Eslicarbazepine Brand Name– Aptiom
What is Eslicarbazepine
Eslicarbazepine is an oral anticonvulsant indicated for monotherapy or adjunctive treatment of partial seizures.
Eslicarbazepine acetate is a prodrug for eslicarbazepine (S-licarbazepine), which is the active metabolite of oxcarbazepine. In a pharmacokinetic study comparing eslicarbazepine acetate to oxcarbazepine, administration of eslicarbazepine acetate resulted in greater exposure to the eslicarbazepine metabolite and lower exposure to the R-licarbazepine and oxcarbazepine metabolites.
This may correlate with improved tolerability of eslicarbazepine acetate compared with oxcarbazepine.
Efficacy for monotherapy treatment was established in 2 dose-blinded historical control trials.
Various exit criterion indicative of seizure activity occurred in approximately 13—44% of patients, where a pre-specified threshold below 65% defined efficacy.
Efficacy for adjunctive treatment was established in clinical trials which enrolled patients with partial onset seizures who were not controlled with 1 to 3 concomitant antiepileptic drugs (AEDs). In these studies, eslicarbazepine resulted in a statistically significant reduction in seizure frequency compared with placebo.
In addition, a reduction in seizure frequency of >= 50% was reported in statistically significantly more patients treated with eslicarbazepine compared with placebo.
Eslicarbazepine is also under investigation as a possible treatment for bipolar disorder.
Eslicarbazepine was FDA-approved in November 2013.
Indications
- partial seizures
For monotherapy or adjunctive treatment of partial seizures
NOTE: Eslicarbazepine is a prodrug for the active metabolite of oxcarbazepine and should therefore not be used as adjunctive therapy with oxcarbazepine.
Side Effects
- abdominal pain
- agranulocytosis
- amnesia
- anaphylactoid reactions
- angioedema
- aphasia
- asthenia
- ataxia
- blurred vision
- confusion
- constipation
- cough
- cystitis
- depression
- diarrhea
- diplopia
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysarthria
- elevated hepatic enzymes
- fatigue
- gastritis
- headache
- hyperbilirubinemia
- hypercholesterolemia
- hypertension
- hypertriglyceridemia
- hypochloremia
- hyponatremia
- impaired cognition
- insomnia
- lethargy
- leukopenia
- malaise
- megaloblastic anemia
- memory impairment
- nausea
- nystagmus
- pancytopenia
- peripheral edema
- physiological dependence
- psychomotor impairment
- rash
- seizures
- SIADH
- Stevens-Johnson syndrome
- suicidal ideation
- thrombocytopenia
- toxic epidermal necrolysis
- tremor
- vertigo
- visual impairment
- vomiting
- withdrawal
Monitoring Parameters
- LFTs
- serum chloride
- serum sodium
Contraindications
- abrupt discontinuation
- breast-feeding
- depression
- driving or operating machinery
- eslicarbazepine hypersensitivity
- ethanol intoxication
- geriatric
- hepatic disease
- hyponatremia
- oxcarbazepine hypersensitivity
- pregnancy
- renal impairment
- suicidal ideation
Eslicarbazepine is contraindicated in patients with a history of eslicarbazepine hypersensitivity or oxcarbazepine hypersensitivity.
Interactions
- Abemaciclib
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Alprazolam
- Amiodarone
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamines
- Aprepitant, Fosaprepitant
- Aripiprazole
- Artemether; Lumefantrine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atorvastatin
- Atorvastatin; Ezetimibe
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Avapritinib
- Axitinib
- Barbiturates
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benzhydrocodone; Acetaminophen
- Boceprevir
- Brigatinib
- Bromocriptine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Butabarbital
- Capmatinib
- Carbamazepine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cariprazine
- Carisoprodol
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Citalopram
- Clarithromycin
- Clobazam
- Clopidogrel
- Clozapine
- Cobicistat
- Cobimetinib
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Cyclosporine
- Daclatasvir
- Dapsone
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deflazacort
- Dienogest; Estradiol valerate
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doravirine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxorubicin
- Dronabinol
- Dronedarone
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Elvitegravir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Entrectinib
- Erdafitinib
- Erlotinib
- Escitalopram
- Esomeprazole
- Esomeprazole; Naproxen
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Exemestane
- Ezetimibe; Simvastatin
- Fedratinib
- Fentanyl
- Flibanserin
- Fosamprenavir
- Fosphenytoin
- Glasdegib
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guanfacine
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydrocortisone
- Hydroxychloroquine
- Ibrutinib
- Ibuprofen; Oxycodone
- Ifosfamide
- Isavuconazonium
- Isocarboxazid
- Ivabradine
- Lacosamide
- Lansoprazole
- Lansoprazole; Naproxen
- Lefamulin
- Lemborexant
- Leuprolide; Norethindrone
- Levonorgestrel
- Lidocaine
- Lidocaine; Prilocaine
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lorlatinib
- Lovastatin
- Lovastatin; Niacin
- Lumateperone
- Lurasidone
- Lurbinectedin
- Maraviroc
- Mephobarbital
- Mestranol; Norethindrone
- Methohexital
- Monoamine oxidase inhibitors
- Nanoparticle Albumin-Bound Paclitaxel
- Neratinib
- Niacin; Simvastatin
- Nisoldipine
- Norethindrone
- Norgestrel
- Olaparib
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Oral Contraceptives
- Oxcarbazepine
- Oxycodone
- Pemigatinib
- Pentobarbital
- Perampanel
- Perindopril; Amlodipine
- Phenelzine
- Phenobarbital
- Phenytoin
- Pimavanserin
- Praziquantel
- Primidone
- Quetiapine
- Rabeprazole
- Ranolazine
- Remdesivir
- Rilpivirine
- Rimegepant
- Ritonavir
- Rivaroxaban
- Secobarbital
- Segesterone Acetate; Ethinyl Estradiol
- Selegiline
- Selpercatinib
- Selumetinib
- Simeprevir
- Simvastatin
- Simvastatin; Sitagliptin
- Siponimod
- Sirolimus
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sonidegib
- Sufentanil
- Sunitinib
- Tacrolimus
- Tasimelteon
- Tazemetostat
- Telaprevir
- Terbinafine
- Thiopental
- Tolvaptan
- Tranylcypromine
- Triazolam
- Tricyclic antidepressants
- Ubrogepant
- Ulipristal
- Venetoclax
- Vincristine
- Vincristine Liposomal
- Vorapaxar
- Voxelotor
- Warfarin
- Zanubrutinib
- Ziprasidone
- Zolpidem
