oxcarbazepine
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.
What is Oxcarbazepine (Trileptal)?
What is Oxcarbazepine (Trileptal) used for?
- Partial-onset seizures (or focal aware seizures)
How Oxcarbazepine (Trileptal) works
Oxcarbazepine (Trileptal) is an antiepileptic or an anti-seizure medication. It’s not exactly known how the medication works to treat seizures. But it's thought to block signaling in the brain to calm brain activity. This helps stop seizures from happening.
Drug facts
Side effects of Oxcarbazepine (Trileptal)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- 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.
Oxcarbazepine (Trileptal) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction or skin reaction: hives, rash, skin reddening, blisters, skin peeling, fever, swelling of the lips or tongue, trouble breathing
- Low sodium levels: nausea, tiredness, headache, muscle cramps, confusion, hallucinations (seeing things that aren't real), seizures, unconsciousness
- Suicidal thoughts or behaviors
- Seizures
More on Oxcarbazepine (Trileptal) side effects
The following Oxcarbazepine (Trileptal) 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.
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Pros and cons of Oxcarbazepine (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
Pharmacist tips for Oxcarbazepine (Trileptal)
- You can take oxcarbazepine (Trileptal) with or without food. If you feel nauseous or have stomach upset from the medication, try taking it with food to help.
- You can feel sleepy and dizzy while taking oxcarbazepine (Trileptal). Don't drive or do anything that needs your attention until you know how the medication affects you.
- It's a good idea to limit or avoid alcohol while taking oxcarbazepine (Trileptal). Both can make you feel sleepy or dizzy. Mixing them together can make these side effects worse. This can raise your risk of accidents and getting hurt.
- Oxcarbazepine (Trileptal) might raise your chance of having thoughts about suicide. Talk to your prescriber right away if you or someone else notices changes in your behavior or mood. And call 911 if you start thinking about hurting yourself.
- There's a risk of having a serious skin reaction from oxcarbazepine (Trileptal). Get medical help right away if you have any red rashes, painful blisters, or peeling skin.
- Tell your healthcare team about all the medications you take or plan to take. Oxcarbazepine (Trileptal) can interact with some common medications. They can raise the risk of serious problems. These medications include phenytoin (Dilantin), carbamazepine (Tegretol), and diuretics. Your care team can make sure all your medications are safe to take together.
- If you can get pregnant, talk to your prescriber or gynecologist about what birth control is best for you. Oxcarbazepine (Trileptal) can make birth control pills not work as well, which can lead to an unplanned pregnancy.
- Don't change your dose or stop taking oxcarbazepine (Trileptal) without talking to your prescriber first. Lowering your dose or stopping too quickly can make your seizures come back. They could happen more often or last longer, which can be dangerous. Your prescriber will help you lower your dose slowly and safely if you need to stop.
More tips for the oxcarbazepine (Trileptal) oral suspension (liquid)
- Each 5 mL contains 300 mg of oxcarbazepine. Ask your pharmacist or prescriber if you're not sure how many mL of the suspension you need to take.
- Shake the bottle well before measuring out the dose. Make sure to only use oral syringes from the pharmacy to measure it out. Don't use household spoons. They aren't accurate and using them might cause you to take the wrong dose.
- After drawing up the dose, you can mix it with a small glass of water or take it straight from the syringe. Be sure to take the medication right after drawing it up. Then, rinse the syringe with warm water and let it dry completely.
- Store the suspension at room temperature in the original bottle it came in. Use the medication within 7 weeks of opening the bottle. After it's been open for 7 weeks, throw away the bottle, even if there's still some medication left.
Common questions about Oxcarbazepine
Weight gain isn't a common side effect of Oxcarbazepine. Keep in mind that some people could be taking it with other seizure medications that tend to cause weight gain. Talk to your prescriber if you gain weight while taking this medication and it bothers you.
No, Oxcarbazepine isn't a controlled substance. It isn't known to have a risk of misuse or dependence.
Most of Oxcarbazepine leaves your body in about 10 hours. Note that after you take the medication, it breaks down into a substance that helps control seizures. This substance stays in your body longer (about 2 days). These times are based on the half-lives of Oxcarbazepine and this active chemical. It measures how long it takes for half of the medication to leave your body. If you have kidney problems, it might take longer for the medication to leave your body. Talk to your prescriber if you have more questions about this.
Some medications can interact with Oxcarbazepine. For example, Oxcarbazepine can make the levels of phenytoin (Dilantin) in the body go up. This can raise your risk of side effects. It can also make hormonal birth control not work as well, which can lead to unplanned pregnancy. And other medications, like phenobarbital, can make Oxcarbazepine work less well. Share a full medication list with your prescriber and pharmacist so they can look for drug interactions. They can tell you which medications to avoid and adjust your doses to keep you safe.
Oxcarbazepine isn't approved by the FDA to treat bipolar disorder. But guidelines from the American Psychiatric Association say that it's a possible option in some situations. Most times, it's considered if first-choice medications like lithium don't work well. This is called an off-label use of the medication. Talk to your prescriber about your treatment options for bipolar disorder.
Oxcarbazepine isn't approved by the FDA to help with anxiety. Talk to a healthcare professional about other ways to manage and treat anxiety.
Oxcarbazepine and carbamazepine (Tegretol) are two very similar medications. Both can help treat partial-onset seizures. But carbamazepine can also treat other types of seizures and nerve pain in the face. Studies suggest that Oxcarbazepine might be better tolerated. Both have a risk of serious skin reactions. But the risk might be lower with Oxcarbazepine. Ask your prescriber to learn more about comparing between the two medications.
If you're pregnant or thinking of getting pregnant, talk to your prescriber. They can help you understand the risks and benefits of taking Oxcarbazepine. It's important to keep seizures controlled while pregnant. But we don't know for sure how safe this medication is. Oxcarbazepine is similar to carbamazepine (Tegretol), which can cause birth defects. Your prescriber can help you choose the safest seizure medication for you. If you take Oxcarbazepine, you can join a pregnancy registry. It helps researchers learn more about the risks of taking seizure medications during pregnancy.
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Risks and warnings for Oxcarbazepine (Trileptal)
Oxcarbazepine (Trileptal) 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 sodium levels
- Risk factors: Older adults | Taking other medications that can lower your sodium level
Oxcarbazepine (Trileptal) can sometimes cause low sodium levels in your blood. In studies, it usually happened within the first 3 months of starting this medication. But it can also happen later — even after a year. Most people didn't have symptoms. Instead, their care team found the problem through blood tests. In most cases, sodium levels went back to normal a few days after stopping the medication.
To be safe, your prescriber might check your sodium levels while you're taking oxcarbazepine (Trileptal). Call your care team if you feel nauseous, tired, or dizzy or have muscle cramps. And get medical help right away if you feel confused or start having more seizures. These could be signs of low sodium.
Severe allergic reaction
- Risk factors: Allergy to carbamazepine (Tegretol)
Although rare, severe allergic reactions to oxcarbazepine (Trileptal) are possible. This can be life-threatening. Signs include swelling of the face, lips, eyes, tongue, or throat. In particular, swelling in the tongue or throat can make it hard to breathe. You might also have other signs of anaphylaxis, like rash or hives. Call 911 right away if you think you're having an allergic reaction.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is another rare reaction that can happen. It can cause a red, peeling rash; fever; and swollen lymph nodes. Get medical help right away if you notice these signs.
Tell your prescriber if you're allergic to carbamazepine (Tegretol). People who had an allergic reaction to it might also have one with oxcarbazepine (Trileptal). Your prescriber might choose a different seizure medication that's safer for you.
Serious skin reactions
- Risk factors: Asian descent | Carrying the HLA-B*1502 allele (a certain gene that raises your risk of skin reactions) | Allergy to carbamazepine (Tegretol)
Oxcarbazepine (Trileptal) can sometimes cause serious skin reactions that can be dangerous. These problems include Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN). The risk is higher if you have a gene called HLA-B*1502. This gene is mostly found in people of Asian background. Serious skin reactions usually happen in the first few months after starting this medication.
Stop taking oxcarbazepine (Trileptal) and get medical help right away if you have a serious skin reaction. Look out for a rash, painful blisters, skin reddening, or skin peeling.
Risk of suicidal thoughts and behavior
- Risk factors: History of depression or other mental health conditions
Oxcarbazepine (Trileptal) can raise the risk of having thoughts of suicide or harming yourself. This risk can happen as early as a week after starting the medication.
If you or someone else notices that you're acting differently, talk to your prescriber. Watch for anxiety, panic attacks, feeling angry or irritated, or restlessness. If you ever think about hurting yourself, call 911 right away.
Trouble with concentration, speech, and movement
- Risk factors: Taking high doses of oxcarbazepine (Trileptal) | Drinking alcohol | Taking other medications that can cause sleepiness or dizziness
Some people taking oxcarbazepine (Trileptal) can have trouble concentrating. It can also make you sleepy or dizzy. This can make it hard to think, react, and focus. Other side effects can include speech or language problems and problems with coordination.
Your risk might be higher if you're taking other medications that can make you feel sleepy or dizzy. These include benzodiazepines, muscle relaxants, and sleep medications.
Make sure you know how oxcarbazepine (Trileptal) makes you feel before you drive or do anything that you need to pay attention to. Talk to your prescriber right away if it makes you feel too sleepy or if these side effects disrupt your daily life.
Higher risk of having new seizures
- Risk factors: Children
Oxcarbazepine (Trileptal) works well to keep seizures under control. But it's possible that it might make seizures get worse. Some people had a new type of seizure while taking oxcarbazepine (Trileptal). This is more likely to happen in children, but it can also happen in adults.
Make sure your family and friends know what a seizure looks like. That way, they can get medical help quickly if you have a seizure while taking oxcarbazepine (Trileptal).
Withdrawal seizures
Stopping oxcarbazepine (Trileptal) too fast can raise the risk of seizures. These seizures can happen more often or last longer, which can be dangerous.
Don't stop taking oxcarbazepine (Trileptal) without talking to your prescriber first. If you need to stop, your prescriber will help you do this safely. Usually, this means slowly lowering the dose over time to help prevent seizures.
Oxcarbazepine (Trileptal) dosage
Typical dosage for Oxcarbazepine (Trileptal)
-
People ages 17 years and older
- The typical starting dose is 300 mg by mouth twice daily. If needed, your prescriber will raise your dose slowly over a few weeks.
- The maximum dose ranges from 600 mg to 1,200 mg twice daily (a total of 1,200 mg to 2,400 mg per day). This depends on if you're taking other seizure medications.
-
Children ages 2 to 16 years
- The prescriber will calculate the dose based on your child’s body weight. The typical starting dose is 8 mg/kg to 10 mg/kg (up to a maximum of 600 mg), split into 2 doses and taken by mouth twice daily. If needed, the prescriber will raise the dose slowly over a few weeks.
- The maintenance dose ranges from 300 mg to 1,050 mg twice daily (a total of 600 mg to 2,100 mg per day). It depends on your child’s age, weight, and other seizure medications.
Your dose might be different if you have kidney problems. It might also be different if you take a medication that interacts with oxcarbazepine (Trileptal).
More on Oxcarbazepine (Trileptal) dosage
Interactions between Oxcarbazepine (Trileptal) and other drugs
More on Oxcarbazepine (Trileptal) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
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 Oxcarbazepine (Trileptal) cost?
Oxcarbazepine (Trileptal) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Oxcarbazepine (Trileptal) will not be safe for you to take.
- Allergy to oxcarbazepine or eslicarbazepine (Aptiom)
What are alternatives to Oxcarbazepine (Trileptal)?
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