Oxcarbazepine, Trileptal/Oxtellar XR
Description: Anticonvulsant; Miscellaneous
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.
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. “
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It 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.
Indications For Use
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.
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.
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.
Pharmacist Tips On Using
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)
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
Frequently Asked Questions
Why do I feel so down/depressed since starting this medication? /Why am I having mood swings since starting this medication?
Rarely antiepileptic medications such as this can cause mood or behavior changes and in severe cases result in suicidal ideation. If you are feeling any of these things or family members are reporting mood or behavioral changes, see your physician immediately to discuss your options as it could be a result of this medication. Many scenarios where this medication is used can also result in these mood or behavioral changes so it is important to be open and honest with your physician about your feelings to make sure they have all of the information to treat you.
Why would my physician prescribe a medication with such serious side effects?
Your physician takes the most recent clinical guidelines to make evidence-based decisions on what medication is appropriate in which situations. Your current medications, your allergies, age, cost of medication, comorbid conditions and many other factors will further complicate or limit which medications are appropriate. This medication is used for many serious conditions and your physician has determined the benefits outweigh the risks. Furthermore, they will be monitoring your bloodwork and symptoms closely to see if any serious complications are starting to arise and be able to adjust therapy to prevent progression.