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carbamazepine (Carbella / Carnexiv)

✓ Approved

Ligand Pharmaceuticals · SCN1A · Small Molecule

What is carbamazepine?

carbamazepine is a small molecule developed by Ligand Pharmaceuticals. It is approved for therapeutic indications via injectable (others) or intravenous (iv).

Drug Profile

Brand NamesCarbella, Carnexiv
CompanyLigand Pharmaceuticals
Drug ClassSmall Molecule
Molecular TargetSCN1A, SCN2A, SCN3A
RouteInjectable (Others), Intravenous (IV)
StatusApproved
Sources: ClinicalTrials.gov, Ligand Pharmaceuticals

Mechanism of Action

Molecular Targets

carbamazepine acts on 3 molecular targets:

SCN1Asodium voltage-gated channel alpha subunit 1 (DEE6B, FEB3)
SCN2Asodium voltage-gated channel alpha subunit 2 (Na(v)1.2, BFNIS)
SCN3Asodium voltage-gated channel alpha subunit 3 (Nav1.3, NAC3)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

carbamazepine is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Nervous system disordersGeneralised tonic-clonic seizure✓ Approved

Related Research Articles

PubMedBMC pediatrics2026-07-17

An evaluation of cytokine responses and antiseizure medication levels during mild upper respiratory infections in children with epilepsy.

Arslan Elif Acar EA, Özkaya Aslı Begüm AB, Özkan Esra E, Durgut Betül Diler BD et al.

This study aimed to investigate the effect of upper respiratory tract infections on serum antiseizure medication levels in children with idiopathic epilepsy and the relationship between that condition and inflammation. Forty-nine patients aged 2-18 years presenting to our paediatric neurology clinic who were under follow-up with a diagnosis of idiopathic epilepsy and who were receiving valproate or carbamazepine therapy were included in this study. All patients were using either valproic acid (n = 31) or carbamazepine (n = 18). Patients were evaluated at the time of presentation with symptoms of upper respiratory tract infection and during the control period one month later. Serum antiseizure medication, interleukin-17 A and interleukin-23 levels, complete blood count, alanine transaminase levels, creatinine levels, albumin levels, erythrocyte sedimentation rates, and C-reactive protein levels were measured during infection and during the control period one month later. Simultaneous electroencephalography examinations were also performed. No provoked seizures occurred in any patient during the infection period. Serum valproic acid levels were higher in patients during the infection period than in those same patients during the control period after one month, although this difference was not statistically significant (p = 0.073). There was also no significant difference in carbamazepine levels (p = 0.484). While no difference was observed in the interleukin-23 values between the two periods in patients receiving valproic acid, these values were greater in the patients who received carbamazepine during the infection period (p = 0.039). The findings of this study suggest that mild upper respiratory tract infections do not cause clinically significant alterations in serum valproate or carbamazepine levels.

PMID 42464153
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PubMedJournal of colloid and interface science2026-07-17

Engineering an S-scheme Bi2O2S/boron nitride heterojunction with dual-channel charge transfer for superior photocatalytic degradation of carbamazepine.

Dai Xing X, Duan Lijie L, Wang Chaozhong C, Qian Feng F et al.

The persistent and ecotoxic pharmaceutical carbamazepine (CBZ) poses a significant threat to aquatic environments. Although semiconductor photocatalysis offers a green solution, its efficiency is often hindered by rapid charge recombination and limited light absorption. In this study, we reported the rational design and construction of an S-scheme dibismuth oxysulfide/boron nitride (Bi2O2S/BN) heterojunction through intimate interfacial coupling between Bi2O2S and BN. This strategic integration induced strong interfacial electron coupling, resulting in a built-in electric field that regulated interfacial band bending and facilitated spatial charge separation of photogenerated electron-hole pairs, as unequivocally validated by experimental characterizations and density functional theory (DFT) calculations. The optimized Bi2O2S/BN heterojunction achieved 93.4% ± 0.1% CBZ removal within 120 min, with an apparent rate constant of 0.0155 ± 0.0001 min-1, representing a 4.7-fold enhancement over pristine Bi2O2S. Notably, beyond conventional activity improvement, this system established spatially partitioned redox sites via work-function-driven charge redistribution, enabling a dual-channel oxidative pathway that selectively targeted distinct electrophilic and nucleophilic sites of the CBZ molecule. This molecular-level reaction matching distinguished the proposed system from previously reported CBZ photocatalysts, which primarily relied on indiscriminate reactive oxygen species (ROS) oxidation. This study reports a highly effective and stable photocatalyst for remediating persistent pollutants. Additionally, it provides mechanistic insights into interfacial charge regulation and charge-transfer dynamics in heterojunction systems, offering a valuable blueprint for designing advanced photocatalytic systems for practical environmental applications.

PMID 42462672
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PubMedMolecular pharmaceutics2026-07-17

In-Depth Comparison of Fasted State Simulated Intestinal Fluid (FaSSIF) Versions via NMR Spectroscopy and Complementary Methods.

Mildner Malte M, Daskalova Svetla S, Hossain Shakhawath S, Scheller Lena L et al.

Efficient screening methods in the early drug development stage are key to quickly finding promising drug candidates. Solutions simulating conditions in the small intestine, the main absorption region for orally administered drugs, such as FaSSIF-V2 and V3, are essential. Updated versions aim to better mimic the natural environment with modified concentrations of the main components, taurocholate and lecithin, or inclusion of oxidation products. Here, we use NMR spectroscopy to investigate the aggregation behavior and interactions between drugs and/or polymers with the components in FaSSIF-V2 and -V3 on a molecular level. BCS-class II compounds carbamazepine, ketoconazole, and efavirenz served as model drugs. We found that while the individual FaSSIF versions alone showed a different apparent diffusion, addition of either drugs or polymers evened out these differences. The more complex composition of FaSSIF-V3 results in a higher signal overlap in the NMR spectra. Furthermore, the simultaneous presence of similar chemical entities with different solubilities is challenging for the DOSY analysis, as one NMR signal contains differently diffusing species. NMR spectroscopy complemented by solubility and DLS measurements as well as MD simulations showed that the different diffusion behavior of FaSSIF-V2 and -V3 is indeed a result of the solubility variations of the lecithin-like molecules. Furthermore, it was observed that all model drugs behaved differently in the FaSSIF media, spanning behavior from barely interacting (carbamazepine) to drug molecules in fast exchange between bile colloids and free solution (ketoconazole) to molecules fully incorporated into the bile aggregates (efavirenz). Although FaSSIF-V3 mimics the natural environment better, FaSSIF-V2 behaved overall more robustly across the different analytical tools and the molecular-level picture obtained for the individual media was overall similar.

PMID 42463987
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PubMedBioorganic chemistry2026-07-17

Structural optimization and anticonvulsant evaluation of aminoalkyl indole derivatives.

Hu Di D, Mei Tiantian T, Hong Yun Y, Yu Jinling J et al.

A series of twenty-two novel aminoalkyl indole derivatives were rationally designed and synthesized via Friedel-Crafts acylation followed by nucleophilic substitution, targeting the cannabinoid receptor 2 (CB2R) as a novel approach for anticonvulsant therapy. Systematic structural optimization of the indole C-3 cycloheptanecarbonyl moiety and the N-1 aminoalkyl side chain was conducted to balance CB2R affinity, subtype selectivity, lipophilicity, and blood-brain barrier (BBB) permeability. In vitro pharmacological characterization identified compound 6d as a potent and selective CB2R agonist (EC₅₀ = 4.00 nM), with approximately 46-fold functional selectivity over CB1 receptors. In the subcutaneous pentylenetetrazole (scPTZ) seizure model, compound 6d demonstrated favorable anticonvulsant efficacy (ED₅₀ = 21.28 mg/kg, i.p.) with a high protective index (PI = 21.28), comparing favorably with the reference drug carbamazepine in both potency and safety margin. Compound 6d also exhibited favorable pharmacokinetic properties, including moderate BBB permeability (PAMPA-BBB), acceptable metabolic stability in mouse liver microsomes, sufficient brain-to-plasma exposure ratios, and negligible cytotoxicity in HepG2 cells at therapeutic concentrations. Additionally, analogue 6 g displayed moderate activity in the maximal electroshock (MES) model with a favorable safety profile. These findings indicate that the cycloheptanecarbonyl-indole scaffold represents a valuable lead structure for the development of brain-permeable, selective CB2R-targeted antiepileptic agents.

PMID 42462518
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PubMedmedRxiv : the preprint server for health sciences2026-07-17

HIV as a Host Susceptibility State for Severe Drug Hypersensitivity: Disentangling Biological Susceptibility from Drug Exposure in the FAERS Database.

Mukherjee Eric E, Park Dodi D, Asiaee Amir A, Krantz Matthew S MS et al.

HIV infection has long been associated with increased incidence of severe cutaneous adverse reactions (SCAR). It remains unknown whether this increased incidence is a direct biological result of HIV infection, differences in drug exposure, or other demographic factors. To evaluate the association between HIV and SCAR and determine whether this relationship persists after adjusting for demographic factors and structured drug exposure. We analyzed reports from the FDA Adverse Event Reporting System (FAERS) from 2013-2023. SCAR outcomes included Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), and generalized bullous fixed drug eruption (GBFDE). HIV status was determined using antiretroviral exposure, indication text, and machine-learning imputation. Logistic regression models were constructed sequentially: unadjusted, demographic-adjusted, and fully adjusted with drug principal components to account for polypharmacy. Drug-level disproportionality and HIV-drug interaction analyses were also performed. In unadjusted models, HIV was strongly associated with SCAR (OR ∼2.0-2.7). Adjustment for demographics attenuated this association, and further adjustment for drug exposure reduced the effect to near null for overall SCAR and DRESS. A modest residual association persisted for SJS/TEN (OR ∼1.3). Disproportionality analyses demonstrated enrichment of specific high-risk drugs in PLWH. Interaction modeling revealed drug-specific amplification of SCAR risk in HIV, notably for carbamazepine and clarithromycin, whereas other drugs showed minimal interaction. The association between HIV and SCAR is largely explained by differences in drug exposure and demographic factors. Residual risk is drug-specific rather than uniform, supporting a model in which HIV modifies susceptibility to select drug triggers rather than acting as a global risk factor. Further prospective and retrospective studies are required to quantify associations. What is already known about this topic?: HIV infection is associated with increased risk of severe cutaneous adverse reactions, but the relative contributions of biological susceptibility and drug exposure remain unclear.What does this article add to our knowledge?: This study demonstrates that much of the HIV-SCAR association is explained by drug exposure patterns, with residual risk limited to specific drugs and phenotypes.How does this study impact current management guidelines?: These findings support focusing risk mitigation on specific high-risk drugs in HIV rather than assuming uniformly elevated SCAR risk across all medications.

PMID 42465900
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PubMedDusunen adam : Bakirkoy Ruh ve Sinir Hastaliklari Hastanesi yayin organi2026-07-16

A growing concern: Carbamazepine abuse in Turkish correctional settings and its clinical and ethical implications.

Cakmak Isik Batuhan IB

PMID 42459780
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