Two medicines, side by side
Carbamazepine vs meperidine
Carbamazepine is labeled for bipolar disorder and seizures and epilepsy; meperidine for pain. Their labels share no use, so they are not alternatives to each other. Drugs@FDA records approvals of carbamazepine since 1968 and of meperidine since 1942. Pharmacies paid $0.119 per carbamazepine 200 mg tablet and $0.157 per mL (Meperidine 50 mg/5 mL solution) (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 meperidine an opioid agonist.
Check it at the source: the carbamazepine FDA label on DailyMed (effective August 20, 2026); the meperidine FDA label on DailyMed (effective November 29, 2025).
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 meperidine record
Meperidine (Demerol) · label of November 29, 2025
SERIOUS AND LIFE-THREATENING RISKS FROM USE OF MEPERIDINE HYDROCHLORIDE TABLETS Addiction, Abuse, and Misuse Because the use of Meperidine hydrochloride tablets exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death, assess each patient’s risk prior to prescribing and reassess all patients regularly for the development of these behaviors and conditions [see Warnings and Precautions (5.2) ].
Used for
From the label: indicationsMeperidine hydrochloride tablets are indicated for the management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. […]
On the market
- Earliest approval on file
- November 10, 1942
- Generic labelers
- 3 labelers
- Pharmacy cost
- $0.157 per mL
Supply and safety
- Shortage
- Listed; available
- Recalls
- 0
Source: FDA drug labels via openFDA (Carbamazepine label of August 20, 2026, Meperidine label of November 29, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do carbamazepine and meperidine differ on the record?
In FDA's classes, carbamazepine is a mood stabilizer and meperidine an opioid agonist.
How each works, in its label's words: Carbamazepine, “It appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation.”; Meperidine, “Meperidine is an opioid agonist with multiple actions qualitatively similar to those of morphine; the most prominent of these involve the central nervous system and organs composed of smooth muscle.”
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.”; Meperidine, “Elimination The elimination half-life is 3 to 8 hours in healthy volunteers.”
Both labels carry a boxed warning; the records quote them.
Generics: carbamazepine since 1986; meperidine since 1972 (Drugs@FDA).
DEA schedule: carbamazepine none; meperidine CII.
| Carbamazepine | Meperidine | |
|---|---|---|
| Labeled for | Bipolar disorder, Seizures and epilepsy | Pain |
| Pharmacologic class | Mood Stabilizer | Opioid Agonist |
| 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. | Meperidine is an opioid agonist with multiple actions qualitatively similar to those of morphine; the most prominent of these involve the central nervous system and organs composed of smooth muscle. |
| Half-life (label) | Initial half-life values range from 25 to 65 hours, decreasing to 12 to 17 hours on repeated doses. | Elimination The elimination half-life is 3 to 8 hours in healthy volunteers. |
| Earliest approval on file (Drugs@FDA) | March 11, 1968 | November 10, 1942 |
| First generic approved | August 14, 1986 | April 26, 1972 |
| Generic labelers (NDC) | 42 labelers | 3 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.119 per tablet (Carbamazepine 200 mg tablet) | $0.157 per mL (Meperidine 50 mg/5 mL solution) |
| 12-month price change | +0.6% | -2% |
| Boxed warning | Yes | Yes |
| Shortage now | A presentation being discontinued | Listed; available |
| Recalls recorded | 11 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 66,615 | 9,161 |
| DEA schedule | none | CII |
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?
Meperidine label, drug interactionsCYP3A4 and CYP2B6 Inducers Clinical Impact: The concomitant use of meperidine hydrochloride tablets and CYP3A4 or CYP2B6 inducers can decrease the plasma concentration of meperidine, resulting in decreased efficacy or onset of a withdrawal syndrome in patients who have developed … intervals for signs of respiratory depression and sedation. Examples: Rifampin, carbamazepine, phenytoin
Meperidine label, warnings and precautionsSimilarly, discontinuation of a CYP3A4 inducer, such as rifampin, carbamazepine, and phenytoin, in meperidine hydrochloride tablets-treated patients may increase meperidine plasma concentrations and prolong opioid adverse reactions.
Source: FDA drug labels via openFDA
What do the labels say about using others of their kind?
Meperidine label, warnings and precautionsRisks from Concomitant Use with Benzodiazepines or Other CNS Depressants Profound sedation, respiratory depression, coma, and death may result from the concomitant use of meperidine hydrochloride tablets with benzodiazepines and/or other CNS depressants, including alcohol (e.g., non-benzodiazepine sedatives/hypnotics, anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics, gabapentinoids …
Source: FDA drug labels via openFDA
What next?
- Alternatives to carbamazepine
- every medicine labeled for the same conditions