oxcarbazepine

oxcarbazepine /ox·car·baz·e·pine/ (oks″kahr-baz´ĕ-pēn) an anticonvulsant used in the treatment of partial seizures.

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oxcarbazepine

[oks′kär-baz′ĕ-pēn]

an anticonvulsant used in the treatment of partial seizures. It is administered orally.

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oxcarbazepine [oks″kahr-baz´ĕ-pēn]

an anticonvulsant used in the treatment of partial seizures, administered orally.

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oxcarbazepine

Trileptal

Pharmacologic class: Carboxamide derivative

Therapeutic class: Anticonvulsant

Pregnancy risk category C

Action

Blocks sodium channels in neural membranes, stabilizing hyperexcitable states and inhibiting neuronal firing and impulse transmission in brain

Availability

Oral suspension: 300 mg/5-ml bottle

Tablets: 150 mg, 300 mg, 600 mg

⊘Indications and dosages

➣ Adjunctive therapy for partial seizures

Adults: 300 mg P.O. b.i.d. May increase by up to 600 mg/day q week, to a maximum of 1,200 mg/day.

Children ages 4 to 16: Initially, 8 to 10 mg/kg/day P.O. to a maximum of 600 mg/day

➣ Conversion to monotherapy for partial seizures

Adults: 300 mg P.O. b.i.d. May increase by 600 mg/day at weekly intervals over 2 to 4 weeks, to a maximum of 2,400 mg/day

Children ages 4 to 16: Initially, 8 to 10 mg/kg/day P.O. given in two divided doses, increased to a maximum of 10 mg/kg/day

➣ Initiation of monotherapy

Adults: 300 mg P.O. b.i.d., increased by 300 mg/day P.O. q 3 days up to 1,200 mg/day

Children ages 4 to 16: Initially, 8 to 10 mg/kg/day P.O. given in two divided doses; increase by 5 mg/kg q 3 days to a maximum of 1,200 mg/day

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• renal impairment
• pregnant or breastfeeding patients
• children younger than age 4 (safety not established).

Administration

• Administer twice daily with or without food.
• Shake oral suspension well. If desired, mix in small glass of water.

Route	Onset	Peak	Duration
P.O.	Unknown	Unknown	Unknown

Adverse reactions

CNS: dizziness, vertigo, drowsiness, fatigue, headache, ataxia, tremor, emotional lability

EENT: abnormal vision, diplopia, nystagmus, rhinitis

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia

Metabolic: hyponatremia

Skin: acne, rash

Other: thirst, allergic reactions, edema, lymphadenopathy

Interactions

Drug-drug. Carbamazepine, valproic acid, verapamil: decreased oxcarbazepine blood level

CNS depressants (including antidepressants, antihistamines, opioids, sedative-hypnotics): additive CNS depression

Felodipine, hormonal contraceptives: decreased blood levels of these drugs

Phenobarbital: decreased oxcarbazepine and increased phenobarbital blood levels

Phenytoin: increased phenytoin blood level

Drug-diagnostic tests. Sodium: decreased level

Drug-behaviors. Alcohol use: additive CNS depression

Patient monitoring

• Monitor neurologic status closely for changes in cognition, mood, wakefulness, balance, and gait.
• Check sodium level. Watch for signs and symptoms of hyponatremia.

Patient teaching

• Instruct patient to take at same time each day, with or without food.
• Tell patient to report vision changes and significant neurologic changes.
• Advise patient to have periodic eye exams.
• Tell female patient that drug makes hormonal contraceptives less effective.
• Inform patient that he may need frequent tests to check drug blood levels.
• Tell patient not to drink alcohol.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects him.
• As appropriate, review all significant adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.