oxcarbazepine
Trileptal (oxcarbazepine) helps treat partial-onset seizures (also known as focal onset aware seizures), which are seizures that start on one side of the brain. It can be taken by both adults and children, either on its own or with other antiseizure medications. Trileptal (oxcarbazepine) is taken by mouth, either once or twice daily. Some common side effects include dizziness, nausea, and headaches. It's available as generic tablets and oral suspensions, and also under the brand names Trileptal and Oxtellar XR.
What is Trileptal (oxcarbazepine)?
What is Trileptal (oxcarbazepine) used for?
How Trileptal (oxcarbazepine) works
Trileptal (oxcarbazepine) is an antiepileptic known as a sodium channel blocker. The exact way Trileptal (oxcarbazepine) works to treat seizures isn't known. But it's thought to lower seizure activities by blocking certain nerve cell activities in your brain.
Drug Facts
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What are the side effects of Trileptal (oxcarbazepine)?
Common Side Effects
- Dizziness (22%)
- Nausea (16%)
- Headache (13%)
- Vomiting (7%)
- Diarrhea (7%)
- Runny nose, sore throat, and other symptoms of an upper respiratory tract infection (7%)
Other Side Effects
- Constipation
- Heartburn
- Poor balance or coordination
- Nervousness
Serious Side Effects
- Serious allergic and skin reactions: hives, rash, blisters, fever, swelling of the lips or tongue, difficulty breathing, skin reddening
- Low blood sodium levels: nausea, fatigue, headache, confusion, disoriented, hallucinations (seeing things that aren't real), seizures, unconsciousness
- Suicidal thoughts or behaviors
- Seizures
Source: DailyMed
More on Trileptal (oxcarbazepine) side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Change in vision
change in walking or balance
clumsiness or unsteadiness
crying
dizziness
double vision
false sense of well-being
feeling of constant movement of self or surroundings
mental depression
sensation of spinning
uncontrolled back-and-forth or rolling eye movements
Less common
Agitation
awkwardness
bloody or cloudy urine
blurred vision
bruising
confusion about identity, place, and time
decreased urination
difficulty with focusing the eyes
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast or irregular heartbeat
frequent falls
frequent urge to urinate
headache
hoarseness
increased thirst
loss of consciousness
memory loss
muscle cramps
pain or burning while urinating
pain or tenderness around the eyes or cheekbones
problems with coordination
shaking or trembling of the arms, legs, hands, and feet
seizures
skin rash
stuffy or runny nose
tightness in the chest
trouble with walking
troubled breathing
unusual feelings
unusual tiredness or weakness
Rare
bleeding or crusting sores on the lips
burning feeling in the chest or stomach
chills
irritability
joint pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
muscle pain or weakness
purple spots on the skin
rectal bleeding
redness, blistering, peeling, or loosening of the skin
restlessness
sores, ulcers, or white spots in the mouth or on the lips
stomach upset
swelling of the legs
swollen glands
Incidence not known
Black, tarry stools
dark urine
decrease in height
decreased awareness or responsiveness
difficulty swallowing
dry skin and hair
fainting
feeling cold
hostility
indigestion
loss of appetite
loss of consciousness
muscle stiffness or twitching
pain in the back, ribs, arms, or legs
pains in the stomach, side, or abdomen, possibly radiating to the back
pounding, slow heartbeat
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rapid weight gain
severe sleepiness
swelling of the face, ankles, or hands
swollen, painful, or tender lymph glands in the neck, armpit, or groin
unusual bleeding or bruising
unusual drowsiness, dullness, or feeling of sluggishness
vomiting
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Trileptal (oxcarbazepine)
Pros
Works well for partial-onset seizures
Immediate-release oxcarbazepine (Trileptal) can be used in children as young as 2 years old
Available as an extended-release tablet taken once daily
Available as an oral liquid for people having trouble swallowing the tablets
Cons
Safety in pregnant and breastfeeding females isn't completely clear
Interacts with many medications
Can affect focus, concentration, and your ability to react quickly
Can cause life-threatening skin reactions
Pharmacist tips for Trileptal (oxcarbazepine)
The immediate-release tablet and oral liquid versions (Trileptal) can be taken with or without food. But nausea and vomiting are possible side effects of this medication, so if these happen to you, try taking your doses with food to help.
Take extended-release version (Oxtellar XR) on an empty stomach (1 hour before or 2 hours after a meal). Taking it with food raises your risk of side effects. Swallow the tablet whole. Do not crush, break, cut, or chew them. For the best results, take Trileptal (oxcarbazepine) at the same time every day.
Trileptal (oxcarbazepine) can raise the risk of suicidal thoughts. Contact your provider right away if you or your loved ones notice any new or worsening changes in your behavior or mood while taking the medication.
Sleepiness and dizziness can happen while taking Trileptal (oxcarbazepine). Don't drive or do anything that requires concentration until you know how Trileptal (oxcarbazepine) affects you. Avoid alcohol because it can worsen sleepiness and dizziness.
Most side effects from Trileptal (oxcarbazepine) are temporary and get better or go away after you've been taking it for a few weeks. They are more likely to happen with the extended-release tablets and with higher doses of this medication. These side effects might return if your dose is changed.
Trileptal (oxcarbazepine) can interact with some commonly prescribed medications. Some medications that interact with include phenytoin (Dilantin), phenobarbital, rifampin (Rifadin) and carbamazepine (Tegretol). Make sure to tell your provider and pharmacist about all of the medications you're taking before starting Trileptal (oxcarbazepine).
Trileptal (oxcarbazepine) can cause hormonal birth control (e.g., Vienva, Amethyst, Jolessa, etc.) to not work as well, which can lead to unwanted pregnancies. Talk to your provider about which methods of birth control would be the best option and if you need to use a back-up method of protection while taking Trileptal (oxcarbazepine).
Don't change your dose or suddenly stop taking Trileptal (oxcarbazepine) without talking to your provider first. Doing so can cause your seizures to come back. Follow your provider's instructions to lower your dose slowly over a period of time to stop the medication completely.
More tips for the oral suspension (liquid) only:
Each 5 mL contains 300 mg of oxcarbazepine. Ask your pharmacist or provider if you're not sure how many mL of Trileptal (oxcarbazepine) suspension you need to take.
Shake the bottle well for 5 to 10 seconds before each dose. Make sure to only use a medication dose cup or syringe from the pharmacy to measure out your dose. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose.
Store the suspension at room temperature in the original bottle it came in from the pharmacy for up to 7 weeks. After 7 weeks, throw away the medication bottle, even if there's still some medication left.
Frequently asked questions about Trileptal (oxcarbazepine)
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What are the risks and warnings for Trileptal (oxcarbazepine)?
Trileptal (oxcarbazepine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low blood sodium levels
Risk factors: Older adults | Taking other medications that can lower your sodium level
Though not common, Trileptal (oxcarbazepine) can cause low sodium levels in the blood. For people who did experience this side effect in clinical trials, it typically happened within the first 3 months of starting Trileptal (oxcarbazepine). Most people didn't experience any symptoms, but their low sodium levels were discovered through blood tests. To be safe, your provider might regularly monitor your blood sodium levels before and during treatment with Trileptal (oxcarbazepine). Get medical help right away if you experience weakness, confusion, difficulty concentrating, headache, or memory problems because these could be signs of low blood sodium levels, which is a medical emergency.
Severe allergic and skin reactions
Risk factors: Allergy to carbamazepine (Tegretol) | Asian people | Having certain a gene that raises your risk of skin reactions
Severe allergic reactions to Trileptal (oxcarbazepine) are possible, including life-threatening reactions like facial swelling and anaphylaxis (e.g., closing of the throat). Let your provider know if you're allergic to carbamazepine (Tegretol).
Additionally, Trileptal (oxcarbazepine) can also cause serious skin reactions, such as drug reaction with eosinophilia and systemic symptoms (DRESS) or toxic epidermal necrolysis (TEN), especially in Asian people. Many people experienced these reactions within the first 3 weeks of starting Trileptal (oxcarbazepine). If you notice changes in your skin (e.g., rash, blisters, swollen lymph nodes, skin reddening, skin peeling) or experience swelling in your face or trouble breathing, stop using Trileptal (oxcarbazepine) and get medical attention right away.
Risk of suicidal thoughts
Risk factors: History of depression or other mental health conditions
Taking Trileptal (oxcarbazepine) can raise the risk for thoughts of suicide or harming yourself. This can happen as early as a week after starting Trileptal (oxcarbazepine). If you or anyone around you notice that you have suicidal thoughts or unusual behavior (e.g., anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness) while taking Trileptal (oxcarbazepine), get medical help right away.
Difficulty with speech, concentration, and movement
Risk factors: Taking high doses of Trileptal (oxcarbazepine) | Drinking alcohol | Taking other medications that can cause sleepiness or dizziness
Because Trileptal (oxcarbazepine) affects how your brain works, some people have experienced side effects such as difficulty concentrating, speech or language problems, and problems with coordination. Additionally, Trileptal (oxcarbazepine) can cause extreme dizziness and sleepiness, which can lower your ability to think, react, and focus. Your risk might be higher if you're taking other medications that can cause you to feel sleepy or dizzy (e.g., benzodiazepines, muscle relaxants, sleep medications). Make sure you know how this medication affects you before driving a car or doing activities that require your concentration. Talk to your healthcare provider right away if you feel too sleepy from taking Trileptal (oxcarbazepine).
Higher risk for other seizures
Risk factors: Children
Even though Trileptal (oxcarbazepine) works well to control seizures, it's possible for it to worsen seizures. This is more likely to happen in children, but can also happen in adults. If you or your loved ones notice seizure symptoms, stop taking Trileptal (oxcarbazepine) and seek medical help right away.
Withdrawal
As with many other seizure medications, stopping Trileptal (oxcarbazepine) too suddenly can raise the risk of seizures. Don't stop taking Trileptal (oxcarbazepine) without first talking with your provider. If you need to stop this medication, your provider will help you do so slowly over time to minimize the risk for seizures.
Trileptal (oxcarbazepine) dosage forms
Typical dosing for Trileptal (oxcarbazepine)
Oxcarbazepine (Trileptal) immediate-release tablet and oral suspension (liquid)
People ages 17 years and older: The typical starting dose is 300 mg by mouth twice daily. If needed, your provider will raise your dose slowly over 2 to 4 weeks. The maximum daily dose ranges from 1,200 mg to 2,400 mg, depending on whether you're taking other antiseizure medications.
People ages 2 to less than 17 years: Your child's provider will determine your child's dose based on their body weight. The typical starting dose is 8 mg/kg to 10 mg/kg of body weight (up to a maximum of 600 mg), split into 2 doses and taken by mouth twice daily. If needed, your child's provider will raise their dose slowly over 2 to 4 weeks. The typical maintenance dose ranges from 900 mg to 2,100 mg daily, depending on their age, body weight, and whether they're taking other antiseizure medications.
Oxcarbazepine (Oxtellar XR) extended-release tablet
People ages 17 years and older: The typical starting dose is 600 mg by mouth once daily. If needed, your provider will raise your dose weekly. The typical recommended dose ranges from 1,200 mg to 2,400 mg daily.
Ages 6 to less than 17 years: Your child's provider will determine your child's dose based on their body weight. The typical starting dose is 8 mg/kg to 10 mg/kg of body weight taken by mouth once daily (up to a maximum of 600 mg). The typical maintenance dose ranges from 900 mg to 1,800 mg daily, depending on your child's body weight.
Your dose might be different if you're an older adult or taking a medication that interacts with oxcarbazepine, or if you've kidney problems.
More on Trileptal (oxcarbazepine) dosage forms
Interactions between Trileptal (oxcarbazepine) and other drugs
More on Trileptal (oxcarbazepine) interactions
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Cabotegravir
- Doravirine
- Rilpivirine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Amiodarone
- Benzhydrocodone
- Buprenorphine
- Calcifediol
- Carbamazepine
- Cilostazol
- Citalopram
- Clarithromycin
- Cobicistat
- Codeine
- Daclatasvir
- Darunavir
- Desogestrel
- Dienogest
- Dihydrocodeine
- Dolutegravir
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Dronedarone
- Drospirenone
- Elvitegravir
- Enzalutamide
- Estradiol
- Ethinyl Estradiol
- Ethynodiol
- Etonogestrel
- Fentanyl
- Fosphenytoin
- Gestodene
- Hemin
- Hydrocodone
- Ifosfamide
- Lacosamide
- Ledipasvir
- Levonorgestrel
- Linagliptin
- Lumacaftor
- Lumateperone
- Medroxyprogesterone
- Meperidine
- Mestranol
- Methadone
- Mitotane
- Naloxegol
- Nifedipine
- Nomegestrol
- Norelgestromin
- Norethindrone
- Norgestimate
- Norgestrel
- Orlistat
- Oxycodone
- Paclitaxel
- Palbociclib
- Panobinostat
- Pentazocine
- Perampanel
- Phenobarbital
- Phenytoin
- Rifampin
- Rivaroxaban
- Segesterone
- Sertraline
- Simeprevir
- St John's Wort
- Sufentanil
- Tacrolimus
- Tenofovir Alafenamide
- Tolvaptan
- Tramadol
- Tranylcypromine
- Ubrogepant
- Velpatasvir
- Vilazodone
- Voxilaprevir
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Felodipine
- Ginkgo
- Lamotrigine
- Ospemifene
- Simvastatin
- Valproic Acid
- Verapamil
How much does Trileptal (oxcarbazepine) cost?
Trileptal (oxcarbazepine) contraindications
Past allergy to Aptiom (eslicarbazepine)
What are alternatives to Trileptal (oxcarbazepine)?
Seizures (partial seizures, tonic-clonic seizures)
Seizures of Lennox-Gastaut syndrome - immediate-release only
Bipolar disorder - immediate-release only
Mixed seizure patterns
Trigeminal neuralgia (facial nerve pain)
Bipolar I disorder - Equetro brand only
What is the latest news about Trileptal (oxcarbazepine)?
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References
Best studies we foundBen-Menachem, E. (2008). Seizure Aggravation—Evidence That Oxcarbazepine Requires Monitoring. Epilepsy Currents.
Drugs and Lactation Database (LactMed). (2021). Oxcarbazepine. National Institute of Child Health and Human Development.
Garoufi, A., et al. (2016). Weight gain in children on oxcarbazepine monotherapy. Epilepsy Research.
Geng, H., et al. (2017). Efficacy and safety of oxcarbazepine in the treatment of children with epilepsy: a meta-analysis of randomized controlled trials. Neuropsychiatric Disease and Treatment.
Hirschfeld, R. M. A., et al. (2010). PRACTICE GUIDELINE FOR THE Treatment of Patients With Bipolar Disorder Second Edition. American Psychiatric Association.
Kiriakopoulos, E. (n.d.). Focal onset aware seizures (simple partial seizures). Epilepsy Foundation.
Novartis Pharmaceuticals Corporation. (2023). TRILEPTAL- oxcarbazepine tablet, film coated TRILEPTAL- oxcarbazepine suspension [package insert]. DailyMed.
Preuss, C. V., et al. (2023). Oxcarbazepine. StatPearls.
Supernus Pharmaceuticals, Inc. (2023). OXTELLAR XR- oxcarbazepine tablet [package insert]. DailyMed.
The North American AED Pregnancy Registry. (n.d.). Empowering Pregnant Women with Information About Anticonvulsants through Research.
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