Oxcarbazepine (Trileptal)

Trade name Trileptal

Routes include oral tablets or suspension.

Bioavailability > 95%.

Metabolism is hepatic.

Half-life is 1-5 hours and has renal excretion.

An anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy.

Utilized to treat anxiety and mood disorders, and benign motor tics.

Has greater mood enhancement abilities and reduces anxiety symptoms more than other drugs employed to treat epilepsy.

Effective in approximately half of patients with bipolar disorders.

Well tolerated agent.

A derivative of carbamazepine , but has fewer side effects.

Mechanism of action- sodium channel inhibition.

A prodrug which is activated to eslicarbazepine in the liver.

Available as 300mg Trileptal tablets

Side effects: dizziness, drowsiness, blurred or double vision, fatigue, headaches, nausea, and vomiting, impaired concentration and mental sluggishness, and hyponatremia in 2.7% of patients.

Headaches tend to fade with time, usually 60 to 90 minutes.

May be associated with a craving for salty foods.

May be associated with stomach pain, ; rash, diarrhea, constipation, decreased appetite, tremors, and dry mouth.

Skin sensitivity to sunlight also may increase.

May cause oral hormonal contraceptives to be less

Likely a human teratogen.

Used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Excreted in human breast milk.

Can be taken with or without food.

Treatment should be initiated with a dose of 600 mg/day, given in a twice-a-day regimen.

The dose may be increased by a maximum of 600 mg/day at approximately weekly intervals; the recommended daily dose is 1200 mg/day.

Daily doses above 1200 mg/day show somewhat greater effectiveness, but most patients are not able to tolerate the 2400 mg/day dose, primarily because of CNS effects.

In pediatric patients aged 4-16 years, treatment should is initiated at a daily dose of 8-10 mg/kg not to exceed 600 mg/day, given in a twice-a-day regimen.

The target maintenance dose is to be achieved over two weeks, and is dependent upon patient weight.

In pediatric patients aged 2-<4 years, treatment initiated at a daily dose of 8-10 mg/kg, and should not to exceed 600 mg/day, given in a twice-a-day regimen.

For patients under 20 kg, a starting dose of 16-20 mg/kg may be considered.

In patients receiving concomitant antiepileptic drugs, converting to monotherapy by initiating treatment with standard doses, while simultaneously initiating the reduction of the dose of the concomitant antiepileptic drugs to be completely withdrawn over 3-6 weeks.

Dose adjustments are not required in patients with mild-to-moderate hepatic impairment, but with impaired renal function therapy should be initiated at one-half the usual starting dose (300 mg/day) and increased slowly to achieve the desired clinical response.

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