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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

PubMedKidney medicine2026-08-30

Granulomatous Interstitial Nephritis With Perivascular Involvement in Carbamazepine-Induced DRESS Syndrome: A Case Report.

Okubo Naoto N, Wakabayashi Hanae H, Tsuchida Tomoka T, Inoue Hiroko H et al.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe hypersensitivity reaction caused by certain medications, including allopurinol, antibiotics, and antiepileptic drugs. It is characterized by a widespread rash, fever, lymphadenopathy, eosinophilia, and multiorgan dysfunction, including hepatic and renal impairment. DRESS syndrome differs from typical drug eruptions in that clinical symptoms may continue or worsen even after the causative medication has been discontinued. We report the case of a 75-year-old Japanese woman who developed DRESS syndrome after taking carbamazepine. She subsequently experienced severe acute kidney injury. Despite drug discontinuation, renal function progressively deteriorated over 2 months. Renal biopsy revealed granulomatous interstitial nephritis characterized by granulomatous lesions confined to the perivascular areas of the arcuate and interlobular arteries. Additionally, lymphangiogenesis was observed. Administration of prednisolone 0.8 mg/kg/d resulted in partial improvement in renal function; however, chronic kidney disease persisted. This patient showed perivascular granulomatous interstitial nephritis, a rare histological finding in DRESS syndrome. This finding shows that granuloma formation may involve crosstalk between persistent interstitial inflammation and lymphangiogenesis. Therefore, delayed treatment initiation may negatively affect renal outcomes, underscoring the essence of the prompt recognition and treatment of DRESS syndrome.

PMID 42668610
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PubMedPharmacogenomics and personalized medicine2026-08-30

Low Frequency of HLA-B*15:02 in Northwest China: Implications for Carbamazepine-Induced Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Screening Strategies.

Wang Xu X, Yang Ping P, Rao Feng F, Wang Longnan L et al.

HLA-B*15:02 is an important genetic marker for predicting carbamazepine (CBZ)-induced Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN) in Asian populations. This descriptive pooled analysis aimed to characterize HLA-B*15:02 distribution in Northwest China and inform regional screening strategies. We genotyped HLA-B*15:02 via next-generation sequencing (NGS) in 98 healthy volunteers from Ningxia, and combined these data with 11 previously published studies (total N=3400) from Northwest China. Weighted means, medians, and interquartile ranges (IQR) were calculated by region and ethnicity, with Pearson's chi‑square tests for group comparisons (significance threshold: P < 0.05). The overall HLA-B*15:02 frequency was 1.81% (range: 0.00%-3.30%; IQR: 0.24-1.97%). Regional weighted frequencies were 2.12% (Qinghai), 1.98% (Shaanxi), 1.02% (Ningxia), and 0.38% (Xinjiang); ethnic frequencies ranged from 0% (Kazakh) to 2.28% (Hui). No significant regional (χ2 = 7.60, P = 0.055) or ethnic (χ2 = 7.35, P = 0.119) differences were observed, nor was there a significant difference between Han and other ethnic groups (P = 0.074). The overall frequency of HLA-B*15:02 in Northwest China is 1.81%, substantially lower than in South China, suggesting a lower expected yield of routine screening in this region.

PMID 42668977
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PubMedJournal of environmental management2026-08-28

Preparation of K2CO3-activated biochar from peanut shell and Chlorella for enhanced carbamazepine adsorption: Performance, mechanism, and reusability.

Li Zhenzhen Z, Wu Jiayu J, Cheng Ting T, Zhou Liling L et al.

Leveraging the fibrous architecture of peanut shell and the intrinsic nitrogen-rich composition of Chlorella, a porous biochar (KBC) was synthesized via one-step K2CO3-activated pyrolysis using peanut shell and Chlorella as precursors to address the persistence of carbamazepine (CBZ) in conventional water treatment. K2CO3 activation substantially enhanced the physicochemical properties of KBC, which possessed a high specific surface area of 362.67 m2/g, a total pore volume of 0.34 cm3/g, and enhanced graphitization, suggesting reduced surface polarity. Adsorption kinetics and isotherms were well fitted by the pseudo-second-order and Langmuir models, with a maximum capacity of 121.56 mg/g at 318 K. Thermodynamic analysis confirmed spontaneous and endothermic adsorption with increased entropy. KBC exhibited consistent adsorption performance across a wide pH range of 3-12 and retained approximately 66.26% of its initial capacity after four consecutive cycles, indicating favorable reusability. Combined experimental characterization and density functional theory (DFT) calculations collectively revealed that CBZ uptake is governed by synergistic physisorption mechanisms, including pore filling, π-π electron donor-acceptor (EDA) interactions, hydrogen bonding, and hydrophobic interaction, with adsorption energies ranging from -0.361 to -0.753 eV. This work provides an efficient, sustainable biochar adsorbent for emerging contaminant removal while supporting agricultural waste valorization.

PMID 42664919
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PubMedTherapie2026-08-28

Epidemiology and risk factors of severe cutaneous drug reactions and evaluation through available databases.

Bettuzzi Thomas T, Lebrun-Vignes Bénédicte B

Severe cutaneous adverse drug reactions (SCARs), comprising mainly Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms, acute generalized exanthematous pustulosis, generalized bullous fixed drug eruption (GBFDE), are rare adverse reactions to drugs, hampered by a significant morbidity and mortality. Due to their unpredictable nature, they completely disrupt the benefit-risk balance of drug prescription. Nonetheless, a partial predictability is emerging. Firstly, all drugs do not carry the same risk for SCARs. Drugs carrying the higher risk are allopurinol, carbamazepine, lamotrigine, iodinated contrast media, and antibiotics, particularly sulfonamides and aminopenicillins. In addition, main risk factors comprise genetic polymorphisms of the HLA system and increased drug dosage. A targeted HLA genetic screening together with drug avoidance in case of high risk allowed to reduce the incidence of SCARs associated with carbamazepine and allopurinol. Similarly, a progressive titration of lamotrigine dose allowed to reduce the incidence of SCARs associated with lamotrigine. Pharmacovigilance databases allow the quick identification of culprit drugs, together with the implementation of whistle-blowing policies. Nonetheless, they present with quantitative and qualitative limitations and their own particular biases. Pharmacoepidemiologic databases allow the computation of SCAR incidences and confirm previously identified associations between drugs and SCARs. They may also allow help to identify the main clinical risk factors, e.g., chronic renal disease and Asian ethnicity for allopurinol. Nonetheless, they are limited by measure bias and lack of clinical and biological data. Ultimately, clinical and pharmacogenomic databases allow the identification of more precise risk factors, comprising precise genetic polymorphisms, drug dosage and impaired metabolism. The combination of all allows to establish a personalized risk stratification across SCARs subtypes and drug prescriptions. Ultimately, this allows the establishment of prescribing policies and the decrease of SCARs incidence.

PMID 42665466
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PubMedEpilepsy research2026-08-28

Risk factors for adverse maternal‑neonatal outcomes in pregnant women with epilepsy and the impact of different anti-seizure medications exposures on neonatal birth weight.

Fang Chun C, Yang Heqin H, Yang Yongmei Y

To investigate the risk factors for adverse maternal‑neonatal outcomes in pregnant women with epilepsy and to analyze the effects of different anti-seizure medications (ASMs) on neonatal birth weight, thereby providing clinical evidence for the management of epilepsy during pregnancy. A total of 218 pregnant women with epilepsy who delivered at our hospital between January 2021 and December 2025 were enrolled. Demographic data, epilepsy‑related clinical characteristics, ASM regimens, pregnancy complications, and maternal‑neonatal outcomes were collected. Patients were divided into an adverse outcome group (n = 74) and a favorable outcome group (n = 144) based on the occurrence of adverse maternal‑neonatal outcomes (including preterm birth, low birth weight, fetal distress, and neonatal malformations). Logistic regression analysis was performed to identify independent risk factors for adverse outcomes. Among patients receiving monotherapy (n = 131, 60.09%), they were categorized into lamotrigine, levetiracetam, carbamazepine, oxcarbazepine, and valproate groups according to ASM exposure during pregnancy; a separate polytherapy group (n = 87, 39.91%) was also included. Analysis of variance (ANOVA) was used to compare neonatal birth weight across groups. Multivariate logistic regression showed that uncontrolled epilepsy before and during pregnancy (presence of seizures within six months before pregnancy: OR=4.300, P < 0.001; any seizure during pregnancy: OR=3.661, P < 0.001; increased seizure frequency during pregnancy: OR=3.781, P < 0.001), focal epilepsy (OR=2.245, P = 0.005), polytherapy (OR=2.046, P = 0.014), and gestational hypertension (OR=2.764, P = 0.008) were independent risk factors for adverse maternal‑neonatal outcomes. Regarding neonatal birth weight, the monotherapy group had a significantly higher mean birth weight (3170 ± 452 g) than the polytherapy group (2963 ± 501 g, P = 0.002). Among monotherapy regimens, the valproate group had the lowest mean birth weight (2805.50 ± 395.53 g), which was significantly lower than that of the lamotrigine group (3273.51 ± 429.49 g, P = 0.012) and the levetiracetam group (3236.51 ± 407.47 g, P = 0.023). No significant differences were observed among the lamotrigine, levetiracetam, carbamazepine, and oxcarbazepine groups (ANOVA: F=3.822, P = 0.006). Uncontrolled epilepsy before and during pregnancy, polytherapy, focal epilepsy, and gestational hypertension are independent risk factors for adverse maternal‑neonatal outcomes in pregnant women with epilepsy. Different ASMs have differential effects on neonatal birth weight; valproate and polytherapy are associated with significantly lower birth weight. Physicians should counsel women with epilepsy that achieving at least six months of seizure freedom before conception is associated with improved maternal-neonatal outcomes. Lamotrigine or levetiracetam monotherapy should be prioritized whenever possible, and close monitoring should be maintained throughout pregnancy.

PMID 42659781
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PubMedWaste management (New York, N.Y.)2026-08-28

Balancing benefits and risks in food waste biochar: Pyrolysis severity effects on contaminant fate, nutrient leaching, and biological safety.

Wada Ojima Z OZ, Al-Gaashani Rashad R, Udayakumar Sruthi S, Wahib Sara S et al.

Thermochemical conversion of food waste into biochar offers a compelling circular economy pathway for soil amendment, yet comprehensive safety assessments remain limited. This study assessed the stability, contaminant fate, nutrient leaching, and microbial compatibility of bone and mixed vegetable biochars pyrolyzed at 300-600 °C. Feedstock identity dominated variance in yield, ash, and carbon (η2 = 0.73-0.91), whereas temperature governed the volatile heteroatoms H, O and N (η2 = 0.44-0.74; all p < 0.001). At 600 °C, bone retained higher yield (60.3 ± 0.7 % vs 34.4 ± 0.7 %) and appreciable porosity (118.0 m2/g), whereas vegetable biochar showed negligible surface area (≤1.0 m2/g) yet preserved a carbon-rich matrix (59.5 ± 0.5 % vs 11.5 ± 1.3 % C). Vegetable biochar attained thermal stability (H/C < 0.7) by 400 °C, while bone did not cross this threshold. Bone was nutrient-dense (Ca 145,285 ± 25,963; P 73,321 ± 18,435 mg/kg), but its ions remained matrix-bound, raising leachate pH/EC only to 8.5 ± 0.18 and 235.7 ± 7.9 µS/cm versus 10.3 ± 0.08 and 1,202.5 ± 6.4 µS/cm for K-rich (25,325 ± 5,060 mg/kg) vegetable biochar, releasing far more labile ions (Na 96.4 % vs 44.8 %; p < 0.001). Mild pyrolysis (300 °C) eliminated key agrochemical and pharmaceutical contaminants (carbamazepine, pyrimethanil, o-hydroxybiphenyl) without generating EPA-priority polycyclic aromatic hydrocarbons; industrial plasticizers persisted at 600 °C, highlighting the need for upstream feedstock screening. Pyrolysis reduced dissolved organic carbon to < 10 mg/L, lowering colony counts to control levels, unlike raw bone (59-fold higher, p = 0.001). Bone biochar thus functions as a slow-release mineral scaffold, while vegetable biochar confers liming potential for acidic soils, manageable by pre-washing. Pyrolysis severity and feedstock selection are jointly critical to biochar safety.

PMID 42664606
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