Oxcarbazepine (Trileptal)

Primer

Oxcarbazepine (Trade name: Trileptal) is a mood stabilizer and antiepileptic used in the treatment of epilepsy and bipolar disorder. It is generally better tolerated than carbamazepine.

Advantages

Oxcarbazepine was developed due to several problems noticed in carbamazepine. Oxcarbazepine has the effectiveness as carbamazepine, but fewer problems, including:
Minimal induction of cytochrome P450 enzymes
No need for plasma level monitoring
Much lower risk for agranulocytosis
Lower risk for Stevens-Johnson Syndrome
Less anticholinergic side effects such as dizziness, sedation and weight gain
However, oxcarbazepine is more likely to cause hyponatremia compared to carbamazepine

Pharmacokinetics

See also article: Introduction to Pharmacology

Pharmacokinetics of Oxcarbazepine

Absorption
Distribution
Metabolism
Elimination
Half-life

See also article: Cytochrome (CYP) P450 Metabolism

Oxcarbazepine: Cytochrome P450 Metabolism

Substrate of (Metabolized by)
Induces
Inhibits

Pharmacodynamics

Mechanism of Action

Toxicity

Indications

Dosing

Dosing for Oxcarbazepine

Starting
Titration
Maximum
Taper

Formulations

Oxcarbazepine comes in

Monitoring

Contraindications

Absolute

Relative

Drug-Drug Interactions

Side Effects

Adverse Events

Clinical Pearls

Special Populations

Geriatric

See main article: Geriatric Pharmacology

Pediatric

See main article: Pediatric Pharmacology

Obstetric and Fetal

See main article: Obstetric and Fetal Pharmacology

Medically Ill

See main article: Psychotropic Dosing in the Medically Ill

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