Oxcarbazepine

Oxcarbazepine is a prescription medication used to treat partial seizures in adults and children 2 years and older with epilepsy. It may be used alone or with other medications.  Oxcarbazepine belongs to a group of drugs called anticonvulsants, which work by decreasing abnormal electrical activity in the brain.

This medication comes in a tablet, an extended release tablet, and in an oral suspension form. Oxcarbazepine is usually taken twice daily, with or without food.

Common side effects of oxcarbazepine include dizziness, sleepiness, double vision, and nausea. Do not drive or operate heavy machinery until you know how oxcarbazepine affects you.

Oxcarbazepine is a prescription medicine used:

• alone or with other medicines to treat partial seizures in adults.
• alone to treat partial seizures in children 4 years and older. 
• with other medicines to treat partial seizures in children 2 years and older.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Oxcarbazepine may be found in some form under the following brand names:

• Oxtellar

• Trileptal

See “Drug Precautions”.

Oxcarbazepine may cause other serious side effects including:

• your seizures can happen more often or become worse 
• trouble concentrating 
• problems with your speech and language 
• feeling confused 
• feeling sleepy and tired
• trouble walking and with coordination

Get medical help right away if you have any of the symptoms listed above or listed in “Drug Precautions”.

The most common side effects of oxcarbazepine include:

• dizziness 
• sleepiness 
• double vision 
• tiredness 
• nausea 
• vomiting 
• problems with vision 
• stomach pain 
• trembling 
• upset stomach 
• problems with walking and coordination (unsteadiness) 
• rash
• infections (especially in children)

These are not all the possible side effects of oxcarbazepine. For more information, ask your healthcare provider or pharmacist.

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you take:

• amiodarone (Cordarone)
• amitriptyline (Elavil)
• amlodipine (Norvasc)
• diltiazem (Cardizem, Dilacor, Tiazac)
• felodipine (Plendil)
• isradipine (DynaCirc)
• nicardipine (Cardene)
• nifedipine (Procardia)
• nimodipine (Nimotop)
• nisoldipine (Sular)
• verapamil (Calan, Covera, Isoptin, Verelan)
• chlorpromazine (Thorazine)
• clomipramine (Anafranil)
• cyclophosphamide (Cytoxan, Neosar)
• desmopressin (DDAVP, Minirin, Stimate)
• diazepam (Valium)
• diuretics
• hormonal contraceptives (birth control pills, rings, patches, implants, injections, and intrauterine devices)
• indapamide (Natrilix)
• other medications for seizures such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenobarbital, phenytoin (Dilantin), and valproic acid (Depakene, Depakote)
• proton-pump inhibitors such as lansoprazole (Prevacid), omeprazole (Prilosec), and pantoprazole (Protonix)
• theophylline (Theo-Dur)
• selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft).

Taking oxcarbazepine with certain other medicines may cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider.

Do not stop taking oxcarbazepine without first talking to your healthcare provider.

Stopping oxcarbazepine suddenly can cause serious problems.

Oxcarbazepine can cause serious side effects, including:

1. Oxcarbazepine may cause the level of sodium in your blood to be low. Symptoms of low blood sodium include:

• nausea 
• tiredness, lack of energy 
• headache 
• confusion 
• more frequent or more severe seizures.

Similar symptoms that are not related to low sodium may occur from taking oxcarbazepine. You should tell your healthcare provider if you have any of these side effects and if they bother you or they do not go away.

Some other medicines can also cause low sodium in your blood. Be sure to tell your healthcare provider about all the other medicines that you are taking.

2. Oxcarbazepine may also cause allergic reactions or serious problems which may affect organs and other parts of your body like the liver or blood cells. You may or may not have a rash with these types of reactions.

Call your healthcare provider right away if you have any of the following:

• swelling of your face, eyes, lips, or tongue 
• trouble swallowing or breathing
• a skin rash
• hives
• fever, swollen glands, or sore throat that do not go away or come and go
• painful sores in the mouth or around your eyes
• yellowing of your skin or eyes 
• unusual bruising or bleeding
• severe fatigue or weakness 
• severe muscle pain 
• frequent infections or infections that do not go away

Many people who are allergic to carbamazepine are also allergic to oxcarbazepine. Tell your healthcare provider if you are allergic to carbamazepine.

3. Like other antiepileptic drugs, oxcarbazepine may cause suicidal thoughts or actions in a very small number of people, about 1 in 500.

Call a doctor right away if you have any of these symptoms, especially if they are new, worse, or worry you:

• thoughts about suicide or dying 
• attempts to commit suicide 
• new or worse depression 
• new or worse anxiety 
• feeling agitated or restless 
• panic attacks 
• trouble sleeping (insomnia) 
• new or worse irritability 
• acting aggressive, being angry, or violent 
• acting on dangerous impulses 
• an extreme increase in activity and talking (mania) 
• other unusual changes in behavior or mood

Watch for early symptoms of suicidal thoughts and actions:

• Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. 
• Keep all follow-up visits with your healthcare provider as scheduled.

Call your healthcare provider between visits as needed, especially if you are worried about symptoms.

Do not stop taking oxcarbazepine without first talking to a healthcare provider.

Stopping oxcarbazepine suddenly can cause serious problems. Stopping a seizure medicine suddenly in a patient who has epilepsy may cause seizures that will not stop (status epilepticus).

Suicidal thoughts or actions may be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes.

• Do not take oxcarbazepine if you are allergic to oxcarbazepine or any of the other ingredients in oxcarbazepine. Many people who are allergic to carbamazepine are also allergic to oxcarbazepine.
• Do not drive, operate heavy machinery, or do other dangerous activities until you know how oxcarbazepine affects you. Oxcarbazepine may slow your thinking and motor skills.
• Do not drink alcohol or take other drugs that make you sleepy or dizzy while taking oxcarbazepine until you talk to your healthcare provider. Oxcarbazepine taken with alcohol or drugs that cause sleepiness or dizziness may make your sleepiness or dizziness worse.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of oxcarbazepine there are no specific foods that you must exclude from your diet when receiving oxcarbazepine.

Before taking oxcarbazepine, tell your healthcare provider about all your medical conditions, including if you:

• have or have had suicidal thoughts or actions, depression or mood problems
• have liver problems
• have kidney problems
• are allergic to carbamazepine. Many people who are allergic to carbamazepine are also allergic to oxcarbazepine. 
• use birth control medicine. Oxcarbazepine may cause your birth control medicine to be less effective. Talk to your healthcare provider about the best birth control method to use. 
• are pregnant or plan to become pregnant. 

• are breastfeeding or plan to breastfeed. 

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your healthcare provider if you are pregnant or plan to become pregnant. Oxcarbazepine may harm your unborn baby. Tell your healthcare provider right away if you become pregnant while taking oxcarbazepine. You and your healthcare provider will decide if you should take oxcarbazepine while you are pregnant.

If you become pregnant while taking oxcarbazepine, talk to your healthcare provider about registering with the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The purpose of this registry is to collect information about the safety of antiepileptic medicine during pregnancy. You can enroll in this registry by calling 1-888-233-2334. 

Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Oxcarbazepine passes into breast milk. You and your healthcare provider should discuss whether you should take oxcarbazepine or breastfeed; you should not do both.

• Do not stop taking oxcarbazepine without talking to your healthcare provider. Stopping oxcarbazepine suddenly can cause serious problems, including seizures that will not stop (status epilepticus).
• Take oxcarbazepine exactly as prescribed. Your healthcare provider may change your dose and how many times a day you may take oxcarbazepine. Your healthcare provider will tell you how much oxcarbazepine to take. 
• Take oxcarbazepine with or without food.
• Before taking oxcarbazepine oral suspension shake the bottle well and use the oral dosing syringe to measure the amount of medicine needed. Trileptal oral suspension can be mixed in a small glass of water, or swallowed directly from the syringe. Clean the syringe with warm water and let it dry after each use. 

Take oxcarbazepine exactly as prescribed. Follow the directions on your prescription label carefully. The dosage must be individualized based on your age and weight, other medicines you take, as well as other medical conditions you have.

If you take too much oxcarbazepine, call your healthcare provider or local Poison Control Center right away.

Store oxcarbazepine tablets and oral suspension between 15°C to 30°C (59°F to 86°F)

• Keep oxcarbazepine tablets dry.
• Keep oxcarbazepine oral suspension in the original container. Use within 7 weeks of first opening the bottle. Shake well before using.

Keep oxcarbazepine and all medicines out of the reach of children.