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Understanding Oxcarbazepine: Uses, Dosage, and Safety Guidelines


Why is this medication prescribed?

Oxcarbazepine (Trileptal) is used alone or in combination with other medications to control certain types of seizures in adults and children. Oxcarbazepine extended-release tablets (Oxtellar XR) are used in combination with other medications to control certain types of seizures in adults and children 6 years of age and older. Oxcarbazepine is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in the brain.

How should this medicine be used?

Oxcarbazepine comes as a tablet, an extended-release tablet, and a suspension (liquid) to take by mouth. The tablet and suspension are usually taken every 12 hours (twice a day) with or without food. The extended-release tablet is usually taken once a day on an empty stomach, 1 hour before or 2 hours after a meal. Take oxcarbazepine at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take oxcarbazepine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the suspension well right before each use to mix the medication evenly. Use the oral dosing syringe that came with the medication to withdraw the right amount of suspension from the bottle. You can swallow the suspension straight from the syringe or you can mix it with a small glass of water and swallow the mixture. Wash the syringe with warm water and allow it to dry thoroughly after use.

Swallow the extended-release tablets whole with water or another liquid; do not split, chew, or crush them.

Your doctor will probably start you on a low dose of oxcarbazepine and gradually increase your dose, not more often than once every 3 days. If you were taking another medication to treat your seizures and are switching to oxcarbazepine, your doctor may gradually decrease your dose of the other medication while increasing your dose of oxcarbazepine. Follow these directions carefully and ask your doctor if you are not sure how much medication you should take.

Oxcarbazepine may help control your seizures but will not cure your condition. Continue to take oxcarbazepine even if you feel well. Do not stop taking oxcarbazepine without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood. If you suddenly stop taking oxcarbazepine, your seizures may get worse. Your doctor will probably decrease your dose gradually.

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with oxcarbazepine and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website or the manufacturer’s website to obtain the Medication Guide.

Oxcarbazepine, also known as Trileptal, is occasionally employed in the treatment of bipolar disorder (manic-depressive disorder). This disorder involves episodes of depression, frenzied abnormal excitement, and other abnormal mood fluctuations. Consult your doctor to discuss potential risks associated with using this medication for your specific condition.

This medication may be prescribed for additional purposes not mentioned here. For more information, consult your doctor or pharmacist.

Dosage Recommendations:

The dosage of Oxcarbazepine is typically determined by healthcare professionals based on individual factors such as age, weight, and the specific condition being treated. Patients are advised to strictly follow their doctor’s instructions regarding dosage and administration.

Tablet and Suspension: Usually taken every 12 hours (twice a day) with or without food.
Extended-Release Tablet: Taken once a day on an empty stomach, either one hour before or two hours after a meal.
It is crucial to adhere to a consistent schedule, taking Oxcarbazepine at the same times each day for optimal effectiveness.

Special Precautions to Follow:

Before initiating Oxcarbazepine treatment, consider the following precautions:


Inform your doctor if you are allergic to oxcarbazepine, carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), or any other medications, including inactive ingredients in oxcarbazepine tablets, extended-release tablets, or suspension. Request a list of inactive ingredients from your pharmacist.

Medication Interaction:

Notify your doctor and pharmacist about all prescribed and over-the-counter medications, vitamins, supplements, and herbal products you are currently taking or planning to take. Mention medications such as amiodarone, amitriptyline, calcium channel blockers, chlorpromazine, clomipramine, diuretics, proton-pump inhibitors, theophylline, and selective serotonin reuptake inhibitors, among others. Your doctor may need to adjust your medication doses or monitor you for potential side effects due to interactions.

Health Conditions:

Disclose any history of kidney or liver disease to your doctor.

Ethnic Background:

If you are of Chinese, Thai, Malaysian, Korean, Indian, or Filipino descent, inform your doctor. Individuals of Asian ancestry may have an increased risk of life-threatening allergic reactions such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). Your doctor may conduct a test to determine if you have a genetic risk factor before prescribing oxcarbazepine.

Pregnancy and Breastfeeding:

Advise your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Women using hormonal contraceptives should be aware that these may be less effective when combined with oxcarbazepine. Consult your doctor for alternative birth control methods.

Drowsiness and Vision Changes:

Be aware that oxcarbazepine may cause drowsiness, dizziness, affect your movement, or lead to double vision or other vision changes. Avoid driving or operating machinery until you understand how the medication affects you.

Alcohol Interaction:

Recognize that alcohol can intensify the drowsiness induced by this medication.

Mental Health Changes:

Understand that your mental health may undergo unexpected changes, and you may experience suicidal thoughts while taking oxcarbazepine. Promptly notify your doctor if you observe symptoms such as panic attacks, restlessness, worsening irritability, aggression, or thoughts of self-harm.

It is essential that you and your healthcare provider make informed decisions about the benefits and risks of using oxcarbazepine for your specific condition. Keep your family or caregiver informed about serious symptoms that may require immediate medical attention.

Guidelines for Storage and Disposal of this Medication

Here’s what you should know about storing and getting rid of this medication:


Keep this medication in its original container, securely closed, and away from the reach and view of children.

Store it at room temperature, avoiding excess heat and moisture (refrain from storing it in the bathroom).

Protect extended-release tablets from light.

Dispose of any unused suspension within 7 weeks after opening the bottle.


Dispose of unneeded medications in a manner that ensures they cannot be accessed by pets, children, or others.

Do not flush this medication down the toilet. Instead, opt for a medicine take-back program.

Consult your pharmacist or contact your local garbage/recycling department to inquire about take-back programs in your community.

If a take-back program is unavailable, refer to the FDA’s Safe Disposal of Medicines website for alternative guidance.

Child Safety:

Keep all medications out of sight and reach of children, as certain containers (like weekly pill organizers, eye drop containers, creams, patches, and inhalers) may not be child-resistant, and children can easily open them.

To prevent poisoning in young children, always lock safety caps and promptly store the medication in a secure location—preferably one that is elevated, out of sight, and beyond the reach of children.


Q. Does Oxcarbazepine lead to hair loss?
A. Yes, hair loss is a common side effect of Oxcarbazepine, though not experienced by everyone. If significant hair loss occurs, consult your doctor.

Q. Does Oxcarbazepine impact weight?
A. Yes, Oxcarbazepine may cause weight changes, with both weight gain and loss reported. Seek guidance from a dietitian to manage your weight effectively.

Q. Does Oxcarbazepine result in memory loss?
A. Yes, memory loss is a common side effect, but it varies among individuals. If concerning, consult your doctor for personalized advice.

Q. How should I take Oxcarbazepine?
A. Follow your doctor’s instructions precisely. Take it twice daily, with or without food, at the same time each day for optimal benefits and to aid in remembering.

Q. Who should avoid Oxcarbazepine?
A. Those allergic to Oxcarbazepine, eslicarbazepine, pregnant or birth control pill users, severe liver/kidney issues, and individuals with psychiatric disorders should avoid Oxcarbazepine.

Q. What are Oxcarbazepine’s advantages over carbamazepine?
A. Oxcarbazepine presents fewer side effects compared to carbamazepine and allows for a clinically effective dose initiation, reducing the need for frequent doctor visits to determine dosage based on patient response.

Q. How can I monitor early signs of suicidal thoughts?
A. Pay attention to sudden mood, behavior, thought, or feeling changes. Watch for warning signs such as talking about self-harm, withdrawal, depression, and stay connected with your doctor.


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