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Trileptal vs. Zonegran

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Trileptal (oxcarbazepine) and zonisamide (Zonegran) are both antiepileptic medications used to treat partial-onset seizures, but they have some key differences. Trileptal is available in both immediate-release and extended-release (Oxtellar XR) forms, and it can be used alone or with other seizure medications. The immediate-release form is suitable for children as young as 2 years old. On the other hand, zonisamide is typically used as an add-on treatment and is only approved for people aged 16 and older. Trileptal can cause dizziness, nausea, and headaches, while zonisamide may lead to sleepiness, dizziness, and loss of appetite. Additionally, zonisamide carries a risk of serious allergic reactions in people with sulfa allergies (eg, Bactrim). Both medications can cause serious skin reactions and increase the risk of suicidal thoughts, but zonisamide also has specific warnings about heat stroke and kidney problems. Both medications are available as lower-cost generics, with the exception of the brand-name oral suspension of zonisamide (Zonisade).

Oxcarbazepine

(Trileptal)

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Zonisamide

(Zonegran)

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Summary for Trileptal

Prescription only

Oxcarbazepine (Trileptal) is used to treat partial-onset seizures (also called focal aware seizures). This antiepileptic is for people 2 years of age and older. It helps calm the brain to keep seizures from happening. Oxcarbazepine (Trileptal) comes as immediate-release tablets and an oral suspension. You take it by mouth twice a day. Some common side effects include dizziness, nausea, and headaches. Immediate-release oxcarbazepine comes in both brand-name and generic versions. You can take it by itself or with other anti-seizure medications.

Indications for Trileptal

Pros and Cons for Trileptal

Pros

  • Okay for children as young as 2 years old with partial-onset seizures to take
  • Available as an oral liquid for people who have trouble swallowing the tablets
  • Dose can be adjusted based on response to the medication

Cons

  • Can make it hard to focus and react quickly
  • Can cause serious skin reactions
  • Interacts with many medications, including some antidepressants and other seizure medications

Common Side Effects for Trileptal

  • Dizziness
  • Sleepiness
  • Tiredness
  • Nausea
  • Vomiting
  • Headache
  • Trouble walking
  • Double vision
  • Other changes in vision
  • Shaky eye movements (nystagmus)

Note: Side effects were reported by people who took oxcarbazepine (Trileptal) either by itself or with other seizure medications.

Warnings for Trileptal

  • Low sodium levels
  • Severe allergic reaction
  • Serious skin reactions
  • Risk of suicidal thoughts and behavior
  • Trouble with concentration, speech, and movement
  • Higher risk of having new seizures
  • Withdrawal seizures

Summary for Zonegran

Prescription only

Zonisamide (Zonegran) is an antiepileptic. It helps control partial-onset seizures in people 16 years and older with epilepsy. It's usually taken along with other seizure medications. Zonisamide comes as a capsule in both generic forms and the brand name Zonegran. It also comes as a liquid called Zonisade, which is brand name only. You take it by mouth once or twice a day. Common side effects are drowsiness, dizziness, and headache. Some medications can interact with zonisamide (Zonegran) and make side effects worse or raise the risk of seizures.

Indications for Zonegran

Pros and Cons for Zonegran

Pros

  • Can be a good add-on option when other medications aren't working well enough to help control seizures
  • Can take with or without food
  • Also comes as a liquid suspension for people who have problems swallowing pills

Cons

  • Not approved for children younger than 16
  • Can take several weeks to get the full benefits of the medication
  • Not safe to take if you have a sulfa allergy

Common Side Effects for Zonegran

  • Sleepiness (17%)
  • Dizziness (13%)
  • Low appetite (13%)
  • Headache (10%)
  • Nausea (9%)
  • Agitation or irritability (9%)
  • Fatigue (8%)
  • Tiredness (7%)
  • Stomach pain (6%)
  • Confusion (6%)
  • Depression (6%)
  • Trouble sleeping (6%)
  • Problems with concentration or memory (6%)
  • Clumsy movement (6%)
  • Double vision (seeing double; 6%)

Warnings for Zonegran

  • Potentially serious allergic reaction to sulfa medications
  • Serious skin reactions
  • DRESS syndrome (a serious allergic reaction)
  • Less sweating and risk of heat stroke
  • Serious eye problems
  • Suicidal thoughts or behavior
  • Changes in mood or thinking, or problems with cognitive skills
  • Effect on kidney function
  • Too much acid in the blood
  • High ammonia levels
  • Withdrawal seizures after stopping zonisamide (Zonegran) suddenly
  • Harm to an unborn baby

Prices with our coupons for Trileptal vs. Zonegran

Price Card Drug Icon
Oxcarbazepine60 tablets / 300mg
$9.00$9.00
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Price Card Drug Icon
Zonisamide120 capsules / 100mg
$24.44$70.93
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