome: Following discontinuation of carbamazepine and supportive management, the patient normalized sodium levels and symptomatically started resolving within days. No further complications were reported.
Conclusion: This case imparts the importance of recognizing carbamazepine-induced hyponatremia and the pivotal involvement of clinical pharmacists on the detection, management, and prevention of adverse drug reactions. The multidisciplinary approach benefits both patient safety and clinical outcomes.
Keywords: Carbamazepine, Hyponatremia, SIADH, Clinical Pharmacist, Adverse Drug Reaction, Antiepileptic Drugs
Cite This Article:
Please cite this article in press Challa Srilekha et al.,Carbamazepine-Induced Hyponatremia: A clinical Pharmacist Intervention., Indo Am. J. P. Sci, 2025; 12(08).
Number of Downloads : 10
References:
1. Tolou-Ghamari Z, Zare M, Habibabadi JM, Najafi MR. A quick review of carbamazepine pharmacokinetics in epilepsy from 1953 to 2012. J Res Med Sci. 2013 Mar;18(Suppl 1):S81-5.
2. Okuma T, Kishimoto A. A history of investigation on the mood stabilizing effect of carbamazepine in Japan. Psychiatry Clin Neurosci. 1998;52:3–12.
3. Liamis G, Milionis H, Elisaf M. A review of drug-induced hyponatremia. Am J Kidney Dis. 2008 Jul;52(1):144-53.
4. Sterns RH, Silver SM. Complications and management of hyponatremia. Curr Opin Nephrol Hypertens. 2016 Mar;25(2):114-9
5. Albayrak A, Başgut B, Bıkmaz GA, Karahalil B. Clinical pharmacist assessment of drug-related problems among intensive care unit patients in a Turkish university hospital. BMC Health Serv Res. 2022 Jan 15;22(1):79.
6. Ooi H, Asai Y, Sakakura Y, Takahashi M. Diagnostic assistance provided by a pharmacist for the syndrome of inappropriate antidiuretic hormone secretion caused by carboplatin plus nab-paclitaxel chemotherapy in an elderly patient with lung cancer: a case report. J Pharm Health Care Sci. 2025 Apr 23;11(1):35.
7. Kuz GM, Manssourian A. Carbamazepine-induced hyponatremia: assessment of risk factors. Ann Pharmacother. 2005 Nov;39(11):1943-6
8. Kaeley N, Kabi A, Bhatia R, Mohanty A. Carbamazepine-induced hyponatremia – A wakeup call. J Family Med Prim Care. 2019 May;8(5):1786-1788.
9. Ponte CD, Pollard S, Dattola RK. A suspected case of carbamazepine-induced hyponatremia. J Fam Pract. 1990 Dec;31(6):664, 666-7.
10. Kalff R, Houtkooper MA, Meyer JW, Goedhart DM, Augusteijn R, Meinardi H. Carbamazepine and serum sodium levels. Epilepsia. 1984 Jun;25(3):390-7.