Two medicines, side by side
Carbamazepine vs nortriptyline
Carbamazepine is labeled for bipolar disorder and seizures and epilepsy; nortriptyline for depression. Their labels share no use, so they are not alternatives to each other. Drugs@FDA records approvals of carbamazepine since 1968 and of nortriptyline since 1964. Pharmacies paid $0.119 per carbamazepine 200 mg tablet and $0.113 per nortriptyline HCl 10 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 nortriptyline a tricyclic antidepressant.
Check it at the source: the carbamazepine FDA label on DailyMed (effective August 20, 2026); the nortriptyline FDA label on DailyMed (effective December 4, 2024).
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 nortriptyline record
Nortriptyline (Pamelor) · label of December 4, 2024
Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of nortriptyline hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.
Used for
From the label: indicationsPamelor™ (nortriptyline HCl) is indicated for the relief of symptoms of depression. Endogenous depressions are more likely to be alleviated than are other depressive states.
On the market
- Earliest approval on file
- November 6, 1964
- Generic labelers
- 25 labelers
- Pharmacy cost
- $0.113 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Source: FDA drug labels via openFDA (Carbamazepine label of August 20, 2026, Nortriptyline label of December 4, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do carbamazepine and nortriptyline differ on the record?
In FDA's classes, carbamazepine is a mood stabilizer and nortriptyline a tricyclic antidepressant.
Both labels carry a boxed warning; the records quote them.
Generics: carbamazepine since 1986; nortriptyline since 1992 (Drugs@FDA).
| Carbamazepine | Nortriptyline | |
|---|---|---|
| Labeled for | Bipolar disorder, Seizures and epilepsy | Depression |
| Pharmacologic class | Mood Stabilizer | Tricyclic Antidepressant |
| 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. | n/a |
| Half-life (label) | Initial half-life values range from 25 to 65 hours, decreasing to 12 to 17 hours on repeated doses. | n/a |
| Earliest approval on file (Drugs@FDA) | March 11, 1968 | November 6, 1964 |
| First generic approved | August 14, 1986 | March 30, 1992 |
| Generic labelers (NDC) | 42 labelers | 25 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.119 per tablet (Carbamazepine 200 mg tablet) | $0.113 per capsule (Nortriptyline HCl 10 mg capsule) |
| 12-month price change | +0.6% | -2% |
| Boxed warning | Yes | Yes |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 11 | 2 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 66,615 | 5,761 |
| 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, contraindicationsCONTRAINDICATIONS Tegretol should not be used in patients with a history of previous bone marrow depression, hypersensitivity to the drug, or known sensitivity to any of the tricyclic compounds, such as amitriptyline, desipramine, imipramine, protriptyline, nortriptyline, etc. Likewise, on theoretical grounds its use with monoamine oxidase (MAO) inhibitors is not recommended.
Carbamazepine label, contraindicationsCONTRAINDICATIONS Carbamazepine should not be used in patients with a history of previous bone marrow depression, hypersensitivity to the drug, or known sensitivity to any of the tricyclic compounds, such as amitriptyline, desipramine, imipramine, protriptyline and nortriptyline.
Source: FDA drug labels via openFDA
What do the labels say about using others of their kind?
Nortriptyline label, warningsIf concomitant use of Pamelor with other serotonergic drugs, including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, tryptophan, and St. John’s Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases.
Source: FDA drug labels via openFDA
What next?
- Alternatives to carbamazepine
- every medicine labeled for the same conditions