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Apo-Oxcarbazepine (CA), Trileptal
Pharmacologic class: Carboxamide derivative
Therapeutic class: Anticonvulsant
Pregnancy risk category C
Blocks sodium channels in neural membranes, stabilizing hyperexcitable states and inhibiting neuronal firing and impulse transmission in brain
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 2 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
• Renal impairment
• Children ages 2 to younger than 4 weighing less than 20 kg (44 lb)
• Hypersensitivity to drug or its components
Use cautiously in:
• renal impairment
• pregnant or breastfeeding patients
• children younger than age 2 (safety not established).
• Administer twice daily with or without food.
• Shake oral suspension well. If desired, mix in small glass of water.
CNS: dizziness, vertigo, drowsiness, fatigue, headache, ataxia, tremor, emotional lability
EENT: abnormal vision, diplopia, nystagmus, rhinitis
GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia
Skin: acne, rash
Other: thirst, allergic reactions, edema, lymphadenopathy
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
• Monitor neurologic status closely for changes in cognition, mood, wakefulness, balance, and gait.
• Check sodium level. Watch for signs and symptoms of hyponatremia.
• 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.