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Trileptal® (oxcarbazepine)

Brand name: Trileptal®

– Tablets: 150 mg, 300 mg, 600 mg

  • Liquid: 300 mg/5 mL

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 ‘high”

  • 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

  • Headache, fatigue, abnormal vision, and upset stomach

  • Feeling dizzy or drowsy

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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