Eslicarbazepine

Eslicarbazepine is a prescription medicine used to treat epilepsy (seizures). It helps to decrease the abnormal and excessive activity of the nerve cells and calms the brain.

Eslicarbazepine may be taken with or without food, preferably at the same time each day. Take this medicine in the dose and duration as advised by your doctor. If you have missed a dose, take it as soon as you remember it. Do not skip any doses and finish the full course of treatment even if you feel better.

Eslicarbazepine is an anti epileptic medication. It works by blocking the voltage gated sodium channels that stabilizes the hyperexcited nerve cells in the brain. In this way, it treats seizures or fits.

• Partial-Onset Seizures: Indicated for partial-onset seizures as monotherapy or adjunctive therapy.

Anti-epileptic drugs

Sodium Channel Blocker

Eslicarbazepine is an antiepileptic drug; eslicarbazepine acetate is a prodrug that is activated to eslicarbazepine (S-licarbazepine), the major active metabolite of oxcarbazepine. Stabilizes neuronal membranes by blocking Na+ channels; this may inhibit repetitive firing and may decrease the propagation of synaptic impulses; may also increase potassium conductance and modulate the activity of high-voltage activated calcium channels.

Antiepileptic drug; eslicarbazepine acetate is a prodrug that is activated to eslicarbazepine (S-licarbazepine), the major active metabolite of oxcarbazepine. Stabilizes neuronal membranes by blocking Na+ channels; this may inhibit repetitive firing and may decrease the propagation of synaptic impulses; may also increase potassium conductance and modulate the activity of high-voltage activated calcium channels.

Adult Dose:

• Initial: 400 mg PO qDay (some patients may initiate at 800 mg qDay).
• Titration & Maintenance: Increase by weekly increments of 400-600 mg based on clinical response and tolerability.
• Recommended maintenance dose: 800-1600 mg once daily.
• Monotherapy: Consider 800 mg/day if unable to tolerate 1200 mg/day.
• Adjunctive therapy: Consider 1600 mg/day if unsatisfactory response with 1200 mg/day.
• Mild-moderate hepatic impairment: No dosage adjustment required.

Renal Dose (CrCl <50 mL/min): Reduce initial, titration, and maintenance doses by 50%.

Child Dose (<18 years): Safety and efficacy not established.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Eslicarbazepine may be taken with or without food, but it is better to take it at a fixed time.

If you miss a dose of Eslicarbazepine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common Side Effects:

• Sleepiness
• Blurred vision
• Nausea
• Headache
• Vomiting
• Double vision
• Fatigue
• Balance disorder
• Diarrhea
• Impaired coordination
• Vertigo
• Decreased appetite
• Decreased sodium level in blood
• Dizziness

Precautions:

• Eslicarbazepine may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
• Take your medication regularly as directed by your doctor as missing doses can trigger seizures.
• Do not change the brand of your medicine and make sure that you have sufficient amount of medicine present.
• Inform your doctor if you develop any unusual changes in mood or behavior, new or worsening depression, or suicidal thoughts.
• It may cause a reduction in blood sodium level (hyponatremia). Your doctor may monitor your blood sodium level regularly.
• Inform your doctor if you notice skin reaction such as rash, skin peeling, and itching.
• Do not stop taking the medication suddenly without talking to your doctor as it may increase the seizure frequency.

Contraindications:

• Hypersensitivity to the active substance, to other carboxamide derivatives (carbamazepine, oxcarbazepine) or to any excipients
• Second or third degree atrioventricular (AV) block

Drug Interactions:

• Oral Contraceptive Pills: Decreases levels (additional contraceptive methods needed).
• Carbamazepine, Oxcarbazepine, Phenytoin, Phenobarbital: May decrease eslicarbazepine levels.
• Simvastatin, Atorvastatin: Statin levels may be decreased.

Food Interactions: It is not known whether it is safe to consume alcohol with Eslicarbazepine. Consult your doctor.

Use in Pregnancy: Eslicarbazepine may be unsafe to use during pregnancy. Animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing.

Use in Lactation: Eslicarbazepine is probably safe to use during breastfeeding. Limited human data suggests the drug does not represent significant risk to the baby. Should be used for short periods and baby's sleepiness should be watched.

Pediatric Use: Safety and efficacy in children under 18 years have not been established.

Geriatric Use: No specific dosage adjustment is necessary for elderly patients.

Renal Impairment: Use with caution in severe kidney disease. CrCl <50 mL/min: Reduce dose by 50%. Not recommended in severe kidney disease.

Hepatic Impairment: Use with caution. Mild-moderate: No dosage adjustment needed; Severe: Not recommended.

Overdose: Limited information is available on overdose. In case of overdose, symptomatic treatment should be given and seek immediate medical attention.

Storage: Store below 30°C in a cool and dry place. Keep away from light and moisture. Keep out of reach of children.

Eslicarbazepine