Oxcarbazepine (Trileptal® and generic forms) belongs to a group of medications called “anticonvulsants” or “mood stabilizers.”

What is this medication used for?

Oxcarbazepine is approved by Health Canada to treat certain types of seizure disorders (epilepsy) in children and adolescents.

When potential benefits outweigh risks, oxcarbazepine may be used “off-label” for treatment of episodes of mania associated with bipolar disorder and prevention of future manic episodes. Learn more about off-label medication use: http://bit.ly/KMH-off-label-use

Tell your doctor or pharmacist if you:

• Have allergies or bad reactions to a medication
• Take (or plan to take) other prescription or non-prescription medications, including natural medicines. Some medications interact with oxcarbazepine. Your doctor may adjust medication doses or monitor for side effects
• Have a history of heart, kidney or liver disease, seizures, blood disorders, low blood sodium (called hyponatremia), hallucinations or serious skin disorders
• Miss a menstrual period, are pregnant, breast-feeding or planning a pregnancy
• Use alcohol or drugs. Taking oxcarbazepine together with certain substances may cause a bad reaction. Learn more at www.DrugCocktails.ca

When will the medication start to work?

When used to control a manic episode, oxcarbazepine needs to be taken for 1 to 2 weeks before you notice an improvement in symptoms. You may notice an improvement earlier if oxcarbazepine is combined with other medications. A delay in response is normal.

It is important that you continue taking oxcarbazepine regularly, even if you are feeling well or there are no improvements in the first few weeks. Talk with your doctor if you feel that the oxcarbazepine treatment has not been helpful or if side effects are too bothersome. Your doctor may recommend switching you to a different medication.

This medication is not addictive. Do not stop taking it before talking to your doctor.

How do I take this medication?

Oxcarbazepine is usually taken two to four times a day, at the same time(s) each day with food. Usually, you will start with a low dose and slowly increase this dose over several days or weeks, based on how you tolerate it.

Your doctor may ask you to have blood tests to measure the amount of oxcarbazepine in your blood. Do not take your oxcarbazepine dose just before a blood test as this can affect your results. Instead, take your dose after the blood test is completed.

There are two forms of oxcarbazepine: tablets and liquid. If you take the liquid form, shake the bottle well before each use. You may mix the liquid in a small glass of water and drink the mixture right away. The bottle of oxcarbazepine liquid expires 7 weeks after opening and should not be used after this time.

Possible common or serious side effects:

Oxcarbazepine is similar to another medication called carbamazepine, but oxcarbazepine may cause fewer serious side effects. Side effects may be more common when starting a medication or after a dose increase. Talk to your doctor, nurse or pharmacist if any side effect concerns you.

• Dizziness, clouded thinking, headache, or confusion
• Drowsiness, clumsiness or unsteadiness
• Blurred or double vision
• Stomach ache, nausea or vomiting
• Increased sensitivity to the sun

Contact your doctor immediately if you experience:

• Seizure, agitation, unusual confusion, chills or muscle twitching
• Fever, sore throat, infection, mouth ulcers or unusual bruising or bleeding
• Unusual nausea
• Irregular heartbeat or chest pain
• Swelling in the face, ankles, feet or lower legs
• Yellowish skin/eyes, itchiness or dark colored urine
• Thoughts of hurting yourself, suicide, increased hostility or worsening symptoms

What precautions should my doctor and I be aware of when taking this medication?

• Many medications may interact with oxcarbazepine, including birth control pills, antihistamines, anti-anxiety medications, some antidepressants, some anticonvulsants and several other medications. If you are (or begin) taking any other prescription, over-the counter medication, natural health product or supplement, check with your doctor or pharmacist to see if they are safe to use.
• While taking this medication, if you feel dizzy, drowsy or slowed down, do not drive a car or operate heavy machinery. Alcohol could make this worse. Try to avoid alcohol while taking oxcarbazepine.
• Oxcarbazepine can make you more sensitive to sun exposure. Avoid sunburn by limiting sun exposure and using a daily broad-spectrum sunscreen.

How does this medication work?

Oxcarbazepine affects levels of the brain chemicals GABA and glutamate. This has a “stabilizing” effect on nerves, which helps reduce the spread of seizure activity in the brain and severe mood fluctuations (such as mania) associated with bipolar disorder. The exact way oxcarbazepine treats bipolar disorder is not fully known.

What special instructions should I follow while using this medication?

• Keep all appointments with your doctor and the lab. Your doctor may order lab tests to check how you are responding and monitor for side effects.
• Try to keep a healthy, well-balanced diet and exercise regularly. Some people may gain weight as a result of increased appetite.
• Do not allow anyone else to use your medication.

What should I do if I forget to take a dose of this medication?

If you take oxcarbazepine regularly and forget to take a dose, take the missed dose as soon as you remember. However, if it is within 4 hours of your next scheduled dose, skip the missed dose and continue with your regular schedule. DO NOT double your next dose to try to ‘catch up’.

How do I store this medication?

Keep this medication in the original container, stored at room temperature away from moisture and heat and protected from light. Keep this medication out of reach and sight of children.

How well does the medication work in children and adolescents?

Evidence from adults shows that oxcarbazepine helps reduce symptoms of a manic episode associated with bipolar disorder and also prevents future manic episodes from occurring.

Oxcarbazepine has also been studied in children and adolescents with bipolar disorder and has been shown to be no better than placebo (an inactive pill). Oxcarbazepine may be used alone or in combination with other mood stabilizers to manage bipolar disorder. When effective, oxcarbazepine helps to stabilize mood, control emotions and improve overall functioning. Oxcarbazepine may be helpful for patients who have symptoms of mania and depression occurring at the same time. This medication may also help manage aggressive or impulsive behavioural problems.

How long should I take the medication for?

This depends on the symptoms you have, how frequently they occur, and how long you have had them. Most people with bipolar disorder need to take oxcarbazepine for at least 6 months. This allows time for symptoms to stabilize and for function to improve.

Your doctor will discuss the benefits and risks of taking oxcarbazepine with you. At this time, you can also discuss how long you might need to take this medication. If you have epilepsy or bipolar disorder and you tolerate this medication well, you may be asked to take this medication on an ongoing basis.

Do not increase, decrease, or stop taking this medication without discussing it with your doctor. If you stop taking oxcarbazepine suddenly, it is possible that your symptoms may return or you may experience a seizure.