Oxipin

Indications

Oxcarbazepine is an antiepileptic medicine used to treat focal (partial) seizures, with or without spreading to become generalised seizures, in adults and children. It can be used alone or added to other seizure medicines. Doctors sometimes also use it for trigeminal neuralgia (severe nerve pain in the face).

How It Works

Oxcarbazepine and its active form block sodium channels in nerve cells. This calms overactive nerve signals in the brain and stops them from spreading, which prevents seizures.

Dosage and Administration

Adults: usually started at 300 mg twice a day (600 mg a day) and increased gradually, often by up to 600 mg a day each week, as prescribed. The usual maintenance dose is 600 mg to 2400 mg a day, split into two doses. Children: dosed by body weight, as prescribed. Take it by mouth with or without food. Shake the oral suspension well before measuring. Do not stop it suddenly, as seizures can return; the doctor will reduce the dose slowly.

Interactions

• It makes hormonal contraceptives (pills, implants) less effective; use an extra or non-hormonal method of contraception.
• Carbamazepine, Phenytoin and Phenobarbital lower oxcarbazepine levels, while oxcarbazepine can raise Phenytoin levels and lower Lamotrigine levels.
• Diuretics (water pills), Desmopressin and some antidepressants increase the risk of low sodium.
• Alcohol and other sedating medicines add to drowsiness and dizziness.

Contraindications

• Allergy to oxcarbazepine, Eslicarbazepine or any ingredient of the product.
• People who had a serious reaction to Carbamazepine should tell the doctor, as about a quarter may also react to oxcarbazepine.

Side Effects

Common: dizziness, drowsiness, tiredness, headache, double or blurred vision, unsteadiness, nausea and vomiting. These are often worse when starting or increasing the dose. Low blood sodium is also fairly common.

Get urgent medical help if you have: a rash with blistering, peeling, mouth sores or fever (a serious skin reaction; people of Asian background who carry the HLA-B*1502 gene have a higher risk, and the doctor may test for it); confusion, severe headache, unusual sleepiness, muscle cramps or more frequent seizures (possible low sodium); swelling of the face, lips or throat or trouble breathing; yellow skin or eyes; or new or worsening depression, unusual changes in mood or behaviour, or thoughts of self-harm.

Pregnancy and Lactation

Do not stop the medicine on your own if you become pregnant, as uncontrolled seizures are dangerous for mother and baby. Discuss pregnancy plans with the doctor in advance; folic acid is usually recommended before and during pregnancy. Seizure medicine levels can fall in pregnancy, so closer monitoring may be needed. Oxcarbazepine passes into breast milk; breastfeeding should be discussed with the doctor and the baby watched for drowsiness or poor feeding.

Precautions and Warnings

• The doctor may check blood sodium levels, especially in older adults and those taking diuretics.
• Do not drive or use machines until you know how it affects you, and follow local rules on driving with epilepsy.
• Tell the doctor about kidney disease, liver disease, heart rhythm problems or past reactions to Carbamazepine.
• Patients and families should watch for mood changes and report them.

Overdose

Too much may cause severe drowsiness, dizziness, double vision, unsteadiness, vomiting, low sodium, slow breathing or seizures. Seek emergency medical help.

Therapeutic Class

Antiepileptic (anticonvulsant).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Use the oral suspension within the time stated on the label after opening.