Depletions

Taking carbamazepine may deplete calcium and vitamin B9. Deficiency of sodium may develop during the treatment with oxcarbazepine and eslicarbazepine.

Calcium, along with vitamin D, keeps your bones strong and healthy.

Low levels of calcium may cause:

• Muscle cramps
• Numbness or tingling in toes and feet
• Irregular heartbeat
• Depression
• Bone pain
• Spinal problems
• Seizures

Low levels of folic acid in the body may be linked to:

• Anemia
• Heart disease
• Birth defects

Symptoms may include:

• Weakness
• Mouth sores
• Swollen tongue
• Depression
• Poor growth

Sodium deficiency is rare because it is widely available in dietary sources. When it does occur, low levels have been associated with:

• Weakness
• Nausea and vomiting
• Headache
• Confusion
• Memory impairment
• Reduced attention
• Muscle cramps
• Strong, rapid or irregular heartbeat
• Lack of energy
• Restlessness

Severe cases can cause seizures, loss of consciousness, and possibly coma. The development of symptoms depends on how fast you lose sodium.

Editorial Note

The information presented here covers some of the nutrients that may be affected when you take certain medicines. If you have any of these signs and symptoms, it does not always mean you have low levels of these nutrients.

Factors that affect the level of nutrients are:

• Your medical history
• Diet
• Lifestyle
• How long you have been taking the medicine

Please talk to your health care provider. They can best address your health care needs and see if you are at risk for low levels of any nutrients.

Supporting Research

Dineen R, Hannon MJ, Thompson CJ. Hyponatremia and hypernatremia. In: Jameson JL, De Groot LJ, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 112.

Gold Standard Drug Database: Drug Monograph: Carbamazepine, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-90 . Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Eslicarbazepine, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-3830 . Accessed July 13, 2016.

Gold Standard Drug Database: Drug Monograph: Oxcarbazepine, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-771 . Accessed July 13, 2016.

Gold Standard Drug Database: Drug Monograph: Rufinamide, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-3646 . Accessed July 13, 2016.

Greenbaum LA. Vitamin K deficiency. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 53.

Pfennig CL, Slovis CM. Electrolyte disorders. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 125.

Shenkin A, Roberts NB. Vitamins and trace elements. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics . 5th ed. St. Louis, MO: Elsevier Saunders; 2012:chap 31.

Smogorzewski MJ, Stubbs JR, Yu ASL. Disorders of calcium, magnesium, and phosphate balance. In: Skorecki K, Chertow GM, Marsden PA, Yu ASL, Taal MW, eds. Brenner and Rector's The Kidney . 10th ed. Philadelphia, PA: Elsevier; 2016:chap 19.