In patients with serious heart disease, liver or kidney disorders and in elderly patients, the initiation dose of carbamazepine controlled release should be low. Before starting therapy liver function tests and complete hemogram should be performed. Periodic blood counts and liver function observations should be made. An alteration in liver condition or occurrence of neutropenia, leucopenia and thrombocytopenia should lead to cessation of therapy. However, non-progressive asymptomatic neutropenia does not warrant cessation of therapy. Treatment should not be stopped abruptly, if abrupt cessation is necessary then it should be under the cover of benzodiazepines. In early stages of therapy, sedation and marked motor impairment occur, therefore, patient should be advised against driving and operating machinery.
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