Oxcarbazepine

Question 1

Oxcarbazepine
Brand Name

Answer 1

Trileptal
Oxtellar XR

Question 2

Oxcarbazepine
Formulations

Answer 2

Oral suspension: 300mg/5mL
Tablet: 150mg, 300mg, 600mg
Tablet XR 24 hour: 150mg, 300mg, 600mg

Question 3

Oxcarbazepine
On-Label Indications

Answer 3

Focal seizures

Question 4

Oxcarbazepine
Off-Label Indications

Answer 4

Trigeminal neuralgia
Bipolar mania (uncertain/doubtful efficacy, still used)

Question 5

Oxcarbazepine
MOA

Answer 5

Antiepileptic
Blocks VSSCs and VSCCs

Question 6

Oxcarbazepine
CYP450 Pathway

Answer 6

Less CYP450 interactions than Carbamazepine

Question 7

Oxcarbazepine
Dose Range (Adult)

Answer 7

IR: 300-600mg/day in 2 divided doses
Incr by ≤600mg/day Qweek
Maximum dose: 2400mg/day in 2-3 divided doses
XR: 600mg/day
Incr by 600mg/day Qweek
Max: 2400mg/day

Question 8

Oxcarbazepine
Dosing (Elderly)

Answer 8

IR: see adult
XR: 300-450mg/day
Incr by 300-450mg/day Qweek

Question 9

Oxcarbazepine
Dosing (Liver Impairement)

Answer 9

No dosage adjustments
XR: not recommended in severe impairment

Question 10

Oxcarbazepine
Dosing (Kidney Impairement)

Answer 10

CrCl <30mL/min (Severe): Initiate at 1/2 usual starting dose, incr SLOWLY

Question 11

Oxcarbazepine
OB Considerations

Answer 11

Reduces effectiveness of hormonal birth control, use second method
Limited data on fetal effects and lactation

Question 12

Oxcarbazepine
Side Effects

Answer 12

Less sedating, less bone marrow suppression, less hepatotoxicity
Higher risk hyponatremia

Question 13

Oxcarbazepine
Contraindications

Answer 13

Hypersensitivity to oxcarbazepine, possible cross-sensitivity to Carbamazepine

Question 14

Oxcarbazepine
Interactions

Answer 14

Less than Carbamazepine
Less CYP450 interactions

Question 15

Oxcarbazepine
Required Monitoring

Answer 15

Does not require therapeutic drug monitoring

Question 16

Oxcarbazepine
Pearls

Answer 16

No proven efficacy for bipolar depression or mania, still used for mania if all else fails
Consider benefit/risk profile