How Equetro Works and How It’s Taken

Equetro is an anti-seizure medication that affects sodium and calcium channels and certain chemical messengers in the brain. However, the exact way it works to treat acute manic or mixed episodes associated with bipolar 1 disorder is not fully known. During these episodes, Equetro may help calm overly active brain signaling.

Doctors prescribe Equetro when adults have an acute manic or mixed episode linked to bipolar 1 disorder.

Equetro comes as an extended-release capsule that is taken by mouth. It is usually taken twice a day. The capsule can be swallowed whole or opened and sprinkled over a small amount of food, such as applesauce.

Do not crush or chew the capsule or beads. A healthcare provider may include Equetro as part of a broader bipolar 1 treatment plan.

Typical Dosing for Bipolar 1 Mania

The recommended starting dose of Equetro for acute manic or mixed episodes associated with bipolar 1 disorder is 200 milligrams twice daily. A doctor may increase the dose by 200 milligrams per day to help achieve the best response.

Doses above 1,600 milligrams per day have not been studied for bipolar 1 mania. If treatment needs to be stopped, the dose should usually be lowered gradually rather than stopped suddenly.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Equetro Side Effects

In clinical studies of Equetro for acute manic or mixed episodes associated with bipolar 1 disorder in adults, the most common side effects occurred in about 6 percent to 44 percent of people. These include:

• Dizziness
• Somnolence (sleepiness)
• Nausea
• Vomiting
• Ataxia (trouble with walking or coordination)
• Constipation
• Pruritus (itching)
• Dry mouth
• Asthenia (weakness or low energy)
• Blurred vision
• Speech problems

Serious Side Effects and Warnings

Equetro can cause serious side effects that may require immediate medical attention. These include:

• Serious skin reactions — Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) can cause a painful rash, blistering or peeling skin, mouth sores, or fever.
• Aplastic anemia and agranulocytosis — These blood disorders can cause dangerously low blood cell counts, infections, fever, sore throat, unusual bruising, or bleeding.
• Drug reaction with eosinophilia and systemic symptoms (DRESS) or multiorgan hypersensitivity — A severe allergic reaction can affect organs such as the liver and blood.
• Suicidal thoughts or behaviors — New or worsening depression, mood changes, or thoughts of self-harm can occur.
• Embryo-fetal toxicity — Equetro can harm your baby if you are pregnant.
• Abrupt discontinuation and seizure risk — Stopping Equetro suddenly can cause serious problems, including seizures.
• Hyponatremia (low sodium levels) — This can cause headache, confusion, weakness, or seizures.
• Cognitive and motor impairment — Equetro can impair judgment, thinking, and movement.
• Loss of virologic response with certain antiviral drugs — Equetro can interact with some HIV medications.
• Liver damage — Equetro can cause worsening liver function or, rarely, liver failure.
• AV heart block — This heart rhythm problem can cause dizziness, fainting, or a slow heartbeat.
• Hepatic porphyria — Equetro may trigger attacks in people with hepatic porphyria.
• Increased intraocular pressure — Increased pressure inside the eye can cause eye pain, vision changes, or halos around lights.
• Neuroleptic malignant syndrome (NMS) — This rare, life-threatening reaction can cause high fever, severe muscle stiffness, confusion, and sweating.
• Lupus-like syndrome — Symptoms similar to lupus, such as joint pain, rash, or fever, can occur.
• Aseptic meningitis — Inflammation around the brain and spinal cord can cause severe headache, fever, stiff neck, and sensitivity to light.

Get medical help right away if you think you are having a serious reaction.

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How To Save on Equetro

The Equetro website offers a patient discount card. Eligible people may pay a minimum of $20 and receive up to $100 off their copay or out-of-pocket expenses for a 30-day supply.

The Equetro discount card can be printed and presented at the pharmacy when filling an Equetro prescription. To learn more, visit the Equetro Patient Support page or call 866-297-6945.

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What To Know Before Taking Equetro

Before starting Equetro, your doctor will test or check for:

• The HLA-B*1502 gene in people with ancestry from genetically at-risk populations
• Blood counts, including platelets
• Liver function
• An eye exam, including slit-lamp, funduscopy, and tonometry
• Urinalysis and blood urea nitrogen (BUN), a kidney-related blood test

Before you take Equetro, tell your doctor if you have or have had:

• Suicidal thoughts or actions, depression, or mood problems
• Heart problems
• Blood problems
• Liver problems
• Kidney problems
• Allergic reactions to medications
• Increased pressure in your eye
• Any other medical conditions

Also tell your doctor if you drink grapefruit juice or eat grapefruit, or use birth control. Equetro may make birth control less effective. Tell your doctor if your menstrual bleeding changes while you take birth control and Equetro.

Tell your doctor if you have any allergies to carbamazepine or any ingredients in Equetro. Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Do not take Equetro if you:

• Have a history of bone marrow depression
• Are allergic to carbamazepine
• Are allergic to certain tricyclic antidepressants
• Take delavirdine or certain related HIV medicines
• Take nefazodone
• Take a monoamine oxidase inhibitor (MAOI) or have taken one in the last 14 days

Do not stop taking Equetro without first talking to your doctor. Stopping Equetro suddenly can cause serious problems.

Equetro is also FDA-approved to treat trigeminal neuralgia pain and certain types of seizures.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Equetro, talk with your doctor about the risks and benefits. Equetro can harm your baby if you are pregnant.

There is a pregnancy exposure registry for people who take Equetro during pregnancy. To learn more, visit the North American Antiepileptic Drug (NAAED) Pregnancy Registry or call 888-233-2334.

Community FAQs

These answers are fact-checked by our editorial staff.

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Learn More

On MyDepressionTeam, people share their experiences with depression and related conditions, get advice, and find support from others who understand.

Learn more about Equetro and bipolar 1 care:

• Homepage — Equetro
• 6 Treatments for Bipolar 1: Anticonvulsants, Antipsychotics, and More — MyDepressionTeam
• Supportive Therapy for Bipolar Disorder: How To Prepare — MyDepressionTeam
• Depression — An Overview — MyDepressionTeam
• Bipolar Disorder — National Alliance on Mental Illness

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