Trileptal  (oxcarbazepine) 600mg tablets

Manufacturer: Novartis  

Indication(s):  Monotherapy to treat partial seizures in adults and adjunctive therapy to treat partial seizures in adults and children ages 4 to 16.

Administration:  Usual dosage is 600mg by mouth twice daily for both adjunctive and monotherapy; up to 1,200mg twice daily may be administered for monotherapy.

Pharmacology:  Oxcarbazepine is a prodrug that is quickly converted to a 10-monohydroxy metabolite derivative (MHD), the actual active agent.  The precise mechanism by which oxcarbazepine and MHD exert their antiseizure effect is unknown; however, in-vitro electrophysiological studies indicate that they produce blockade of voltage-sensitive sodium channels, resulting in stabilization of hyper-excited neural membranes, inhibition of repetitive neuronal firing, and diminution of propagation of synaptic impulses.

WebRx Editorial Notes:  Better tolerated than carbamazepine.  Does not induce its own metabolism like carbamazepine does.  Both oxcarbazepine and MHD inhibit CYP2C19 and induce CYP3A4/5 which can alter plasma concentrations of some other drugs such as Dilantin (phenytoin), Plendil (felodipine), and oral contraceptives.  Oxcarbazepine can cause hyponatremia (sodium depletion) and caution should be used in special populations who might be sensitive...watch for nausea, malaise, headache.  Oxcarbazepine causes birth defects in lab animals and is most likely teratogenic in humans as well.

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