Ver el código de «Oxcarbazepine»

==Administration==
*Type: [[Antiepileptics]]<ref>Shorvon S. Oxcarbazepine: a review. Seizure. 2000 Mar;9(2):75-9. PMID 10845729</ref>
*Dosage Forms: 150,300,600mg; 300mg/5 mL
*Routes of Administration: PO
*Common Trade Names: Trileptal

==Adult Dosing==
===Partial seizures===
*adjunct treatment: Dose: 600mg PO bid; Start: 300mg PO bid, increase by up to 600mg/day qwk; Max: 2400mg/day; 
*conversion to monotherapy: Dose: 1200mg PO bid; Start: 300mg PO bid, increase by up to 600mg/day qwk; Max: 2400mg/day; discontinue concomitant anticonvulsants over 3-6wk; taper dose gradually to discontinue
*initial monotherapy: Dose: 600mg PO bid; Start: 300mg PO bid, increase by 300mg/day q3 days; Max: 2400mg/day

===Trigeminal neuralgia===
*450-1200mg PO bid
*Start: 300mg PO bid, may increase by 600mg/day qwk

===Bipolar disorder===
*600-1200mg PO bid
*Start: 300mg PO bid, increase by 300mg/day q3 days or by 600mg/day qwk

==Pediatric Dosing==
===Partial seizures===
====adjunct therapy====
*2-3 yo
**Dose: 60mg/kg/day PO divided bid; Start: 8-10mg/kg/day PO divided BID up to 600mg/day, increase dose over 2-4wk; Max: 60mg/kg/day
**may start 16-20mg/kg/day PO divided BID in patients <20 kg
*4-16 yo, 20-29 kg
**Dose: 600mg PO bid; Start: 8-10mg/kg/day PO divided BID up to 600mg/day, increase to target dose over 2wk
*4-16 yo, >39 kg
**Dose: 900mg PO bid; Start: 8-10mg/kg/day PO divided BID up to 600mg/day, increase to target dose over 2wk

====monotherapy====
*4-16 yo, 20-24 kg
**Dose: 300-450mg PO bid; Start: 8-10mg/kg/day PO divided bid, increase by 5mg/kg/day q3 days if initial monotherapy or by up to 10mg/kg/day qwk if conversion to monotherapy
**Discontinue concomitant anticonvulsants over 3-6wk
*4-16 yo, 25-34 kg
**Dose: 450-600mg PO bid; Start: 8-10mg/kg/day PO divided bid, increase by 5mg/kg/day q3 days if initial monotherapy or by up to 10mg/kg/day qwk if conversion to monotherapy
**Discontinue concomitant anticonvulsants over 3-6wk
*4-16 yo, 35-44 kg
**Dose: 450-750mg PO bid; Start: 8-10mg/kg/day PO divided bid, increase by 5mg/kg/day q3 days if initial monotherapy or by up to 10mg/kg/day qwk if conversion to monotherapy
**Discontinue concomitant anticonvulsants over 3-6wk
*4-16 yo, 45-49 kg
**Dose: 600-750mg PO bid; Start: 8-10mg/kg/day PO divided bid, increase by 5mg/kg/day q3 days if initial monotherapy or by up to 10mg/kg/day qwk if conversion to monotherapy
**Discontinue concomitant anticonvulsants over 3-6wk
*4-16 yo, 50-59 kg
**Dose: 600-900mg PO bid; Start: 8-10mg/kg/day PO divided bid, increase by 5mg/kg/day q3 days if initial monotherapy or by up to 10mg/kg/day qwk if conversion to monotherapy
**Discontinue concomitant anticonvulsants over 3-6wk
*4-16 yo, 60-69 kg
**Dose: 600-1050mg PO bid; Start: 8-10mg/kg/day PO divided bid, increase by 5mg/kg/day q3 days if initial monotherapy or by up to 10mg/kg/day qwk if conversion to monotherapy
**Discontinue concomitant anticonvulsants over 3-6wk
*4-16 yo, >70 kg
**Dose: 750-1050mg PO bid; Start: 8-10mg/kg/day PO divided bid, increase by 5mg/kg/day q3 days if initial monotherapy or by up to 10mg/kg/day qwk if conversion to monotherapy
**Discontinue concomitant anticonvulsants over 3-6wk

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*[[Lactation risk categories|Lactation risk]]: safety unknown
===Renal Dosing===
*Adult: CrCl <30: start 150mg bid; HD/PD: no supplement; Info: titrate dose slowly until response
*Pediatric: CrCl <30: decrease start dose 50%, max start dose 300mg/24h; HD/PD: no supplement; Info: titrate dose slowly until response
===Hepatic Dosing===
*Adult: mild-mod impairment: no adjustment; severe impairment: not defined
*Pediatric: mild-mod impairment: no adjustment; severe impairment: not defined

==Contraindications==
*Allergy to class/drug
*HLA-B*1502 allele (treatment-naive patients)
*avoid abrupt withdrawal
*caution if hypersens. to carbamazepine
*caution in elderly patients
*caution in pregnancy
*caution if hyponatremia<ref>. Oxcarbazepine. 2006. PMID 30000302</ref>
*caution if renal impairment
*caution if depression or history

==Adverse Reactions==
===Serious===
*hyponatremia
*anaphylaxis
*angioedema
*drug reaction with eosinophilia and systemic sx
*Stevens-Johnson syndrome
*toxic epidermal necrolysis
*erythema multiforme
*acute generalized exanthematous pustulosis
*suicidality
*leukopenia
*thrombocytopenia
*pancytopenia
*agranulocytosis
*aplastic anemia
*pancreatitis
*withdrawal seizures if abrupt discontinuation
*withdrawal symptoms if abrupt discontinuation

===Common===
*dizziness
*headache
*nausea/vomiting
*somnolence
*diplopia
*balance disorder
*fatigue/asthenia
*tremor
*hyponatremia
*visual disturbance
*nystagmus
*ataxia
*abnormal gait
*abdominal pain
*dyspepsia
*gastritis
*diarrhea
*constipation
*cognitive dysfunction
*impaired concentration
*confusion
*URI sx
*rash
*nervousness
*insomnia
*acne
*photosensitivity

==Pharmacology==
*Half-life: 2h (parent drug), 7-11h (parent drug, ER form), 9h (metabolite)
*Metabolism: liver; CYP450: 2C19 inhibitor; 3A4/5 inducer; Info: active metabolite
*Excretion: urine 95% (<1% unchanged), feces <4%

==Mechanism of Action==
blocks voltage-sensitive Na channels, stabilizes neural membranes, inhibits repetitive firing, and decreases synaptic impulse propagation

==Comments==

==See Also==
*[[Seizures]]
*[[Anticonvulsants]]

==References==
<references/>
[[Category:Pharmacology]] [[Category:Neurology]]
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