Trileptal® (oxcarbazepine)
Brand
name: Trileptal®
– Tablets: 150 mg, 300
mg, 600 mg
Generic
name: oxcarbazepine (ox
car BAZ e peen)
Medication
class: anticonvulsant
What
is Trileptal® and what does it treat?
Oxcarbazepine
is a medication that works in the brain and is sometimes used in
patients with bipolar disorder (also known as manic depression). It
is approved for the treatment of partial seizures. Bipolar disorder
involves episodes of depression and/or mania.
Symptoms
of depression include:
-
Depressed
mood – feeling sad, empty, or tearful
-
Feeling
worthless, guilty, hopeless, or helpless
-
Loss
of interest or pleasure in normal activities
-
Sleep
and eat more or less than usual (for most people it is less)
-
Low
energy, trouble concentrating, or thoughts of death (suicidal
thinking)
-
Psychomotor
agitation (‘nervous energy’)
-
Psychomotor
retardation (feeling like you are moving in slow motion)
Symptoms
of mania include:
-
Feeling
irritable or ‘highâ€
-
Having
increased self esteem
-
Feeling
like you don’t need to sleep
-
Feeling
the need to continue to talk
-
Feeling
like your thoughts are too quick (racing thoughts)
-
Feeling
distracted
-
Getting
involved in activities that are risky or could have bad consequences
(e.g. excessive spending)
What
is the most important information I should know about Trileptal®?
Do
not stop taking oxcarbazepine or change your dose without first
talking to with your healthcare provider.
Oxcarbazepine
is
used for long-term treatment of bipolar disorder.
Do
not stop taking oxcarbazepine
even when
you feel better. Only
your healthcare provider can determine the length of oxcarbazepine
treatment
that is right for you.
Missing
doses of oxcarbazepine
may
increase your risk for a relapse in your mood symptoms.
In
order for oxcarbazepine to work properly, it should be taken every
day as ordered by your healthcare provider.
Periodically,
your healthcare provider may ask you to provide a blood sample to
assess for side effects, such as changes in blood counts and sodium
levels.
Are
there specific concerns about Trileptal® and
pregnancy?
If
you are planning on becoming pregnant, notify your healthcare
provider to best manage your medications. People
living with bipolar disorder who wish to become pregnant face
important decisions. This is a complex decision since untreated
bipolar disorder has risks to the fetus as well as the mother. It is
important to discuss this with your doctor and caregivers.
Breastfeeding
is not recommended in women who are taking oxcarbazepine. .
What
should I discuss with my healthcare provider before taking
Trileptal®?
-
If
you have taken oxcarbazepine or carbamazepine (Tegretol®)
before and developed a rash
-
Symptoms
that are most bothersome to you about your condition
-
If
you have thoughts of suicide
-
Medications
you have taken in the past to treat bipolar disorder, whether they
were effective or caused any adverse effects
-
Any
psychiatric or medical problems you have
-
All
other medications you are currently taking (including over the
counter products, herbal and nutritional supplements) and any
medication allergies you have
-
Other
non-medication treatment you are receiving (such as psychotherapy
(i.e., talk therapy) or substance abuse treatment). Your provider
can explain how these different treatments work with the medication.
-
If
you are pregnant, plan to become pregnant, or are breast-feeding
-
If
you smoke, drink alcohol, or use illegal drugs
How
should I take Trileptal®?
Oxcarbazepine
is usually taken two times daily with or without food.
The
dose usually ranges from 900-1200 mg/day. Only your healthcare
provider can determine the correct dose you.
Oxcarbazepine
suspension: Measure with a dosing spoon or oral syringe, which you
can get from your pharmacy.
Use
a calendar, pillbox, alarm clock, or cell phone alert to help you
remember to take your medication. You may also ask a family member a
friend to remind you or check in with you to be sure you are taking
your medication.
What
happens if I miss a dose of Trileptal®?
If
you miss a dose of oxcarbazepine, take it as soon as you remember,
unless it is closer to the time of your next dose. Discuss this with
your healthcare provider. Do not double your dose or take
more than what is prescribed.
What
should I avoid while taking Trileptal®?
Avoid
drinking alcohol or using illegal drugs while you are taking
oxcarbazepine. They may decrease the benefits (e.g., worsen your
symptoms) and increase adverse effects (e.g., sedation, dizziness).
What
happens if I overdose with Trileptal®?
If
an overdose occurs call your doctor or 911. You may need urgent
medical care. You may also contact the poison control center at
1-800-222-1222.
A
specific treatment to reverse the effects of oxcarbazepine
does
not exist.
What
are possible side effects of Trileptal®?
Common
Side Effects
Rare
Side Effects
Oxcarbazepine
can cause a decrease in the body’s sodium level, especially at
higher doses. Some signs of low sodium include nausea, drowsiness,
and confusion.
In
rare cases (<1%) a severe, spreading rash with blistering of the
skin in patches over the entire body along with fever, headache and
cough can occur (Stevens-Johnson syndrome). Although this is rare
with oxcarbazepine, discontinuation of this medication is necessary.
Rare cases of severe allergic reactions have been reported.
Symptoms include swelling of the face, eyes, lips, or tongue,
difficulty swallowing or breathing.
Are
there any risks for taking Trileptal® for long periods of time?
To
date, there are no known problems associated with long term use of
oxcarbazepine. It is a safe and effective medication when used as
directed.
What
other medications may interact with Trileptal®?
Oxcarbazepine
may alter levels of several other medications by either increasing or
decreasing their breakdown and elimination from the body. The
effectiveness of oxcarbazepine may be reduced by other medications.
People who are taking oxcarbazepine should consult their doctor
before taking or discontinuing the following:
-
Oral
contraceptives (birth control pills)
-
Antipyschotics:
Latuda® (lurasidone)
-
Anticonvulsants:
Dilantin®(phenytoin),
Depakote® (valproic
acid), Tegretol® (carbamazepine),
Luminal® (phenobarbital),
Lamictal® (lamotrigine)
-
Calcium
channel blockers: Calan®,
Covera-HS®,
Isoptin SR® (verapamil), Plendil® (felodipine)
-
Antibiotics:
Biaxin® (clarithromycin),
Ketek® (telithromycin)
-
Cholesterol
lowering agents: Zocor® (simvastatin),
Lipitor® (atorvastatin), Mevacor® (lovastatin)
How
long does it take for Trileptal® to
work?
It
is very important to tell your doctor how you feel during the first
few weeks after
you start taking oxcarbazepine. It will
probably take several weeks to see big enough changes in your
symptoms to decide if oxcarbazepine is the right medication for you.
Lifelong
treatment with mood stabilizer medication is generally needed for
persons with bipolar disorder. Your doctor can best discuss the
duration of treatment you need based on your symptoms and course of
illness.
Provided
by
College
of Psychiatric and Neurologic Pharmacists
(January
2013)
There
are no FDA Black Box Warnings for oxcarbazepine.
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