Comprehensive medication guide to Tegretol XR including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic carbamazepine ER (Tier 1–2 on most commercial and Medicare Part D plans); brand-name Tegretol XR may be Tier 3–4 or non-formulary, requiring prior authorization.
Estimated Cash Pricing
$174–$247 retail for brand-name Tegretol XR (60 tablets, 200 mg); generic carbamazepine ER averages ~$108 retail but as low as $29–$40 with GoodRx or SingleCare coupons for a 30-day supply.
Medfinder Findability Score
72/100
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Tegretol XR is the brand name for carbamazepine extended-release tablets, manufactured by Novartis. It is an anticonvulsant (anti-seizure) medication that has been used clinically since the 1960s. The "XR" formulation releases the active drug gradually over 12 hours, allowing for twice-daily dosing and more stable blood levels compared to immediate-release carbamazepine.
Tegretol XR is FDA-approved for epilepsy (partial seizures, generalized tonic-clonic seizures, and mixed seizure patterns) and trigeminal neuralgia. It is also used off-label for bipolar disorder maintenance, though Equetro — a different carbamazepine ER formulation — carries the specific FDA approval for bipolar I mania. Generic carbamazepine ER is manufactured by Teva, Sandoz, Apotex, and others.
Tegretol XR extended-release tablets are available in three strengths: 100 mg, 200 mg, and 400 mg. The tablets must be swallowed whole — never crushed, chewed, or split — as the extended-release mechanism depends on an intact tablet. The medication should be taken with food to minimize nausea.
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Tegretol XR works by blocking voltage-gated sodium channels in neurons. These channels are responsible for generating and transmitting electrical signals (action potentials) along nerve cells. In epilepsy, neurons fire abnormally and repeatedly; in trigeminal neuralgia, trigeminal nerve fibers send excessive pain signals. Carbamazepine selectively targets sodium channels in their inactive (post-firing) state, preventing them from rapidly firing again and suppressing abnormal electrical activity.
Carbamazepine is metabolized in the liver to an active metabolite, carbamazepine-10,11-epoxide, which also contributes to anticonvulsant effects. An important pharmacological feature is autoinduction: carbamazepine activates the CYP3A4 liver enzyme that metabolizes it, causing its own half-life to shorten from approximately 25-65 hours initially to 12-17 hours after 3-5 weeks of continuous therapy. This is why doses are titrated gradually and blood levels may need to be rechecked after the first month.
Because carbamazepine is a potent inducer of CYP3A4 and other liver enzymes, it interacts with a large number of medications. It speeds up the metabolism of many drugs, reducing their effectiveness — including hormonal contraceptives, warfarin, antiretrovirals, and immunosuppressants. Therapeutic drug monitoring (target carbamazepine blood level: 4–12 mcg/mL) and regular CBC and liver function testing are required during treatment.
100 mg — extended-release tablet
Used for starting doses and titration, especially in children ages 6-12 or for fine-tuning adult doses.
200 mg — extended-release tablet
Most commonly prescribed maintenance strength for adults. Standard starting dose is 200 mg twice daily.
400 mg — extended-release tablet
Used for patients requiring higher maintenance doses. Reduces daily pill burden.
As of 2026, Tegretol XR is not listed on the FDA Drug Shortage Database. Generic carbamazepine ER is manufactured by multiple companies, providing supply redundancy. However, brand-name Tegretol XR tablets are not routinely stocked at all pharmacies. Most pharmacy chains prioritize generic carbamazepine ER since most insurance plans require it. The 100 mg strength in particular may require advance ordering.
Patients requiring the brand-name Tegretol XR specifically (due to documented tolerability or seizure-control reasons) are most likely to find it at independent pharmacies, which can order it within 1-2 business days. National chain pharmacies like CVS and Walgreens typically stock only generic carbamazepine ER. The 200 mg and 400 mg generic strengths are generally widely available.
To find Tegretol XR in stock near you, use medfinder. medfinder contacts pharmacies in your area to check which ones can fill your specific prescription, texting you the results. This is the fastest way to locate any medication without calling pharmacies yourself.
Carbamazepine (Tegretol XR) is not a DEA-controlled substance, so any licensed prescriber with prescribing authority can write a prescription without special DEA registration. This includes physicians, nurse practitioners, and physician assistants. The appropriate type of prescriber depends on your condition.
Since carbamazepine is not a controlled substance, it can be prescribed via telehealth without requiring an in-person visit first. This makes it accessible through platforms like Teladoc, MDLive, and health system telehealth portals for established patients needing prescription management.
No. Carbamazepine (Tegretol XR) is not a DEA-scheduled controlled substance. This is an important distinction from some other neurological medications: it means Tegretol XR can be prescribed by any licensed prescriber (physician, NP, or PA with prescribing authority) without special DEA registration, and it can be prescribed via telehealth without a prior in-person visit requirement.
While not a controlled substance, Tegretol XR is a prescription-only medication due to its significant side effect profile, boxed warnings, and required laboratory monitoring. It cannot be purchased over the counter. Patients require ongoing medical supervision, including periodic blood counts, liver function tests, electrolyte monitoring, and carbamazepine blood level checks to ensure safe and effective use.
Common side effects (especially when starting or increasing dose):
Tegretol XR carries two FDA boxed warnings for serious side effects:
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Oxcarbazepine (Trileptal)
Closest structural analogue to carbamazepine; same mechanism with fewer drug interactions and better tolerability. First-line alternative for epilepsy and trigeminal neuralgia.
Lamotrigine (Lamictal)
Broad-spectrum anticonvulsant also approved for bipolar I maintenance. Different mechanism; generally well-tolerated. Requires slow titration to reduce skin reaction risk.
Valproic Acid (Depakote)
Effective for seizures and bipolar disorder. Different mechanism. Requires liver function monitoring. Contraindicated in women of childbearing age due to teratogenicity.
Gabapentin (Neurontin)
Used off-label for neuropathic pain including trigeminal neuralgia. Fewer drug interactions than carbamazepine. Not interchangeable for seizure control.
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MAO Inhibitors (phenelzine, tranylcypromine, linezolid)
majorContraindicated — potentially fatal interaction. Do not use within 14 days of each other.
Nefazodone
majorContraindicated — carbamazepine reduces nefazodone to subtherapeutic levels.
Hormonal Contraceptives
majorCarbamazepine significantly reduces effectiveness of birth control pills, patches, rings, injections, and implants. Use additional non-hormonal contraception.
Warfarin (Coumadin)
majorCarbamazepine reduces warfarin levels and anticoagulant effect. Monitor INR closely.
Direct Oral Anticoagulants (apixaban, rivaroxaban)
majorCarbamazepine dramatically reduces levels of these drugs — generally contraindicated.
Erythromycin / Clarithromycin
majorThese macrolide antibiotics inhibit CYP3A4, raising carbamazepine levels and increasing toxicity risk.
Azole Antifungals (ketoconazole, fluconazole)
moderateInhibit CYP3A4, raising carbamazepine levels. Monitor for signs of toxicity.
St. John's Wort
moderateInduces CYP3A4, reducing carbamazepine levels and risking breakthrough seizures. Avoid.
Grapefruit / Grapefruit Juice
moderateInhibits intestinal CYP3A4, raising carbamazepine absorption and blood levels. Avoid.
Alcohol
moderateAdditive CNS depression — increases drowsiness and dizziness significantly.
Tegretol XR (carbamazepine extended-release) remains a foundational medication in the treatment of epilepsy and trigeminal neuralgia. Its decades-long track record, established efficacy, and affordability in generic form make it a durable choice for many patients. The extended-release formulation provides steadier blood levels than immediate-release carbamazepine, which can reduce peak side effects and improve adherence.
Key points to remember: Tegretol XR is not in an active national shortage in 2026, but brand-name access at individual pharmacies can be inconsistent. Generic carbamazepine ER is widely available at much lower cost — as low as $29/month with prescription discount coupons — and is clinically appropriate for most patients under physician supervision. The medication requires regular laboratory monitoring and carries important drug interaction warnings that patients and providers must be aware of.
If you are having trouble finding Tegretol XR at your pharmacy, medfinder can help. medfinder contacts pharmacies near you to find which ones can fill your prescription, so you don't have to call around. Enter your medication, dose, and zip code to get started.
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