Oxcarbazepine Dosages: Your GoodRx Guide

Oxcarbazepine is an anti-seizure medication (also known as an antiepileptic drug, or AED) that treats focal onset seizures (also known as partial seizures) in adults and some children. It’s available as immediate-release (IR) tablets, an oral liquid (Trileptal), and extended-release (XR) tablets (Oxtellar XR).

Understanding your oxcarbazepine dosage, including how much to take at each dose and how many doses to take each day, will help keep you safe. Taking oxcarbazepine incorrectly can increase your risk of side effects or make the medication less effective at treating your seizures.

What’s the typical oxcarbazepine dosage for adults?

Oxcarbazepine dosages for adults are described below. For oxcarbazepine tablets and oral liquid, dosages vary based on whether you take oxcarbazepine alone (monotherapy) or with other AEDs (adjunctive therapy).

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Oxcarbazepine IR tablets and liquid

The recommended starting oxcarbazepine dosage in adults is 300 mg twice daily (600 mg per day). Then your prescriber may increase your dosage up to 600 mg twice daily (1,200 mg per day).

If you’re taking oxcarbazepine alone, they may increase your dose every few days. If you’re taking it with other AEDs, they may increase your dose more slowly, about every week.

In some cases, your prescriber may recommend switching from another AED to oxcarbazepine. In this case, your oxcarbazepine dose will be increased while your other AED dose is decreased slowly. This can take several weeks. The maximum daily oxcarbazepine dosage in this case is 1,200 mg twice daily (2,400 mg per day).

Higher doses may be more effective, but they have a greater risk of side effects. For instance, studies have shown that dizziness, a common oxcarbazepine side effect, is more likely when taking 2,400 mg per day than lower dosages.

Oxcarbazepine XR tablet

The main difference between oxcarbazepine IR and XR formulations is that the XR formulation is taken only once a day. The recommended starting dosage is 600 mg once daily. Your prescriber may increase your dose over several weeks, starting 1 week after you begin treatment, to 1,200 to 2,400 mg once daily. The 2,400 mg dose may be more effective for some people, but it’s known to cause more side effects.

What’s the typical oxcarbazepine dosage for children?

Both forms of oxcarbazepine are approved for treating focal onset seizures in children. Children often require higher oxcarbazepine doses per body weight than adults because they clear the medication faster.

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Oxcarbazepine IR tablets and liquid

Oxcarbazepine IR is approved in children ages 2 to 16 who are taking another AED, and in children ages 4 to 16 who are taking oxcarbazepine as monotherapy. The best oxcarbazepine dosage for your child is based on your child’s weight and age and whether they’re using other AEDs.

It may take a few weeks for your child to reach the right oxcarbazepine dose. So work closely with their prescriber to ensure you’re following the dosage instructions for your child.

In some cases, your child’s prescriber may recommend switching from another AED to oxcarbazepine. In this case, your child’s oxcarbazepine dose will be increased while their other AED dose is decreased slowly. This may take several weeks until they reach the right dose — 300 mg to 1,050 mg twice daily (600 mg to 2,100 mg per day) — depending on their weight.

If your child is over age 16, they may be prescribed an adult dose instead of a children’s dose.

Oxcarbazepine XR tablet

Oxcarbazepine XR is approved for children ages 6 to 17. The dose is based on your child’s weight.

A typical starting dosage is 4 mg/kg to 5 mg/kg twice daily (8 mg/kg to 10 mg/kg per day), up to 300 mg twice daily (600 mg per day). Over time, your child’s prescriber may increase their dose until they reach the recommended target dose (450 mg to 900 mg twice daily, depending on their weight). This may take several weeks.

Are there any situations when dosage adjustments are needed?

Yes, you may need a different oxcarbazepine dose in some situations. This includes:

• Kidney disease: If you have kidney disease, your prescriber may initiate a lower oxcarbazepine dose. This is because oxcarbazepine is removed from the body by the kidneys. If your kidneys aren’t working as expected, it can build up in the body and increase your risk of side effects.

• Liver disease: Oxcarbazepine hasn’t been well studied in people with liver damage, but it’s typically avoided in severe liver disease. This is because it’s metabolized (broken down) by the liver. So severe liver disease may affect this process.

• Adults over age 65: Older adults may require lower oxcarbazepine dosages. This is often because of lower-than-expected kidney function. Additionally, older adults are more likely to experience hyponatremia (low sodium levels), a potential oxcarbazepine side effect.

• Drug interactions: Other medications may speed up enzymes (proteins) that metabolize oxcarbazepine. This can decrease oxcarbazepine levels in the body, so you may need a higher dosage than usual. Examples of medications that can have this effect include other AEDs, such as phenytoin (Dilantin, Phenytek). Rifampin (Rifadin), an antibiotic, can also have this effect.

• Switching from oxcarbazepine IR to oxcarbazepine XR: People switching from the IR formulation to the XR formulation may need a higher dosage.

Before you start taking oxcarbazepine, share your medication list and your medical history with your healthcare team. They can review for any oxcarbazepine interactions and other factors that may affect your dose.

Oxcarbazepine administration tips

To get the most out of oxcarbazepine, it’s important to take it correctly. How to take it varies based on the form you’re prescribed. A few tips are below:

• Oxcarbazepine oral liquid should be shaken well immediately before each dose. Use the oral dosing syringe supplied with your prescription to properly measure the dose. Ask a pharmacist for a dosing syringe if you misplace it or didn’t receive it. You can swallow oxcarbazepine oral liquid directly from the syringe, or mix it with a small glass of water.

• You can store the oral liquid at room temperature. But you should use it within 7 weeks of opening the bottle.

• Don’t split, cut, crush, or chew oxcarbazepine XR tablets. This product should be swallowed whole.

• Oxcarbazepine IR tablets and oral liquid can be taken with or without food, but the XR tablets should be taken without food. Oxcarbazepine XR should be taken at least 1 hour before or 2 hours after eating. This is because food increases the absorption of oxcarbazepine XR, which increases your risk of side effects.

What happens if you miss a dose of oxcarbazepine?

Oxcarbazepine works best when it’s taken consistently and as prescribed. If you realize you’ve missed a dose, take it as soon as you remember.

But if it’s close to time for your next dose, then skip the missed dose and take a dose at your usual time. Don’t double up on doses to make up for a missed dose. This increases your risk for oxcarbazepine side effects.

If you have questions about what to do after missing a dose of oxcarbazepine, contact your prescriber. They can advise you on how to get back on track with your dosing schedule. Missing too many doses in a row can be dangerous since it increases your risk of having a seizure.

What should you do if you take too much oxcarbazepine?

Taking too much oxcarbazepine can cause nausea and vomiting, drowsiness, and agitation. More seriously, confusion, shortness of breath, and coma are potential serious symptoms.

If you believe you or your child has taken too much oxcarbazepine, contact your prescriber or call Poison Control immediately at 1-800-222-1222. Call 911 or go to the ER if symptoms seem severe.

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Written by:

Alex Brewer, PharmD, MBA

Alex Brewer, PharmD, MBA, is a licensed pharmacist specializing in chronic disease and health and wellness. Upon completing his residency, he worked in the managed care field, conducting medication therapy management and adherence counseling sessions with Medicaid, Medicare, and private insurance patients, before transitioning to a career in medical writing.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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