Two medicines, side by side
Carbamazepine vs fluoxetine
Carbamazepine and fluoxetine are both labeled for bipolar disorder. Drugs@FDA records approvals of carbamazepine since 1968 and of fluoxetine since 1987. Pharmacies paid $0.119 per carbamazepine 200 mg tablet and $0.0519 per fluoxetine HCl 40 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, carbamazepine is a mood stabilizer and fluoxetine a serotonin reuptake inhibitor.
Check it at the source: the carbamazepine FDA label on DailyMed (effective August 20, 2026); the fluoxetine FDA label on DailyMed (effective January 8, 2026).
Highlights of the carbamazepine record
Carbamazepine (Tegretol) · label of August 20, 2026
SERIOUS DERMATOLOGIC REACTIONS AND HLA-B*1502 ALLELE SERIOUS AND SOMETIMES FATAL DERMATOLOGIC REACTIONS, INCLUDING TOXIC EPIDERMAL NECROLYSIS (TEN) AND STEVENS-JOHNSON SYNDROME (SJS), HAVE BEEN REPORTED DURING TREATMENT WITH TEGRETOL. THESE REACTIONS ARE ESTIMATED TO OCCUR IN 1 TO 6 PER 10,000 NEW USERS IN COUNTRIES WITH MAINLY CAUCASIAN POPULATIONS, BUT THE RISK IN SOME ASIAN COUNTRIES IS ESTIMATED TO BE ABOUT 10 TIMES HIGHER.
Used for
From the label: indicationsEpilepsy Tegretol is indicated for use as an anticonvulsant drug. Evidence supporting efficacy of Tegretol as an anticonvulsant was derived from active drug-controlled studies that enrolled patients with the following seizure types: Partial seizures with complex symptomatology (psychomotor, temporal lobe). Patients with these seizures appear to show greater improvement than those with other types. […]
On the market
- Earliest approval on file
- March 11, 1968
- Generic labelers
- 42 labelers
- Pharmacy cost
- $0.119 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 11
Highlights of the fluoxetine record
Fluoxetine (Prozac) · label of January 8, 2026
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older [see Warnings and Precautions ( 5.1 )].
Used for
From the label: indicationsPROZAC ® is indicated for the treatment of: Acute and maintenance treatment of Major Depressive Disorder [see Clinical Studies ( 14.1 )]. Acute and maintenance treatment of obsessions and compulsions in patients with Obsessive Compulsive Disorder (OCD) [see Clinical Studies ( 14.2 )]. […]
On the market
- Earliest approval on file
- December 29, 1987
- Generic labelers
- 58 labelers
- Pharmacy cost
- $0.0519 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 9
Source: FDA drug labels via openFDA (Carbamazepine label of August 20, 2026, Fluoxetine label of January 8, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do carbamazepine and fluoxetine differ on the record?
In FDA's classes, carbamazepine is a mood stabilizer and fluoxetine a serotonin reuptake inhibitor.
How each works, in its label's words: Carbamazepine, “It appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation.”; Fluoxetine, “Although the exact mechanism of PROZAC is unknown, it is presumed to be linked to its inhibition of CNS neuronal uptake of serotonin.”
Half-life, in each label's words: Carbamazepine, “Initial half-life values range from 25 to 65 hours, decreasing to 12 to 17 hours on repeated doses.”; Fluoxetine, “Its mean terminal half-life after a single dose was 8.6 days and after multiple dosing was 9.3 days.”
Both labels carry a boxed warning; the records quote them.
Generics: carbamazepine since 1986; fluoxetine since 2001 (Drugs@FDA).
| Carbamazepine | Fluoxetine | |
|---|---|---|
| Labeled for | Bipolar disorder, Seizures and epilepsy | Depression, Anxiety, Bipolar disorder |
| Pharmacologic class | Mood Stabilizer | Serotonin Reuptake Inhibitor |
| How it works (label) | Mechanism of Action Tegretol has demonstrated anticonvulsant properties in rats and mice with electrically and chemically induced seizures. It appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation. | Although the exact mechanism of PROZAC is unknown, it is presumed to be linked to its inhibition of CNS neuronal uptake of serotonin. |
| Half-life (label) | Initial half-life values range from 25 to 65 hours, decreasing to 12 to 17 hours on repeated doses. | Its mean terminal half-life after a single dose was 8.6 days and after multiple dosing was 9.3 days. |
| Earliest approval on file (Drugs@FDA) | March 11, 1968 | December 29, 1987 |
| First generic approved | August 14, 1986 | August 2, 2001 |
| Generic labelers (NDC) | 42 labelers | 58 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.119 per tablet (Carbamazepine 200 mg tablet) | $0.0519 per capsule (Fluoxetine HCl 40 mg capsule) |
| 12-month price change | +0.6% | -20% |
| Boxed warning | Yes | Yes |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 11 | 9 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 66,615 | 131,827 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Carbamazepine label, drug interactionsDrugs that have been shown, or would be expected, to increase plasma carbamazepine levels include aprepitant, cimetidine, ciprofloxacin, danazol, diltiazem, macrolides (e.g., erythromycin, clarithromycin), fluoxetine, fluvoxamine, trazodone, omeprazole, oxybutynin, isoniazid, niacinamide (nicotinamide), azoles (e.g., ketaconazole, itraconazole, fluconazole, voriconazole), acetazolamide, verapamil, ticlopidine …
Carbamazepine label, drug interactionsAcetazolamide, aprepitant, azole antifungals (e.g., ketoconazole, itraconazole, fluconazole, voriconazole), cimetidine, ciprofloxacin, clarithromycin, dalfopristin, danazol, dantrolene, delavirdine, diltiazem, erythromycin, fluoxetine, fluvoxamine, grapefruit juice, ibuprofen, isoniazid, loratadine, macrolides, nefazodone, niacinamide, nicotinamide, olanzapine, omeprazole, oxybutynin, protease inhibitors …
Fluoxetine label, drug interactionsAnticonvulsants – Patients on stable doses of phenytoin and carbamazepine have developed elevated plasma anticonvulsant concentrations and clinical anticonvulsant toxicity following initiation of concomitant fluoxetine treatment.
Source: FDA drug labels via openFDA
What do the labels say about using others of their kind?
Fluoxetine label, warnings and precautionsSerotonin syndrome has been reported with SSRIs and SNRIs, including PROZAC, both when taken alone, but especially when co-administered with other serotonergic agents.
Source: FDA drug labels via openFDA
What next?
- Alternatives to carbamazepine
- every medicine labeled for the same conditions