Oxcarbazepine | Side Effects, Dosage, Uses & More
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Generic Name:

oxcarbazepine, Oral tablet

All Brands

  • Trileptal
SECTION 1 of 5

Highlights for oxcarbazepine

Oral tablet
1

Oxcarbazepine is an oral drug that’s used to treat a type of seizure, called a partial seizure, in people with epilepsy.

2

This drug may be used as the only medication in the treatment of your epilepsy. Or it may be used as add-on therapy to another drug.

3

Oxcarbazepine is a generic drug. It’s also available in brand-name versions called Trileptal and Oxtellar XR.

4

This drug can cause low sodium levels in your blood. Symptoms include nausea, tiredness, lack of energy, headache, confusion, and more frequent or more severe seizures.

5

Don’t suddenly stop taking this drug unless your doctor tells you to. Doing so may cause you to have more severe seizures. If your doctor is stopping your treatment with oxcarbazepine, your dose will be slowly lowered to reduce your chance of having more seizures.

IMPORTANT INFORMATION

Serious skin reaction

This drug may cause life-threatening allergic reactions. These are called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These reactions may cause severe damage to your skin or internal organs. Your risk may be higher if you have Asian ancestry with a genetic risk factor. You can still have these conditions without the genetic risk factor. Call your doctor right away if you have any of these symptoms:

  • skin rash
  • hives
  • sores in your mouth
  • blistering or peeling of your skin

Suicidal thoughts

This drug may increase your risk of suicidal thoughts. Your risk may be higher if you already have a mood disorder, such as depression or anxiety. Call your doctor right away if you have any of these symptoms, especially if they are new or worse, or if they worry you:

  • thoughts about suicide or dying
  • attempts to commit suicide
  • new or worse depression
  • new or worse anxiety
  • feeling agitated or restless
  • panic attacks
  • new or worse irritability

What is oxcarbazepine?

This medication is a prescription drug. It is available in these forms: extended-release tablet, immediate-release tablet, and oral suspension.

This drug is available as a generic drug. It’s also available in brand-name versions called Trileptal and Oxtellar XR. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

The immediate-release tablet and oral suspension may be used alone or as part of a combination therapy with other medications to treat seizures. The extended-release tablet is always used with other medications, not alone.

Why it's used

This drug is used to treat partial seizures in people with epilepsy.

How it works

This drug belongs to a class of drugs called antiepileptic medications.

More Details

How it works

This drug belongs to a class of drugs called antiepileptic medications. A class of drugs refers to medications that work similarly. They are often used to treat similar conditions.

It isn’t known exactly how this drug works to stop seizures. It may block sodium channels to stop seizures from spreading to the rest of the brain. It may also act on potassium and calcium in the brain to stop seizures.

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SECTION 2 of 5

oxcarbazepine Side Effects

Oral tablet

Most Common Side Effects

The more common side effects of oxcarbazepine depend on the drug form.

  • Side effects for all forms of the drug include:

    • dizziness
    • sleepiness
    • tiredness
    • nausea
    • vomiting
    • eye problems, such as double vision, blurred vision, or cataracts
    • trembling
    • problems with walking and coordination (unsteadiness)
  • Oxcarbazepine immediate-release tablets and oral suspension have also been shown to cause the following:

    • skin rash
    • infections, especially in children
    • stomach pain
    • upset stomach
  • Oxcarbazepine extended-release tablets may also cause the following:

    • headache
    • weakness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • low sodium levels in your blood. Symptoms can include:

    • nausea
    • tiredness, lack of energy
    • headache
    • confusion
    • more frequent or more severe seizures
  • allergic reactions or serious problems (multi-organ hypersensitivity) that affect your organs and other parts of your body, such as the liver or blood cells. Symptoms can include:

    • fever, swollen glands, or sore throat that don’t go away or come and go
    • skin rash
    • swelling of your face, eyes, lips, or tongue
    • trouble swallowing or breathing
    • hives
    • painful sores in your mouth or around your eyes
    • yellowing of your skin or the whites of your eyes
    • unusual bruising or bleeding
    • severe tiredness or weakness
    • severe muscle pain
    • frequent infections or infections that don’t go away
  • suicidal thoughts or actions. Symptoms can include:

    • thoughts about suicide or dying
    • attempts to commit suicide
    • new or worse depression
    • new or worse anxiety
    • feeling agitated or restless
    • panic attacks
    • trouble sleeping (insomnia)
    • new or worse irritability
    • anger
    • acting aggressive or violent
    • acting on dangerous impulses
    • an extreme increase in activity and talking (mania)
    • other unusual changes in behavior or mood
  • serious skin reactions. Oxcarbazepine may cause life-threatening allergic skin reactions. These are called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These may cause severe damage to your skin and internal organs. Your risk may be higher if you have Asian ancestry with a genetic risk factor. If you’re Asian, your doctor may test you for this genetic factor. You can still have these conditions without the genetic risk factor. Call your doctor right away if you have any of these symptoms:

    • skin rash
    • hives
    • sores in your mouth, nose, or eyes
    • blistering or peeling of your skin
  • serious blood disorders. Oxcarbazepine may cause a decrease in all types of blood cells or just white blood cells. Symptoms can include:

    • bruising more easily
    • bleeding from your nose, or your gums after brushing your teeth
    • blood in your urine
    • blood in your stool, which may appear either bright red or dark and tarry
    • increased infections
    • longer illnesses as compared to normal
    • tiredness
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug may cause drowsiness. It can also slow your thinking and reaction time. You shouldn’t drive, use machinery, or do similar tasks that require alertness until you know how this drug affects you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

oxcarbazepine May Interact with Other Medications

Oral tablet

Oxcarbazepine can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol interaction

You shouldn’t drink alcohol while taking oxcarbazepine. Alcohol can worsen certain side effects from the drug, such as sleepiness or dizziness.

Medications that might interact with this drug

Angina (chest pain) drugs
  • ranolazine (Ranexa)

Oxcarbazepine may decrease the levels of ranolazine in your body. This means that it won’t work as well to treat your condition and you may have more chest pain. Talk with your doctor before taking these drugs together.

Cancer drugs
  • chemotherapy drugs, such as:
    • ibrutinib (Imbruvica)
    • gefitinib (Iressa)
    • nilotinib (Tasigna)
    • sunitinib (Sutent)

Oxcarbazepine may decrease the levels of these drugs in your body. This means that they won’t work as well against your cancer. Talk with your doctor before taking these drugs together.

HIV drugs
  • cobicistat/elvitegravir/emtricitabine/tenofovir (Stribild)
  • cobicistat/darunavir (Prezcobix)
  • cobicistat/atazanavir (Evotaz)

Oxcarbazepine may decrease the levels of some of the ingredients in these combination drugs. This could lead to less control of your HIV. Also, the virus could become resistant to the medication. (This means the drug would no longer work against the virus.) Talk with your doctor before taking these drugs together.

Hepatitis C drugs
  • dasabuvir/ombitasvir/paritaprevir/ritonavir (Viekira Pak)

Oxcarbazepine may decrease the levels of some of the ingredients in this combination drug. This raises your risk of hepatitis C treatment failure. Talk with your doctor before taking these drugs together.

Oral birth control pills

Oxcarbazepine makes oral birth control pills less effective. This means that you may get pregnant even though you’re taking birth control pills. You should use a second form of birth control while you’re taking this drug, such as a condom.

Parkinson’s disease drugs
  • selegiline, transdermal (Emsam)

This drug cannot be taken with oxcarbazepine. Taking them together could lead to side effects that could be life-threatening. These include a high blood pressure crisis, seizures, coma, or heart collapse.

Seizure drugs
  • phenytoin

Oxcarbazepine increases phenytoin levels in your blood. This raises your risk of side effects from phenytoin. Your doctor may decrease your dose of phenytoin if you take it with oxcarbazepine.

Other drugs
  • carbamazepine
  • phenobarbital

These drugs decrease the level of oxcarbazepine in your body. If you take these drugs together, oxcarbazepine may not work as well to treat your seizures. Your doctor may increase your dose of oxcarbazepine if you take it with these drugs.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
liver problems
People with liver problems

If you have severe liver disease, you shouldn’t take this drug.

kidney problems
People with kidney problems

This drug is removed from your body by the kidneys. If you have severe kidney damage (creatinine clearance less than 30 mL/minute), your doctor may give you a lower dose, and increase the dose slowly. This is to stop too much of the drug from building up in your body and causing side effects.

pregnant women
Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

This drug passes into breast milk and can cause serious effects in a breastfeeding child.

You and your doctor may need to decide if you’ll take this drug or breastfeed.

for seniors
For seniors

As you age, your kidneys may not work as well as they once did. Your body may process this drug more slowly. Your doctor may start you on a lowered dose so that too much of this drug doesn’t build up in your body. Or they may prescribe a different drug to treat your seizures. Too much of the drug in your body can be dangerous. Your kidney function (creatinine clearance) should be checked before you start taking this drug.

call doctor
When to call the doctor
  • Call your doctor if your seizures get worse or if you have any new types of seizures. 
  • Call you doctor if you become pregnant while taking this drug.
allergies
Allergies

Many people who are allergic to carbamazepine are also allergic to this drug. Tell your healthcare provider if you are allergic to carbamazepine.

This drug may cause allergic reactions. Symptoms can include:

  • swelling of your face, eyes, lips, or tongue
  • painful sores in the mouth or nose, or around the eyes
  • trouble swallowing or breathing
  • skin rash
  • hives

If you have these symptoms, call your doctor right away. If they are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it before. Taking it a second time after an allergic reaction could be fatal.

SECTION 4 of 5

How to Take oxcarbazepine (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Seizures (epilepsy)

Brand: Trileptal

Form: Oral immediate-release tablet
Strengths: 150 mg, 300 mg, 600 mg
Form: Oral suspension
Strengths: 300 mg/5 mL

Brand: Oxtellar XR

Form: Oral extended-release tablet
Strengths: 150 mg, 300 mg, 600 mg

Generic: oxcarbazepine

Form: Oral immediate-release tablet
Strengths: 150 mg, 300 mg, 600 mg
Form: Oral suspension
Strengths: 300 mg/5 mL
Adult dosage (ages 18–64 years)

Immediate-release tablets and oral suspension:

  • When taking this drug alone to treat seizures:
    • The maximum dose is 1,200 mg taken by mouth two times per day.
    • Your doctor may have you start with 300 mg taken two times per day. Your doctor may then increase your total daily dose by 300 mg every 3 days, or by 600 mg every week.
  • When taking this drug with other medications to treat seizures:
    • The maximum dose is 600 mg taken by mouth two times per day.
    • Start with 300 mg taken two times per day. Each week, your doctor may increase your total daily dose by no more than 600 mg.
    • If you’re taking doses over 1,200 mg per day, you doctor should monitor you closely for side effects during dose increases.
  • When switching from another seizure medication to oxcarbazepine alone:
    • The maximum dose is 1,200 mg taken by mouth two times per day.
    • You may start with 300 mg of oxcarbazepine taken twice per day. At the same time, your doctor may start to reduce the dose of your other seizure drug(s). It may take 2–4 weeks to be completely off your other seizure drug(s). Your doctor should monitor you closely during this overlapping time period.
    • Each week, your doctor may increase your total daily dose by no more than 600 mg.

Extended-release tablets:

  • When taking this drug with other medications to treat seizures:
    • The recommended dose is 1,200–2,400 mg taken by mouth once per day.
    • Each week, your doctor may increase your total daily dose by no more than 600 mg. 

Immediate-release tablets and oral suspension:

Child dosage (ages 0–1 years)

This drug is not recommended for children younger than 2 years.

Child dosage (ages 2–3 years)

Your child’s dosage will be based on their weight.

Child dosage (ages 4–17 years)

Your child’s dosage will be based on their weight. It will also be based on whether they are switching from one seizure medication to another.

Extended-release tablets:

Child dosage (ages 0–5 years)

This drug is not recommended for children younger than 6 years.

Child dosage (ages 6–17 years)

Your child’s dosage will be based on their weight.

Senior dosage (ages 65 years and older)

Immediate-release tablets and oral suspension:

Oxcarbazepine is removed from your body through your kidneys. As you age, your kidneys may not work as well as they used to. If you have kidney problems, your doctor may start you at half of the standard starting dose (300 mg per day) and increase your dose slowly.

Extended-release tablets:

Your doctor may want to start at a lower dose (300 mg or 450 mg per day). Your doctor may increase your dose each week by 300–450 mg per day until you’re at a dose that’s working to control your seizures.

Special considerations

People with kidney problems: If you have severe kidney damage (creatinine clearance less than 30 mL/minute), your doctor may start you at half of the usual starting dose of the immediate-release tablet or suspension (300 mg per day) and increase it slowly.

For the extended-release tablet, your doctor may increase your dose once per week by 300–450 mg per day until the dose is working for you.

 Warnings

  • Immediate-release tablets and oral suspension: If you’re using higher doses (higher than 1,200 mg per day), your doctor should monitor you closely during dose increases.
  • Your dose will decrease as you age since your body gets rid of the drug slower as you age.
  • If your doctor wants to switch you from immediate-release tablets or oral suspension (Trileptal) to the extended-release form (Oxtellar XR), you may need a higher dose.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

This may cause serious problems, such as having more seizures, or seizures that don’t stop.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

Your doctor will treat any symptoms you’re having. These could include tremors, lack of coordination, double vision or trouble seeing, drowsiness, slowed heart rate, or coma.

If you think that you’ve taken too much of this drug, call your doctor or local poison control center. If the symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time. Never try to catch up by taking two doses at once. This could cause dangerous side effects.

How to tell this drug is working

You should have fewer seizures.

This drug is used for long-term treatment.

Take the extended-release form without food

If you don’t take these tablets on an empty stomach, you may be more likely to have side effects. Food causes higher levels of the medication to build up in your blood.

The immediate-release tablet and oral suspension forms can be taken with or without food.

Take the extended-release form one time per day

Take it at least 1 hour before or 2 hours after a meal.

Store this drug carefully

  • Store oxcarbazepine at room temperature between 59°F (15°C) and 86°F (30°C).
  • Use the oral suspension within 7 weeks of opening it. Shake it well before using it.
  • Don’t freeze oxcarbazepine.
  • Keep it away from light.
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff your pharmacy’s label to clearly identify the medication. Keep the original prescription label with you when traveling.
  • Don’t leave this medication in the car, especially when the temperature is hot or freezing.

Self-management

Oral suspension:

  • Shake the bottle well and prepare the dose immediately afterwards.
  • Withdraw your dose from the bottle using the oral syringe that came with it.
  • You can swallow the medication from the syringe or mix it with a little water in a glass.
  • Make sure to rinse the syringe and let it dry after each use.

Clinical monitoring

Before starting and during your treatment with oxcarbazepine, your doctor will check your:

  • kidney function
  • liver function
  • sodium levels
  • complete blood count
  • thyroid function

You and your doctor should also watch for the following:

  • seizure frequency
  • serious skin reactions
  • suicidal thoughts and behaviors

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

SECTION 5 of 5

How Much Does oxcarbazepine Cost?

Oral tablet

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These prices represent the lowest priced national pharmacies for oxcarbazepine on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on August 18, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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