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General Recommendation

  • ECTR is suggested in severe carbamazepine poisoning (2D)



ECTR is recommended if ANY of the following conditions are present:

  • If multiple seizures refractory to treatment occur (1D)

  • If life-threatening dysrhythmias occur (1D)

ECTR is suggested if ANY of the following conditions are present:

  • If prolonged coma and/or respiratory depression requiring mechanical ventilation is present or expected (2D)

  • If significant toxicity persists, especially if carbamazepine concentrations rise or remain elevated, despite MDAC and support measures (2D)


Cessation of ECTR

  • Clinical improvement is apparent (1D)

  • Carbamazepine concentration is below 10 mg/L (42 µmol/L) (2D) 


Choice of ECTR

  • Intermittent HD is the preferred ECTR in carbamazepine poisoning (1D)

The following are alternatives if hemodialysis is not available:

  • Intermittent hemoperfusion (1D)

  • Continuous renal replacement therapy (3D)



  • MDAC should be continued during ECTR (1D)

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