Generic
Oxcarbazepine
11 brands available in the market
At a glance
Oxcarbazepine is an antiepileptic drug used for partial seizures. It blocks voltage-sensitive sodium channels to stabilize hyperexcited neuronal membranes and prevent seizure spread.
Description
Oxcarbazepine exerts pharmacological activity through its 10-monohydroxy metabolite (MHD). It blocks voltage-sensitive sodium channels to stabilize hyperexcited neuronal membranes, inhibit repetitive neuronal firing and reduce synaptic impulse propagation.
Indications
- Partial seizures (Adults: monotherapy or adjunctive therapy)
- Partial seizures (Children 4-16 years: monotherapy; 2-16 years: adjunctive therapy)
Therapeutic class
Adjunct Anti-epileptic Drugs
Pharmacological class
Voltage-sensitive Sodium Channel Blocker
Pharmacology
Oxcarbazepine and its active metabolite MHD block voltage-sensitive sodium channels to stabilize neuronal membranes, inhibit repetitive neuronal firing and reduce synaptic impulse propagation, preventing seizure spread.
Mechanism of action
Prevents seizure spread by blocking sodium channels.
Dosage
Adult Dose (Oral):
- Adjunctive: 300 mg twice daily (initial); increase by 600 mg/day weekly; max 1200 mg/day
- Monotherapy (converting from other AED): 300 mg twice daily (initial); increase by 600 mg/day weekly; max 2400 mg/day
- Monotherapy (AED-naive): 300 mg twice daily (initial); increase by 300 mg/day every 3 days; up to 1200 mg/day
Renal Dose (CrCl <30): Reduce to 50% of usual dose
Administration
- Swallow tablet whole; do not chew, crush or break
- Take at the same time each day
- May be taken with or without food
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Dizziness
- Diplopia
- Headache
- Nystagmus
- Abnormal gait
- Nausea
- Vomiting
- Abdominal pain
- Rash
- Hyponatremia
Precautions & warnings
- Monitor sodium levels (hyponatremia)
- Caution in patients with hypersensitivity to carbamazepine
- Caution while driving
- Avoid alcohol
- Inform doctor if suicidal thoughts or mood changes occur
Contraindications
- Hypersensitivity
- Lactation
Drug interactions
- Reduced serum levels with carbamazepine, phenobarbitone, phenytoin, valproic acid
- May reduce levels/effects of CYP3A4 substrates (benzodiazepines, calcium channel blockers, clarithromycin, ciclosporin, estrogens)
- May reduce efficacy of oral contraceptives
- May increase levels of phenobarbitone and phenytoin
Food interactions
Alcohol may cause excessive drowsiness.
Use in pregnancy
Use in Pregnancy: Oxcarbazepine may be unsafe during pregnancy; animal studies show evidence of fetal harm.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Oxcarbazepine is probably unsafe during breastfeeding; may pass into breast milk and harm the baby; monitor baby for excessive sleepiness and weight gain.
Pediatric use
Dose established for children 2-16 years (weight-based).
Geriatric use
Elderly may require dose adjustment.
Renal / hepatic impairment
Renal Impairment: CrCl <30 mL/min: Reduce initial dose by 50%; titrate slowly; caution in mild-moderate kidney disease.
Hepatic Impairment: No dose adjustment in mild-moderate liver disease; caution in severe liver disease.
Overdose effects
Overdose: Drowsiness, dizziness, diplopia, ataxia, hyponatremia; symptomatic treatment.
Storage conditions
Store at temperature not exceeding 30°C in a dry place; protect from light and moisture; keep out of reach of children.
Chemical structure
Oxcarbazepine