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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

PubMedAnalytical chemistry2026-11-11

DNA-Mediated Self-Assembled SERS Platform Combined with Machine Learning for Therapeutic Drug Monitoring.

Ma Ruiyao R, Li Dan D, Ji Haoyu H, Xing Yaowen Y et al.

Therapeutic drug monitoring (TDM) critically requires rapid, sensitive, and practical methods for personalized medicine. Herein, we present a label-free surface-enhanced Raman spectroscopy (SERS) platform based on self-assembly of T12 DNA on Ag@ITCNPs mediated by Ca2+. This substrate generates abundant electromagnetic hotspots via electrostatic crosslinking and utilizes the intrinsic thymine peak as an internal standard to effectively eliminate serum matrix interference, achieving an analytical enhancement factor (AEF) of 5.93 × 1013. The platform enables ultrasensitive detection of various antiepileptics and immunosuppressants (e.g., cyclosporine A, carbamazepine, valproate) at the fg/mL level, with excellent reproducibility (RSD = 4.10%). By integrating unsupervised algorithms (PCA, t-SNE) and supervised models (CNN, SVM, KNN, LDA, RF, RNN, XGBoost), it achieves near 100% accuracy in discriminating between different drugs and even among individual patients receiving the same medication. Furthermore, regression models based on SERS enable precise quantification, with results showing excellent agreement with the LC-MS/MS gold standard. This work demonstrates that the synergy between self-assembly directed by DNA and machine learning provides a powerful strategy for constructing highly sensitive and selective SERS platforms, offering a promising solution for rapid therapeutic drug monitoring at the point of care in complex biological matrices.

PMID 43010546
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PubMedJournal of mass spectrometry and advances in the clinical lab2026-11-11

A Multiplex LC-MS/MS Approach for Quantifying Antiepileptic Drugs for Therapeutic Drug Monitoring: Validation of 15 Representative Tests.

Tang Xiaoying X, Wei Ruhan R, Chegwidden Emily E, Giles Richard R et al.

Therapeutic drug monitoring of antiepileptic drugs is critical for optimizing clinical outcomes, minimizing toxicity, assessing drug compliance, and managing overdoses and drug interactions. We developed and validated an LC-MS/MS method for the quantification of 15 antiepileptic drugs (ethosuximide, primidone, pentobarbital, carbamazepine-10,11 epoxide, pregabalin, gabapentin, zonisamide, lacosamide, rufinamide, felbamate, lamotrigine, topiramate, 10,11-dihydro-10-hydroxycarbamazepine, perampanel, and brivaracetam). Antiepileptic drugs were extracted from plasma and serum using methanol-based protein precipitation, followed by dilution. A commercial ClinCal® 3-point calibrator was used for all analytes except pentobarbital, which used a 6-point in-house calibrator. Chromatographic separation was achieved using a reverse-phase C18 column with a 7.31 min elution gradient of water and methanol, both containing 2 mM of ammonium acetate. All analytes required a 5 µL injection volume, except ethosuximide and pentobarbital, which required 20 µL and 10 µL, respectively, for optimal performance. The method demonstrated excellent linearity for all 15 antiepileptic drugs within their respective concentration ranges, with acceptable selectivity, accuracy (80.0-118.3%), and intraday and interassay precision (CV < 7.4%). Stability studies showed that antiepileptic drugs were stable in serum and plasma for up to 24 h at room temperature, 7 days at 4 °C, and 30 days at -20 °C, and after extraction for 7 days at 4 °C. This LC-MS/MS method supports routine quantification of 15 antiepileptic drugs in a clinical laboratory using a common sample preparation and chromatography workflow across all measurements. It was operationalized into three instrument methods to accommodate the different injection volume and calibrator requirements.

PMID 43011968
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PubMedLangmuir : the ACS journal of surfaces and colloids2026-11-10

Investigation of the Interactions of Carbamazepine with Lipid Membranes: Insights from Molecular Dynamics Simulations and NMR Experiments.

Khodov Ilya A IA, Ivlev Dmitry V DV, He Xiao X, Huster Daniel D et al.

Carbamazepine (CBZ) is a widely used anticonvulsant whose pharmacological effects include state- and use-dependent inhibition of voltage-gated sodium channels in neuronal membranes. Because CBZ interacts with these targets within a lipid environment, its membrane partitioning, preferred depth, orientation, and influence on bilayer organization are critical to understanding its physicochemical context of action. This study combines solid-state nuclear magnetic resonance spectroscopy and molecular dynamics simulations to investigate CBZ interactions with a POPC bilayer, a well-established model of phospholipid membranes. Through 1H MAS NOESY, 2H, and 31P NMR experiments, the location of CBZ and its effects on lipid chain order and phosphocholine headgroup dynamics were determined. Both experimental and computational approaches demonstrated that CBZ preferentially associates with the lipid-water interface. Molecular dynamics density profiles revealed that CBZ primarily localizes near the glycerol/phosphocholine region, with the amide group favoring the polar interfacial environment and the tricyclic moiety extending further into the membrane. This localization was corroborated by the highest 1H-1H NOESY cross-relaxation rates for the glycerol/phosphocholine segments. At the simulated CBZ concentration, the overall POPC bilayer structure remained largely unchanged, with no significant alterations in acyl-chain order or area per lipid. However, 31P NMR indicated a slight increase in phosphocholine headgroup mobility in the presence of CBZ. These findings suggest that CBZ accumulates strongly at the POPC membrane interface while causing only minimal disruption to overall bilayer organization, thereby providing a lipid-level framework for future studies in more complex neuronal and ion-channel-containing membranes.

PMID 43007106
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PubMedEpilepsy & behavior : E&B2026-11-10

Optimizing antiseizure treatment in women of reproductive age and during pregnancy: Nationwide practice versus specialized epilepsy care in Poland.

Wójcik-Kawa Katarzyna K, Sienkiewicz-Jarosz Halina H, Słowik Agnieszka A, Bosak Katarzyna K et al.

To compare antiseizure medication (ASM) treatment patterns among women with epilepsy (WWE) of reproductive age and pregnant WWE using nationwide administrative data and a university epilepsy referral center cohort in Poland. This retrospective study analyzed two complementary datasets. Nationwide data were obtained from the Polish National Health Fund, including 44,951 WWE aged 20-49 years in 2024 and 594 pregnant WWE who delivered in 2022. Referral center data were collected from medical records of 277 WWE aged 20-49 years treated in 2024 and 112 pregnancies managed between 2019 and 2026. Levetiracetam and lamotrigine were the most frequently prescribed ASMs in both cohorts. Compared with the nationwide population, women of reproductive age treated at the epilepsy center were significantly less likely to receive valproate (18.4 % vs. 31.1 %, p < 0.001) or carbamazepine (6.5 % vs 16 %p < 0.001), while lacosamide, brivaracetam, and cenobamate were prescribed more frequently. The proportion of women receiving monotherapy was similar in both cohorts. Among pregnant WWE, non-valproate monotherapy predominated in both groups but was significantly more common at the referral center (77.7 % vs. 62.0 %, p < 0.001). Valproate use during pregnancy was markedly lower in the referral center than in the nationwide cohort (2.7 % vs. 16.0 %, p < 0.001), whereas levetiracetam and lamotrigine use was comparable. Women managed at an epilepsy referral center were substantially less likely to receive potentially teratogenic ASMs, particularly valproate, despite representing a more clinically complex population. These findings highlight the contribution of specialized epilepsy care to optimizing pharmacological management for women of reproductive age and during pregnancy while supporting adherence to contemporary treatment recommendations.

PMID 43008432
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PubMedEpilepsy & behavior : E&B2026-11-09

Patient characteristics and treatment patterns in Dravet syndrome and Lennox-Gastaut syndrome: real-world evidence from physician- and caregiver-reported data in Japan.

Yamanouchi Hideo H, Shiraishi Hideaki H, Gillespie Alexander A, Grant Nikisha N et al.

Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) are rare, severe childhood-onset developmental and epileptic encephalopathies associated with treatment-resistant seizures and significant cognitive, behavioral, and motor impairments, all of which require extensive support from caregivers. To describe real-world patient characteristics and treatment patterns in those with DS or LGS, and assess caregiver burden in Japan. Data for patients in Japan were analyzed descriptively from the Adelphi DS and LGS Disease Specific Programme™, a cross-sectional linked survey of physicians, patients, and caregivers (November 2022-August 2023). Thirty-four physicians provided data for 81 patients (DS = 31; LGS = 50). Within the 4 weeks prior to data collection, the most common seizure types reported for patients with DS were generalized tonic-clonic (35%) and tonic (32%), and for patients with LGS were tonic (68%) and atypical absence (22%). In both DS and LGS, cognitive and language impairments were reported to be prevalent, and valproate and carbamazepine were reported to be the most common first-line treatments before and after diagnosis. Current treatment satisfaction among responding physicians was reported to be moderate (somewhat satisfied: DS 56%; LGS 45%). Caregivers (n = 25) reported that managing seizures was the most difficult aspect of care for patients with DS or LGS. Moreover, many reported an impact of caregiving on their own health. Patients with DS or LGS in Japan are reported to experience substantial seizure and non-seizure burden, and perceived caregiver burden is high. These data underscore the importance of optimized therapies and comprehensive support systems to address both patient and caregiver needs.

PMID 43002840
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PubMedPediatric health, medicine and therapeutics2026-11-09

Sustained Seizure Freedom and Associated Factors Among Children and Adolescents Attending a Pediatric Neurology Clinic in Uganda: A Retrospective Cross-Sectional Study.

Abraham Nyok Atong A, Augustine Okejomoe Owiny O, Namisi Patrick Charles PC, Sebunya Robert R

Sustained seizure freedom is a central aim of childhood epilepsy care, yet long-term outcome data from specialist pediatric services in Uganda remain limited. We estimated the prevalence of documented sustained seizure freedom and examined associated factors among children and adolescents attending a specialist pediatric neurology clinic in Uganda. We reviewed records of children and adolescents attending the Pediatric Neurology Clinic at St. Francis Hospital Nsambya. The outcome was documented freedom from all epileptic seizures for at least 24 consecutive months. Under the investigator-confirmed recording rule, blank outcome fields were classified as not achieving sustained seizure freedom. Exploratory modified Poisson models with robust standard errors examined associations among records with usable covariates. Of 520 records screened, 496 were included; 385 met the documented endpoint (77.6%; 95% CI 73.7-81.1). Structured medicine selections were available for 395 records. Levetiracetam, sodium valproate, carbamazepine, and lamotrigine were selected in both monotherapy and polytherapy records; clobazam and diazepam were additionally selected in polytherapy in these fields. The available-case adjusted analysis included 389 records, of which 379 met the endpoint. Onset at 1-4 years versus <1 year had an adjusted prevalence ratio (aPR) of 1.08 (95% CI 1.00-1.17); polytherapy versus monotherapy had an aPR of 0.93 (95% CI 0.86-1.00). Point estimates were similar across age-variable specifications, but confidence intervals were close to or crossed the null. More than three-quarters of reviewed records met the documented 24-month seizure-free endpoint. Estimated associations with onset age and polytherapy were small, with uncertainty close to the null across model specifications. They should be interpreted cautiously because the adjusted subset differed from the full cohort and contained few records not meeting the endpoint.

PMID 43001210
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