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Oxcarbazepine Brand Names- Oxtellar XR | Trileptal
What is Oxcarbazepine
Oxcarbazepine the keto-analogue of carbamazepine, is an oral anticonvulsant. Immediate-release formulations are indicated for the treatment of partial-onset seizures as monotherapy in adult and pediatric patients 4 years and older and as adjunct therapy in adult and pediatric patients 2 years and older.
The extended-release tablet is approved as monotherapy or adjunct therapy for partial-onset seizures in adult and pediatric patients 6 years and older.
Major advantages of oxcarbazepine over carbamazepine are that monitoring of drug plasma levels and hematologic profiles are generally not necessary. Oxcarbazepine is one of many initial treatment options, adjunct therapies, or alternatives to other anticonvulsants.
Oxcarbazepine has been used off-label for the treatment of neuropathic pain such as trigeminal neuralgia.
However, unlike carbamazepine, oxcarbazepine has not shown consistent evidence of efficacy in bipolar disorder. In January 2008, the FDA alerted healthcare professionals of an increased risk of suicidal ideation and behavior in patients receiving anticonvulsants to treat various conditions (e.g., epilepsy, psychiatric disorders, migraine, neuropathic pain).
Patients and caregivers should be informed of the increased risk of suicidal thoughts and behaviors and advised to promptly report depression, suicidality, thoughts of self-harm, or other unusual changes in mood or behavior.
Oxcarbazepine initially received FDA approval in 2000.
Indications
- bipolar disorder
- mania
- partial seizures
- trigeminal neuralgia
GENERAL DOSAGE CONVERSION FACTOR (Adults, immediate-release products)
Individualize dosage for epilepsy. Protocols for rapid conversion vary. The usual daily maintenance dose of oxcarbazepine is approximately 1.5 times that of carbamazepine in adults (up to 65 years of age) and 1.2 times that of carbamazepine in geriatric patients (65 years and older). However, lower oxcarbazepine conversions of 1 to 1.25 that of carbamazepine may be better tolerated.
Side Effects
- abdominal pain
- acne vulgaris
- acute generalized exanthematous pustulosis (AGEP)
- agitation
- agranulocytosis
- alopecia
- amnesia
- anaphylactoid reactions
- angioedema
- anorexia
- anxiety
- aphasia
- aplastic anemia
- appetite stimulation
- asthenia
- ataxia
- atopic dermatitis
- back pain
- blurred vision
- bone fractures
- bradycardia
- bronchospasm
- cataracts
- chest pain (unspecified)
- cholelithiasis
- colitis
- confusion
- constipation
- contact dermatitis
- cough
- delirium
- dental pain
- depression
- diarrhea
- diplopia
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysarthria
- dysgeusia
- dyspepsia
- dysphagia
- dysphonia
- dyspnea
- dystonic reaction
- dysuria
- edema
- EEG changes
- elevated hepatic enzymes
- emotional lability
- eosinophilia
- epistaxis
- eructation
- erythema multiforme
- esophagitis
- euphoria
- fatigue
- fever
- flatulence
- flushing
- folliculitis
- gastritis
- gingival hyperplasia
- gingivitis
- headache
- heart failure
- hematemesis
- hematoma
- hematuria
- hemorrhoids
- hepatitis
- hiccups
- hot flashes
- hyperamylasemia
- hyperglycemia
- hyperhidrosis
- hyperkinesis
- hyperreflexia
- hypertension
- hypertonia
- hypocalcemia
- hypoesthesia
- hypoglycemia
- hypokalemia
- hyponatremia
- hyponatremia
- hyporeflexia
- hypotension
- hypothyroidism
- hypotonia
- impaired cognition
- increased urinary frequency
- infection
- insomnia
- leukopenia
- leukorrhea
- libido decrease
- libido increase
- lymphadenopathy
- maculopapular rash
- malaise
- mania
- melena
- menorrhagia
- menstrual irregularity
- migraine
- muscle paralysis
- myasthenia
- mydriasis
- myoclonia
- nausea
- nystagmus
- ocular hemorrhage
- ocular inflammation
- orthostatic hypotension
- osteoporosis
- otalgia
- palpitations
- pancreatitis
- pancytopenia
- peptic ulcer
- peripheral edema
- pharyngitis
- photophobia
- photosensitivity
- polydipsia
- polyuria
- priapism
- pruritus
- psoriasis
- psychosis
- ptosis
- purpura
- rash
- rhinitis
- scotomata
- seizures
- SIADH
- sinus tachycardia
- sinusitis
- Stevens-Johnson syndrome
- stomatitis
- suicidal ideation
- syncope
- teratogenesis
- tetany
- thrombocytopenia
- tinnitus
- toxic epidermal necrolysis
- tremor
- urticaria
- vaginitis
- vertigo
- visual impairment
- vomiting
- water intoxication
- weight gain
- weight loss
- xerophthalmia
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- abrupt discontinuation
- Asian patients
- breast-feeding
- carbamazepine hypersensitivity
- depression
- driving or operating machinery
- geriatric
- hyponatremia
- pregnancy
- renal failure
- renal impairment
- serious rash
- suicidal ideation
Interactions
- Abacavir; Dolutegravir; Lamivudine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Alfentanil
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Alprazolam
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Aripiprazole
- Artemether; Lumefantrine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atorvastatin
- Atorvastatin; Ezetimibe
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benzhydrocodone; Acetaminophen
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Brexpiprazole
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Carbamazepine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cariprazine
- Carisoprodol
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Cisapride
- Citalopram
- Clarithromycin
- Clomipramine
- Clopidogrel
- Clozapine
- Cobicistat
- Colesevelam
- Conjugated Estrogens
- Conjugated Estrogens; Bazedoxifene
- Conjugated Estrogens; Medroxyprogesterone
- Cyclosporine
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Desipramine
- Dienogest; Estradiol valerate
- Diethylstilbestrol, DES
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Dolutegravir
- Dolutegravir; Lamivudine
- Dolutegravir; Rilpivirine
- Doravirine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxepin
- Doxorubicin
- Dronabinol
- Dronedarone
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Elagolix; Estradiol; Norethindrone acetate
- Elvitegravir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Enalapril; Felodipine
- Enzalutamide
- Erlotinib
- Eslicarbazepine
- Esterified Estrogens
- Esterified Estrogens; Methyltestosterone
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Estradiol; Progesterone
- Estrogens
- Estropipate
- Ethanol
- 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
- Etonogestrel
- Ezetimibe; Simvastatin
- Felodipine
- Fentanyl
- Flibanserin
- food
- Fosphenytoin
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Haloperidol
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydroxyprogesterone
- Ibuprofen; Oxycodone
- Imipramine
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Ivabradine
- Lacosamide
- Leuprolide; Norethindrone
- Levonorgestrel
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lovastatin
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lumateperone
- Maraviroc
- Medroxyprogesterone
- Mefloquine
- Mephobarbital
- Mestranol; Norethindrone
- Mitotane
- Molindone
- Monoamine oxidase inhibitors
- Nanoparticle Albumin-Bound Paclitaxel
- Niacin; Simvastatin
- Nisoldipine
- Norethindrone
- Norgestrel
- Nortriptyline
- Ombitasvir; Paritaprevir; Ritonavir
- Oxycodone
- Pazopanib
- Pemoline
- Perampanel
- Perindopril; Amlodipine
- Perphenazine; Amitriptyline
- Phenobarbital
- Phenytoin
- Praziquantel
- Primidone
- Progesterone
- Progestins
- Protriptyline
- Red Yeast Rice
- Remdesivir
- Rifampin
- Rilpivirine
- Ritonavir
- Segesterone Acetate; Ethinyl Estradiol
- Selegiline
- Simeprevir
- Simvastatin
- Simvastatin; Sitagliptin
- Sofosbuvir; Velpatasvir; Voxilaprevir
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Sunitinib
- Tacrolimus
- Telaprevir
- Telithromycin
- Tenofovir Alafenamide
- Tolvaptan
- Trandolapril; Verapamil
- Trimipramine
- Ubrogepant
- Ulipristal
- Verapamil
- Vincristine
- Vincristine Liposomal
