Classifications: anticonvulsant; Therapeutic: anticonvulsant
Pregnancy Category: C
150 mg, 300 mg, 600 mg tablets; 300 mg/5 mL suspension
Anticonvulsant properties may result from blockage of voltage-sensitive sodium channels, which results in stabilization
of hyperexcited neural membranes.
Inhibits repetitive neuronal firing, and decreased propagation of neuronal impulses.
Monotherapy or adjunctive therapy in the treatment of partial seizures in adults and children age 416 y.
Hypersensitivity to oxcarbazepine; pregnancy (category C); children <3 y.
Older adults; renal impairment; renal failure; children <8 y; infertility, hyponatremia, SIADH, and drugs associated with
SIADH as an adverse effect; lactation.
Route & Dosage
Adult: PO Start with 300 mg b.i.d. and increase by 600 mg/d qwk to 2400 mg/d in 2 divided doses for monotherapy or 1200 mg/d as adjunctive
Child: PO 416 y, Initiate with 810 mg/kg/d divided b.i.d. (max: 600 mg/d), gradually increase weekly to target dose (divided b.i.d.)
based on weight: 2029 kg, 900 mg/d; 29.139 kg, 1200 mg/d; >39 kg, 1800 mg/d
Clcr <30 mL/min: initiate at ? usual starting dose (300 mg b.i.d.)
- Initiate therapy at one-half the usual starting dose (300 mg/d) if creatinine clearance <30 mL/min.
- Do not abruptly stop this medication; withdraw drug gradually when discontinued to minimize seizure potential.
- Store preferably at 25° C (77° F), but room temperature permitted. Keep container tightly closed.
Adverse Effects (≥1%)Body as a Whole: Fatigue,
asthenia, peripheral edema, generalized edema, chest pain, weight gain. CV:
Hypotension. GI: Nausea, vomiting, abdominal pain,
diarrhea, dyspepsia, constipation
, anorexia, dry mouth. Hematologic:
Muscle weakness. CNS: Headache, dizziness, somnolence, ataxia, nystagmus, abnormal gait, insomnia
, tremor, nervousness, agitation, abnormal coordination, speech disorder, confusion, abnormal thinking, aggravate
convulsions, emotional lability. Respiratory:
Rhinitis, cough, bronchitis
, pharyngitis. Skin: Acne
, hot flushes, purpura, Stevens-Johnson syndrome, toxic epidermal necrolysis. Special Senses: Diplopia, vertigo, abnormal vision,
abnormal accommodation, taste perversion, ear ache. Urogenital:
Urinary tract infection, micturition frequency, vaginitis
InteractionsDrug: Carbamazepine, phenobarbital, phenytoin, valproic acid, verapamil, calcium channel blockers
may decrease oxcarbazepine
levels; may increase levels of phenobarbital, phenytoin;
may decrease levels of felodipine, oral contraceptives
. Herbal: Ginkgo
may decrease anticonvulsant effectiveness. Evening primrose oil
may decrease the seizure threshold.
Rapidly and completely from GI tract. Peak:
Steady-state levels reached in 23 d. Distribution:
40% protein bound. Metabolism:
Extensively metabolized in liver to active 10-monohydroxy metabolite (MHD). Elimination:
95% in kidneys. Half-Life:
2 h, MHD 9 h.
Assessment & Drug Effects
- Monitor for and report S&S of: Hyponatremia (e.g., nausea, malaise, headache, lethargy, confusion); CNS impairment (e.g.,
somnolence, excessive fatigue, cognitive deficits, speech or language problems, incoordination, gait disturbances).
- Monitor phenytoin levels when administered concurrently.
- Lab tests: Periodic serum sodium, T4 level; when oxcarbazepine is used as adjunctive therapy, closely monitor plasma level of the concomitant antiepileptic
drug during titration of the oxcarbazepine dose.
Patient & Family Education
- Notify physician of the following: Dizziness, excess drowsiness, frequent headaches, malaise, double vision, lack of coordination,
or persistent nausea.
- Exercise special caution with concurrent use of alcohol or CNS depressants.
- Use caution with potentially hazardous activities and driving until response to drug is known.
- Use or add barrier contraceptive since drug may render hormonal methods ineffective.