Oxcarbazepine

From Anvita Health Wiki

Contents 1 Indications 2 Dosage 3 Pharmacokinetics 4 Monitor 5 Adverse-effects 6 Drug-interactions 7 More General Terms 8 Additional Terms 9 Internet Database 10 References

Indications

• partial seizures ( FDA approved use)
• trigeminal neuralgia
• mania

Dosage

• adults: 600-1200 mg PO BID

Pharmacokinetics

• metabolized in liver to 10-Hydroxycarbazepine

Monitor

• thyroid functions tests periodically

• may decrease total serum T4 & free T4
• serum T3 & serum TSH generally unaffected [4]

• serum Na+ [4]

• hyponatremia generally occurs within 1st 3 months of therapy
• consider routine periodic monitoring
• monitor with fluid retention or dyspnea in heart failure
• monitor with renal insufficiency associated with low serum Na+ at baseline: check in 2 weeks & monthly for 3 months
• as clinically indicated
  

• monitor with anticonvulsants

Adverse-effects

• less likely than carbamazepine to cause serious hematologic toxicity or severe skin reactions
• other adverse effects similar to carbamazepine

• dizziness
• drowsiness
• ataxia
• gait disturbances
• rash
• nausea

• hyponatremia (2%)
• Stevens-Johnson syndrome [3]
• toxic epidermal necrolysis [3]
  
• drug adverse effects of anticonvulsants

Drug-interactions

• other anti-epileptic agents
• may reduce efficacy of oral contraceptives
• oxcarbazepine induces cyt P450 3A4

• may diminish levels of drugs metabolized by cyt P450 3A4

More General Terms

• anticonvulsant

Additional Terms

• cytochrome P450 3A4 (cytochrome P450 C3, nifedipine oxidase, P450-PCN1, NF-25, CYP3A4)

Internet Database

PubChem: 34312

References

1. Prescriber's Letter 7(2):7, Feb. 2000
2. Kaiser Permanente Northern California Regional Drug Formulary, 2000
3. FDA Medwatch [1]
4. Prescriber's Letter 17(7): 2010 Recommended Lab Monitoring for Common Medications Detail-Document#: [2] (subscription needed) [3]
5. Greiner-Sosanko E et al Drug monitoring: simultaneous analysis of lamotrigine, oxcarbazepine, 10-hydroxycarbazepine, and zonisamide by HPLC-UV and a rapid GC method using a nitrogen-phosphorus detector for levetiracetam J Chromatogr Sci. 2007 October; 45(9): 616-622 [4]

oxcarbazepine (Trileptal)