Oxcarbazepine

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Brand names: Trileptal®

Chemical formula:

Drug Forms:
• Oxcarbazepine tablets (below)
• Oxcarbazepine oral suspension
• Oxcarbazepine Oral suspension
• Oxcarbazepine Oral tablet

Español:
• Tabletas de oxcarbazepina
• Suspensión oral de oxcarbazepina
• Oxcarbazepina, Suspensión oral
• Oxcarbazepina, Tableta oral

Oxcarbazepine tablets

What are oxcarbazepine tablets?

OXCARBAZEPINE (Trileptal®) can help to control partial seizures (convulsions) in people with epilepsy. Oxcarbazepine can also treat facial nerve pain from trigeminal neuralgia. Generic oxcarbazepine tablets are available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• an alcohol abuse problem
• depression
• kidney disease
• suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
• any unusual or allergic reaction to oxcarbazepine, carbamazepine, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I take this medicine?

Take oxcarbazepine tablets by mouth. Oxcarbazepine tablets may be taken with or without food. Follow the directions on the prescription label. Take your doses at regular intervals. Do not take your medicine more often than directed.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What drug(s) may interact with oxcarbazepine?

• alcohol
• carbamazepine
• felodipine
• female hormones, including birth control pills, injections, patches or implants
• fosphenytoin
• lamotrigine
• phenobarbital
• phenytoin
• primidone
• sevelamer
• valproic acid
• verapamil

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines and herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking oxcarbazepine?

Visit your prescriber or health care professional for a regular check on your progress. Do not stop taking this medicine suddenly. This increases the risk of seizures. Wear a Medic Alert bracelet or necklace. Carry an identification card with information about your condition, medications, and prescriber or health care professional.

Rarely, serious skin allergic reactions may occur with this medicine. If you develop a skin rash, redness, itching, peeling skin inside your mouth, swollen glands, or a fever while taking this medicine, contact your health care provider immediately.

The use of this medicine may increase the chance of suicidal thoughts or actions. Pay special attention to how you are responding while on this medicine. Any worsening of mood, or thoughts of suicide or dying should be reported to your health care professional right away.

You may get drowsy or dizzy when you first start taking this medicine. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Alcohol can increase drowsiness and dizziness. Avoid alcoholic drinks.

If you are female and are taking birth control pills (contraceptive pills) or using other hormonal birth control methods (like injections), you should know that the birth control may not work as well while you are taking this drug. You may need to talk to your prescriber about effective ways to prevent pregnancy. Let your prescriber know if you experience any unusual menstrual-type bleeding or spotting or if you think you might be pregnant while on this medicine.

If you are going to have surgery, tell your prescriber or health care professional that you are taking this medicine.

What side effects may I notice from taking oxcarbazepine?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• allergic reaction (fever, rash, muscle aches or pain, hives, difficulty breathing, or swelling of the lips, throat, or eyelids)
• confusion
• difficulty speaking or walking
• dizziness
• infection
• muscle incoordination
• nausea or vomiting
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• swelling of the legs and ankles
• unexplained tiredness
• unusual bruising or bleeding
• vision changes
• weakness
• worsening of mood, thoughts or actions of suicide or dying

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• constipation
• diarrhea
• difficulty sleeping
• drowsiness
• headache
• loss of appetite
• nervousness
• stomach upset, indigestion
• tremor

Where can I keep my medicine?

Keep out of reach of children in a container that small children cannot open.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep container tightly closed. Protect from light or moisture. Throw away any unused medicine after the expiration date

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Oxcarbazepine
Systematic (IUPAC) name
10,11-Dihydro-10-oxo-5 H -dibenz(b,f)azepine-5-carboxamide
Identifiers
CAS number	28721-07-5
ATC code	N03AF02
PubChem	34312
DrugBank	APRD01308
ChemSpider	31608
Chemical data
Formula	C15H12N2O2
Mol. mass	252.268 g/mol
SMILES	eMolecules & PubChem
Pharmacokinetic data
Bioavailability	> 95%
Protein binding	?
Metabolism	Hepatic (Cytosolic Enzymes & Glucuronic Acid)
Half life	1-5 hours (healthy adults)
Excretion	Renal
Therapeutic considerations
Pregnancy cat.	C(US)
Legal status	POM(UK) ℞-only(US)
Routes	Oral (Tablets or Suspension)

Oxcarbazepine is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. It is also used to treat anxiety disorders. Oxcarbazepine is marketed as Trileptal by Novartis and in egypt is marketed also as Oxaleptal 600mg by Mash Premiere and available in some countries as a generic drug.

Oxcarbazepine is a structural derivative of carbamazepine, with a ketone in place of the carbon-carbon double bond on the dibenzazepine ring. This difference helps reduce the impact on the liver of metabolizing the drug, and also prevents the serious forms of anemia or agranulocytosis occasionally associated with carbamazepine. Aside from this reduction in side effects, it is thought to have the same mechanism as carbamazepine - sodium channel inhibition (presumed to be the main mechanism of action) - and is generally used to treat the same conditions. Oxcarbazepine has recently been found to be associated with a greater enhancement in mood and reduction in anxiety symptoms than other drugs employed to treat epilepsy.^[1]

Contents 1 History 2 Pharmacology 3 Side effects 4 Possible reproductive risks 4.1 Nursing mothers 5 References 6 External links

History

First synthesized in 1966,^{[citation needed]} it was approved for use as an anticonvulsant in Denmark in 1990. It was approved in Spain in 1993, in Portugal in 1997, and eventually for all other EU countries in 1999. It was approved in the US in 2000.

300mg Trileptal tablets

Pharmacology

Oxcarbazepine is a prodrug which is activated to eslicarbazepine in the liver.^[2]

Side effects

Oxcarbazepine causes dizziness, drowsiness, blurred or double vision, fatigue and may cause headaches, nausea, and vomiting. It can also cause hyponatremia (2.7% of patients), so blood sodium levels should be tested if the patient complains of severe fatigue. Some of these side effects (such as headache) are more pronounced shortly after a dose is taken and tend to fade with the passage of time (generally 60 to 90 minutes). A craving for salty foods (such as potato chips) and increased impulsiveness have also been noted. Other side effects include stomach pain; tremor; rash; diarrhea, constipation, decreased appetite; and dry mouth. Skin sensitivity to sunlight also may increase, and patients could experience severe sunburns as a result of sun exposure. The frequency of adverse effects rises above a daily dosage of 1200 mg.

Possible reproductive risks

Oxcarbazapine may cause oral hormonal contraceptives to be less effective.

Increased incidences of fetal structural abnormalities and other manifestations of developmental toxicity (embryolethality, growth retardation) were observed in the offspring of animals (rats and rabbits) treated with either oxcarbazepine or its active 10-hydroxy metabolite (MHD) during pregnancy at doses similar to the maximum recommended human dose.

There are no adequate and well-controlled clinical studies of oxcarbazepine in pregnant women; however, oxcarbazepine is closely related structurally to carbamazepine, which is considered to be teratogenic in humans. Given this fact, and the results of the animal studies described, it is likely that oxcarbazepine is a human teratogen. Oxcarbazepine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nursing mothers

Oxcarbazepine and its active metabolite MHD are excreted in human breast milk. Because of the potential for serious adverse reactions to oxcarbazepine in nursing infants, a decision should be made about whether to discontinue nursing or to discontinue the drug in nursing women, taking into account the importance of the drug to the mother.

References

1. ^ Mazza M, Della Marca G, Di Nicola M, et al. (May 2007). "Oxcarbazepine improves mood in patients with epilepsy". Epilepsy Behav 10 (3): 397–401. doi:10.1016/j.yebeh.2007.01.003. PMID 17300991. 
2. ^ Dulsat, C., Mealy, N., Castaner, R., Bolos, J. (2009). "Eslicarbazepine acetate". Drugs of the Future 34 (3): 189. 

• ChemicalLand21.com: Oxcarbazepine
• Trileptal Story
• Trileptal.com(Novartis)
• Prescribing Information(PDF)

External links

• RxList entry
• http://www.psycheducation.org/depression/meds/moodstabilizers.htm
• http://www.psycheducation.org/depression/meds/trileptal.htm
• DrugBank entry

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