Oxcarbazepine
Mechanism :
The precise mechanism by which oxcarbazepine and MHD exert their antiseizure effect is unknown; however, in vitro electrophysiological studies indicate that they produce blockade of voltage-sensitive sodium channels, resulting in stabilization of hyperexcited neural membranes, inhibition of repetitive neuronal firing, and diminution of propagation of synaptic impulses.
Indication :
- Partial seizures with or without secondary GTCS- as adjunctive treatment or monotherapy.
Contraindications :
Should not be used in patients with a known hypersensitivity to oxcarbazepine or to any of its components. Caution In liver and renal disease, hyponatremia, heart failure and cardiac conduction disorders. Avoid abrupt withdrawal.
Dosing :
Oral:
8-10 mg/kg/day in 2 divided doses. May titrate to higher doses. Max: 600 mg/day.
Adverse Effect :
Dizziness, headache, ataxia, somnolence, abnormal gait, tremors, vertigo, diplopia, abnormal vision, nystagmus, nausea, vomiting, abdominal pain.
Interaction :
Phenobarbital and Phenytoin: May increase plasma levels.
Carbamazepine: May decrease levels.
Oral Contraceptives: May reduce effect of oral contraceptives.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 30-50 | Dose as in normal renal function |
| 10-30 | Dose as in normal renal function. Start with 300 mg daily and titrate slowly |
| <10 | Dose as in normal renal function. Start with 300 mg daily and titrate slowly |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unknown dialysability. Dose as in GFR<10 mL/min |
| HD | Unknown dialysability. Dose as in GFR<10 mL/min |
| HDF/High flux | Unknown dialysability. Dose as in GFR<10 mL/min |
| CAV/VVHD | Unknown dialysability. Dose as in GFR=10–30 mL/min |
Hepatic Dose :
Mild to moderate hepatic impairment: No dosage adjustments are recommended.
Severe hepatic impairment: Use with caution immediate release preparation. Extended release preparations should be avoided.