TRILEPTAL (Oxcarbazepine)

What is this medication?

Oxcarbazepine, Trileptal/Oxtellar XR
Anticonvulsant; Miscellaneous

Oxcarbazepine, Trileptal/Oxtellar XR is officially indicated to treat focal (partial) onset seizures.  It is also prescribed off-label for trigeminal neuralgia if carbamazepine fails.

“Warning:

Blood dyscrasias:
The risk of developing anemia or agranulocytosis is increased during treatment. Complete pre-treatment hematological testing should be obtained prior to use; monitor patient closely if white blood cells or platelet counts decrease during therapy; discontinue if significant bone marrow suppression occurs.

Dermatologic toxicity:
Severe and sometimes fatal dermatologic reactions, including toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), may occur during therapy. The risk is increased in patients with the variant HLA-B*1502 allele, found most often in patients of Asian ancestry. Patients with an increased likelihood of carrying this allele should be screened prior to initiating therapy. Avoid use in patients testing positive for the allele; discontinue therapy in patients who have a serious dermatologic reaction. “

How does this medication work?

Oxcarbazepine, Trileptal/Oxtellar XR and its active metabolite monohydroxy metabolite’s (MHD) mechanism of anticonvulsant effect is not fully understood. Oxcarbazepine and MHD block voltage-sensitive sodium channels.   This has the effects of stabilizing hyperexcited neuronal membranes, inhibiting repetitive firing, and decreasing the propagation of synaptic impulses, which are suspected to be the mechanism of it preventing the spread of seizures. Oxcarbazepine and MHD also modulate high voltage activated calcium channels and increase potassium conductance.

How should I take this medication?

Immediate release: Initial: 300 to 600 mg/day in 2 divided doses. May increase dose by ≤600 mg/day increments at weekly intervals to a maximum dose of 2.4 g/day in 2 to 3 divided doses

Extended release: Initial: 600 mg once daily. May increase dose by 600 mg/day increments at weekly intervals to a maximum dose of 2.4 g/day.

How to Take:
Immediate release: Twice daily without regard to meals.

Extended release: Once daily on an empty stomach at least 1 hour before or 2 hours after food. Swallow whole (do not cut, crush, or chew the tablets)

What should I watch for while using this medication?

Before starting Oxcarbazepine, Trileptal/Oxtellar XR make sure your physician is aware of any allergies or medications you currently take and is prepared to monitor you thoroughly while on Oxcarbazepine, Trileptal/Oxtellar XR.  You can experience drowsiness, agitation, and suicidal ideation.  There are serious side effects associated with taking Oxcarbazepine, Trileptal/Oxtellar XR such as blood dyscrasias, dermatologic toxicity, hepatic toxicity, and multi-organ hypersensitivity reactions.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible.  However, if it is almost time for your next dose, take only that scheduled dose.  Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times.  Store at room temperature, 59 to 86° F (15 to 30° C).  Protect from light.  Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

>10%:

Central nervous system: Dizziness, drowsiness, headache, ataxia, fatigue, abnormal gait, vertigo 

Gastrointestinal: Vomiting, nausea, abdominal pain 

Neuromuscular & skeletal: Tremor 

Ophthalmic: Diplopia, nystagmus, visual disturbance 

Note this is not a complete list of side effects for Carbamazepine, Tegretol only common ones