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Oxcarbazepine (Trileptal® or Oxtellar XR) is an antiepileptic medication that works by inhibiting nerve impulses that cause seizures. Trileptal can be used as a monotherapy or adjunctive therapy in treating adults with partial epilepsy as an adjunctive therapy in epileptic children aged between 4 and 16. Oxcarbazepine is available in
150mg, 300mg, and 600 mg tablets.
If you have seizures or have been diagnosed with epilepsy, you may need to take medicine on a daily basis. Oxcarbazepine prices may vary from one pharmacy to the next. Buy Oxcarbazepine online to cut extra costs and save time because the drug will be delivered to your address.Those looking for cheap and reputable online pharmacies can get the best oxcarbazepine price by checking websites such as Good
Rx and Consumer Reports Best Drugs.
Mechanism of action
Antiepileptic drugs work in different ways to prevent seizures. Some work by increasing inhibition while others decrease excitation. Oxcarbazepine belongs to a class of drugs known as anticonvulsants-drugs that work by reducing hyperactivity in the brain.
10-monohydroxy metabolite (MHD) is the main active metabolite responsible for the pharmacological activity of oxcarbazepine.
MHD works by inhibiting the influx of sodium across the cell membrane. This results in the diminution of propagation of synaptic impulses, inhibition of neural firing, and stabilization of hyperactive neurons. The cumulative effect of these actions prevents electrical excitation in the human brain.
Dosage and Formulation
Adjunct therapy for
Adults above 16 years
Initiate therapy with 300 mg Oxcarbazepine tablets administered twice-a-day.
Increase dosage by 600mg at weekly intervals.
The maximum recommended daily dose is 1200mg. In clinical trials, most patients were intolerant to 2400 mg/day dosage due to effects to the Central Nervous System (CNS).
Conversion to Monotherapy for adults and adolescents above 16 years
Patients under antiepileptic drugs may be converted to monotherapy by being administered with 300mg of Oxcarbazepine tablets issued twice daily while concurrently reducing the dosage of concomitant antiepileptic drugs. The maximum dose of Oxcarbazepine should be achieved in 2 to 4 weeks while concomitant antiepileptic medications should be withdrawn in 3 to 6 weeks. Trileptal dosage
may be increased as per clinical directions to achieve the maximum dosage of 1200 mg administered twice daily. It is important to closely monitor patients during the transition period.
Monotherapy for Adults
Patients who are not under antiepileptic medications may be initiated into monotherapy by being given 300 mg Oxcarbazepine tablets
administered twice daily. The dosage may be increased to attain the maximum 1200 mg/day as clinically indicated. The 1200 mg/day have been shown to be effective in clinical trials. 2400 mg/day dosage is ineffective for adult patients converting from other antiepileptic drugs.
Adjunctive therapy for patients aged 4-16(Pediatric Patients).
Initiate Oxcarbazepine-8 to 10 mg/kg administered twice daily.
Important to note, the target maintenance dose of Oxcarbazepine is dependent on the patient’s weight as illustrated below.
20-29 kg900 mg daily
29-39 kg 1200 mg daily
>39 kg 1800 mg daily
In patients aged between 2 and 4 years, 8-10 mg/kg is recommended. The Maximum recommended dose is 600 mg/day.
Oxcarbazepine comes in the form of Trileptal tablets and suspension. The Tablets are film coated, ovaloid, pale green yellow, slightly biconcave and come in 150mg, 300mg and 600 mg doses. Each milliliter of slightly-red or off-white-to-slightly orange oral suspension contains 60gm oxcarbazepine. Its ingredients include propylene glycol, sorbitol, ascorbic acid, methylparaben, ethanol, water, sorbic acid, propylparaben, sodium saccharin, and polyethylene glycol-400 stearate.
Conversion to Monotherapy for patients aged 2-16.
Patients using other antiepileptic medications may be converted to monotherapy by being initiated to Oxcarbazepine with a dose of 8-10 mg/kg administered twice daily. The dose of concomitant epileptic drugs should be reduced over a period of three to six weeks. Oxcarbazepine dosage can be increased by a maximum dosage of 10mg per kilogram as clinically indicated. It is imperative that patients are closely monitored when converting from concomitant epileptic drugs to Oxcarbazepine.
Monotherapy for patients aged 4-16
For patients who are not under any concomitant antiepileptic drugs, initiate monotherapy with a dose of 8-10 mg/kg Oxcarbazepine tablets administered twice daily.
An increment of 10g/kg per day is recommended at weekly intervals. Maintenance dose is as indicated below.
20kg: 300-450 mg twice daily.
25-30 kg: 450-600 mg twice daily.
35-40 kg: 450-750 mg twice daily.
45kg: 600-750 kg twice daily.
50-55 kg: 600-900 kg twice daily
60-65 kg: 600-1000 mg twice daily
70kg: 1000-1250 mg twice daily
N/B: Oxcarbazepine is administered orally.
After oral administration of Oxcarbazepine tablets, Oxcarbazepine is absorbed and rapidly reduced into its active metabolite 10-monohydroxy metabolite (MHD). Oxcarbazepine is rapidly absorbed into the bloodstream attaining peak concentrations after 2-3 hours. MHD attains peak concentrations at 5-11 hours. Oxcarbazepine tablets and suspensions were shown to have similar bioavailability after a single-dose administration. The median Tmax in healthy fasted male subjects was 4.5 hours after a single-dose administration of Oxcarbazepine tablets. Tmax in healthy male subjects under fasted conditions administered with a single-dose of Oxcarbazepine was 6 hours. Trileptal tablets and suspension can be taken with or without food. Food has no effect on the absorption of Oxcarbazepine.
When Trileptal is administered twice daily, steady-state plasma concentrations of MHD are attained within 2-3 days. At steady state, the pharmacokinetics of MHS show linearity and proportionality over the dose range of 300-2400 mg per day.
Trileptal may decrease the effectiveness of hormonal birth control drugs. Before using Oxcarbazepine, inform your doctor if you are taking any other prescription or non-prescription drugs using calcium channel blockers (e.g. felodipine, verapamil), seizure control drugs, and a certain combination of HIV medication such as emtricitabine and cobicistat. Avoid medicines containing eslicarbazepine with oxcarbazepine because the two drugs work similarly.
Many drugs have side effects. A side effect is an unwanted response to medication when taken in small doses. Side effects can be mild, moderate or severe. If you are concerned that Trileptal medication is causing you unpleasant side effects, discuss the risks and benefits of this drug with your physician. The following are some of the side effects reported by patients taking oxcarbazepine: abdominal pain, anxiety, acne, difficulty concentrating, headache, hair loss, fatigue, problems with speech and coordination, skin rash and nausea. The
following side effects are a cause of concern when their degree is moderate to severe: flu-like symptoms, nervousness and confusion, signs of anemia, signs of clotting problems and changes in vision.
Before taking Trileptal, inform your pharmacist or doctor the drugs you are allergic to Oxcarbazepine. Oxcarbazepine may contain active ingredients that may cause allergic reactions in some patients. Inform your doctor about your medical history, decreased sodium levels, kidney diseases, and recent epileptic episodes. Do not operate machinery or engage in any activity that requires you to be alert. Trileptal
may make you drowsy. It is advisable to limit alcoholic beverages. If you are pregnant or are planning to get pregnant, immediately consult your doctor about the risks of using Oxcarbazepine during pregnancy.