Oxcarbazepine(oks car baz’ e peen)
Apo–Oxcarbazepine (CAN), Oxtellar-XRDNC, Trileptal
PREGNANCY CATEGORY C
Drug Class
Antiepileptic
Therapeutic Actions
Mechanism of action not understood; antiepileptic activity may be related to its ability to block voltage-sensitive sodium channels, increase potassium conductance, and affect high-voltage activated calcium channels, leading to enhanced membrane stability.
Indications
As monotherapy or adjunct therapy in the treatment of partial seizures in adults and children 4 yr and older
Adjunct therapy for children 2 yr and older with epilepsy
Unlabeled uses: Alternative treatment of bipolar disorder, diabetic neuropathy, alcohol withdrawal
Available Forms
Tablets—150, 300, 600 mg; suspension—60 mg/mL; ER tabletsDNC—150, 300, 600 mg
Dosages
Adults
Adjunctive therapy: 300 mg PO bid, may be increased to a total of 600 mg PO bid if clinically needed. ER tablets: Initiate at 600 mg/day PO; increase at weekly intervals in 600-mg/day increments. Target dose, 2,400 mg PO once a day.
Conversion to monotherapy: 300 mg PO bid started while reducing the dose of other antiepileptics; other drugs should be reduced over 3–6 wk while increasing oxcarbazepine over 2–4 wk to maximum of 2,400 mg/day (in divided doses).
Starting as monotherapy: Start with 300 mg PO bid and increase by 300 mg/day every third day until the desired dose of 1,200 mg/day is reached. Some patients may benefit from doses as high as 2,400 mg/day but should be carefully monitored.
Pediatric patients 2–16 yr
Adjunctive therapy:
4–16 yr: 8–10 mg/kg/day PO given in two equally divided doses not to exceed 600 mg/day. Achieve the target dose over 2 wk. Suggested target dosages follow:
Weight (kg)
Dosage (mg/day)
20–29
900
29.1–39
1,200
More than 39
1,800
2–4 yr and more than 20 kg: 8–10 mg/kg/day PO not to exceed 600 mg/day.
2–4 yr and less than 20 kg: 16–20 mg/kg/day PO not to exceed 600 mg/day. Follow same dosage for ER forms.
Monotherapy for partial seizures in epileptic children 4–16 yr: 8–10 mg/kg/day PO in two divided doses. If the patient is taking another antiepileptic, slowly withdraw that drug over 3–6 wk. Then, increase the oxcarbazepine in 10 mg/kg/day increments at weekly intervals to the desired level. If the patient is not taking another antiepileptic, increase the dose by 5 mg/kg/day every third day to the recommended dosage. Recommended dosages by weight:
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