Indications
Eslicarbazepine Acetate is an antiepileptic (anti-seizure) medicine. It is used to treat focal seizures, also called partial-onset seizures, which start in one part of the brain and may or may not spread to the whole brain. In adults it can be used on its own or added to other seizure medicines. In some countries it is also used as an add-on treatment in children over 6 years, under specialist care.
How It Works
After it is swallowed, Eslicarbazepine Acetate is changed in the body into its active form, eslicarbazepine. This blocks sodium channels, tiny gates on nerve cells that let electrical signals pass. By keeping over-active nerve cells calm, it reduces the bursts of abnormal electrical activity that cause seizures.
Dosage and Administration
Adults: treatment is usually started at 400 mg once daily and increased after 1 to 2 weeks to 800 mg once daily. Depending on the response, the doctor may increase it to 1200 mg once daily. Take it at the same time each day, with or without food.
- People with kidney problems need a lower dose, as prescribed.
- Children: dose is based on body weight and set by a specialist, as prescribed.
- Do not stop taking it suddenly, because seizures may return or get worse; your doctor will reduce the dose gradually.
- If you miss a dose, take it when you remember unless it is nearly time for the next one; do not take a double dose.
Interactions
- Hormonal contraceptives (pill, implant, injection): Eslicarbazepine can make them less effective. Use an additional non-hormonal method such as condoms during treatment and for one menstrual cycle after stopping.
- Carbamazepine and Oxcarbazepine: closely related; should not be combined because side effects such as dizziness and double vision increase.
- Phenytoin: levels of Phenytoin may rise while Eslicarbazepine levels fall; dose changes may be needed.
- Warfarin: its effect may be reduced; blood tests (INR) should be checked.
- Simvastatin and some other statins: levels may fall.
- Alcohol and other medicines that cause drowsiness can increase dizziness and sleepiness.
Contraindications
- Allergy to Eslicarbazepine Acetate, Oxcarbazepine or Carbamazepine.
- Second or third degree heart block (a problem with the heart’s electrical conduction), unless a pacemaker is fitted.
Side Effects
Common: dizziness, sleepiness, headache, nausea, vomiting, double or blurred vision, unsteady walking, poor coordination, tiredness and rash. It can lower the blood sodium level (hyponatraemia), which may cause confusion, weakness, headache or more seizures.
Get urgent medical help if you develop a severe skin reaction (widespread rash with blistering, peeling skin, mouth sores or fever), swelling of the face, lips or throat or difficulty breathing, severe confusion or a sudden increase in seizures, fainting or a very slow or irregular heartbeat, or thoughts of harming yourself.
Pregnancy and Lactation
Seizure medicines can carry a risk to the unborn baby, but uncontrolled seizures are also dangerous. If you could become pregnant, plan pregnancy with your doctor, take folic acid as advised, and use effective contraception (remember the reduced effect of hormonal methods). Do not stop the medicine on your own if you become pregnant; talk to your doctor at once. Eslicarbazepine passes into breast milk, so breastfeeding is usually not recommended; discuss this with your doctor.
Precautions and Warnings
- A small number of people taking antiepileptic medicines have thoughts of self-harm; family members should watch for mood changes.
- In people of some Asian backgrounds, a gene called HLA-B*1502 increases the risk of serious skin reactions; your doctor may test for it.
- Blood sodium may be checked, especially in older people and those taking diuretics.
- Dizziness and blurred vision may affect driving or using machinery.
- Tell your doctor about heart rhythm problems, liver or kidney disease.
Overdose
Too much may cause severe dizziness, unsteadiness, vomiting, confusion, low sodium, seizures or heart rhythm problems. Go to the nearest hospital emergency department at once and take the pack with you.
Therapeutic Class
Antiepileptic (anticonvulsant); dibenzazepine sodium channel blocker.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.