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Trileptal (Oxcarbazepine)
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Trileptal

Trileptal is used for treating certain types of seizures in patients with epilepsy. It may be used alone or in combination with other medicines. It may also be used for other conditions.

Other names for this medication:
Actinum, Apydan, Auram, Aurene, Barzepin, Deprectal, Epilexter, Karbox, Leptal, Lonazet, Neurtrol, Oxca, Oxcarb, Oxcarbatol, Oxcarbazepin, Oxcarbazepina, Oxcarbazepine, Oxcarbazepinum, Oxetol, Oxicodal, Oxilepsi, Oxrate, Prolepsi, Rupox, Tevaleptin, Timox, Tolep, Trileptin

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Also known as:  Oxcarbazepine.

Description

Trileptal is used for treating certain types of seizures in patients with epilepsy. It may be used alone or in combination with other medicines. It may also be used for other conditions.

Trileptal is an anticonvulsant. It works by slowing abnormal nerve impulses in the brain.

Trileptal is also known as Oxcarbazepine, Trexapin.

Dosage

Trileptal may be taken with or without food.

It is important to take all doses on time to keep the level of medicine in your blood constant. Take doses at evenly spaced intervals. Do not skip doses.

Taking Trileptal at the same times each day will help you to remember to take it.

Continue to take Trileptal even if you feel well.

Do not miss any doses. Trileptal works best when there is a constant level of Trileptal in your body.

If you want to achieve most effective results do not stop taking Trileptal suddenly. If Trileptal is stopped, this should be done gradually. The risk of seizures may be increased if Trileptal is suddenly stopped.

Overdose

If you overdose Trileptal and you don't feel good you should visit your doctor or health care provider immediately.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture, light and heat. Keep container tightly closed. Store in the original container. Use within 7 weeks of first opening the bottle. Throw away any unused medicine after the expiration date. Keep out of reach of children.

Side effects

The most common side effects associated with Trileptal are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Trileptal if you are allergic to its components.

Do not take Trileptal if you are pregnant, planning to become pregnant, or are breast-feeding.

If you have a history of seizures, you may suddenly lose consciousness while you are taking Trileptal. Avoid activities where loss of consciousness could be dangerous to you or others (driving, swimming, climbing, and operating heavy machinery).

Hormonal birth control pills may not work as well while you are using Trileptal. To prevent pregnancy, use an extra form of birth control (condoms).

Trileptal may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Trileptal. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.

Trileptal must be gradually decreased when discontinued. Talk to your health care provider about the proper way to stop Trileptal.

Notify your health care provider if seizure control worsens.

Lab tests, including sodium blood levels, may be performed while you use Trileptal. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Trileptal should not be used in children younger than 2 years old. Safety and effectiveness in these children have not been confirmed.

Avoid alcohol.

It can be dangerous to stop Trileptal taking suddenly.

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The effects of CYT on the anticonvulsant activity of six AEDs were examined in maximal electroshock (MES)-induced seizures in mice.

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The guidelines on trigeminal neuralgia management published by the American Academy of Neurology (AAN) and the European Federation of Neurological Societies (EFNS) recommended that patients unresponsive to carbamazepine or oxcarbazepine be offered the surgical option. However, because some patients may not be willing to resort to surgery, we searched the literature for treatment in refractory trigeminal neuralgia. We found other oral treatments, intranasal spray, subcutaneous injections, various kinds of peripheral nerve blocks and injections of botulinum toxin. On the basis of the available evidence we suggest that no oral treatment other than carbamazepine or oxcarbazepine is useful. Among the other options, there is increasingly strong evidence that botulinum toxin injections are efficacious and may be offered before surgery or to those unwilling to undergo surgery.

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To evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of BIA 2-093 [S-(-)-10-acetoxy-10,11-dihydro-5H-dibenzo/b,f/aze- pine-5-carboxamide] in healthy male volunteers.

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Thirteen patients (17.6%) in solitary cysticercus granuloma group and 15 patients (33.3%) in normal neuroimaging group had seizure recurrences (P = 0.049). In solitary cysticercus granuloma group, family history of seizure disorder (P = 0.004), headache (P = 0.029), and serial seizures (at onset) (P = 0.001) were significantly associated with the seizure recurrence. Granuloma remained unresolved in all patients. In patients with normal neuroimaging, abnormal EEG (P = 0.043), at inclusion, was only a significant factor of the seizure recurrence.

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A one-compartment open model with first-order absorption and elimination was generated from the results of a previous study measuring plasma concentrations following one 400 mg fasting dose of CBZ-ERC. This model was used to simulate plasma concentrations of CBZ following multiple 400 mg doses of CBZ-ERC at 12-hour intervals, and then when a missed dose is taken 3, 6, or 9 hours late; when two doses are taken at one time; and when a single dose is taken at the time of the next dosing. In comparison, similar modeling was done for monohydroxy derivative (MHD) of OXC at doses of 600 or 1200 mg.

trileptal reviews seizures

The authors examined the ratio between the plasma and the cerebrospinal fluid (CSF) concentration of topiramate in 14 adults with epilepsy. Simultaneous trough samples of venous blood and CSF were collected and analyzed as total and unbound concentrations. Concomitant levels were also analyzed of lamotrigine (n = 5) and the relevant oxcarbazepine metabolite, 10-hydroxycarbazepine (n = 3). There was a close correlation between the plasma and the CSF concentration for both the total and unbound concentration of topiramate. The median CSF/plasma ratio of total topiramate was 0.85. The free topiramate concentration in plasma was not different from the free topiramate concentration in CSF. The CSF/plasma ratios showed little variation and were independent of the plasma level for both the total and the unbound levels. The unbound fraction of topiramate was 84% in plasma and 97% in CSF. The CSF concentrations of lamotrigine and 10-hydroxycarbazepine were 50% and 61% of the plasma concentrations, respectively. For topiramate, there is a close correlation between the plasma concentration and the CSF concentration. There does not seem to be a saturable carrier mechanism restricting topiramate transport across the blood-brain barrier. The concentration of topiramate in CSF is equal to the unbound proportion of topiramate in plasma, implying that the delivery of topiramate to the brain occurs via transfer from the unbound plasma pool. Plasma is thus a relevant matrix for therapeutic drug monitoring of topiramate.

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Two papers that met the inclusion criteria were included. The first paper involved 198 patients, including 108 cases in the levetiracetam therapy group and 97 cases in the placebo group. Seven cases (6.9%) were seizure free in the levetiracetam therapy group compared with 1 case (1%) in the placebo group (p<0.01) 14 weeks after treatment. Levetiracetam therapy decreased significantly the frequency of seizures compared with the placebo treatment. The second paper involved 39 patients, including 21 cases in the levetiracetam therapy group and 18 cases in the oxcarbazepine therapy group. Nineteen cases (90.5%) were seizure-free in the levetiracetam therapy group compared with 13 cases (72.2%) in the oxcarbazepine therapy group (P=0.410) during a follow-up of 12-24 months. The adverse effects in the levetiracetam therapy group were not significantly different from the placebo and the oxcarbazepine therapy groups.

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In this prospective study, 31 adults with newly diagnosed epilepsy were included who were started on therapy with either oxcarbazepine (OXC, n=16, mean age 45.6 years, 37.5% female) or valproate (VPA, n=15, mean age 42.2 years, 33.3% female). Clinical characteristics were obtained at baseline, after 2 weeks and 3 months. In addition, blood samples were drawn at each visit. Calcium, phosphate, alkaline phosphatase (AP), receptor activator of NF-κB ligand (RANKL), osteoprotegerin (OPG), osteocalcin (OC) and cathepsin K were determined.

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We recommend using OXC as monotherapy or as add-on therapy in refractory mania, but we recommend it be used predominantly as an add-on treatment for other phases of BD in patients who have not improved with well-established treatments or in patients who have difficulty tolerating adequate dosages.

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This study highlights the importance of taking into consideration not only seizure control but also the appearance of side effects when choosing antiepileptic drugs in this patients population.

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We presented a case of a 50 years old woman with bipolar disorder who is treated with lithium and oxcarbazepine, she presented a manic episode and a confusional syndrome after she stopped taking the medication. The magnetic resonance showed a restricted diffusion area at the splenium of the corpus callosum and bifrontal hygromas that disappear two weeks later.

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trileptal lethal dose 2015-06-26

Hyponatremia induced by antiepileptic drugs (AEDs) has not received sufficient attention in patients with epilepsy. Areas covered: We reviewed articles between 1966 and 2015 about hyponatremia as an adverse effect of AEDs in patients with epilepsy. The incidence, clinical symptoms, onset times of AEDs-induced hyponatremia are discussed in detail, as are the risk factors associated with AEDs-induced hyponatremia and mechanisms underlying its development. We also briefly describe strategies for treating AED-induced hyponatremia. Expert opinion: Carbamazepine and oxcarbazepine are the most common AEDs which induce hyponatremia in patients with epilepsy. Recently, other AEDs, such as eslicarbazepine, sodium valproate, lamotrigine, levetiracetam and gabapentin have also been reported to cause hyponatremia. Understanding the risk associated with AED-induced hyponatremia and taking effective measures to Cymbalta 60mg Cost combat serum sodium imbalance induced by AED therapy are necessary.

trileptal 2400 mg 2015-10-09

Administrative claims data on 24,574 patients with BD were analyzed with competing risk survival analysis. Inclusion criteria were (i) one year of no prior hypothyroid diagnosis nor BD drug treatment, (ii) followed by at least one thyroid test during BD monotherapy on lithium carbonate, mood-stabilizing anticonvulsants (lamotrigine, valproate, oxcarbazepine, or carbamazepine) or antipsychotics (aripiprazole, olanzapine, risperidone, or quetiapine). The outcome was cumulative incidence of hypothyroidism per drug, in the presence of the competing risk of Duphaston Tab Indication ending monotherapy, adjusted for age, sex, physician visits, and thyroid tests.

trileptal high dose 2016-06-09

Concentrations of the antiepileptic drugs carbamazepine (Cbz), oxcarbazepine (OxCz) and their main metabolites were predicted in a wastewater treatment plant (WTP) and in the vicinity of its submarine outfall located in a Mediterranean coastal zone. Refined predicted environmental concentrations (PECs) were calculated in effluents based on consumption data and human excretion rates. PECs were estimated in the sea using the hydrodynamic MARS 3D model integrating meteorological data, oceanic conditions (wind, tide, atmospheric pressure), freshwater and sewage inputs. Measured environmental concentrations (MECs) were compared to PECs to assess the estimation relevance. In the coastal zone, PEC and MEC were in the same magnitude range. Modeling of Cbz diffusion and advection just above the submarine outfall showed the influence of the thermocline during summer, with low diffusion of Cbz from Eldepryl Drug Classification the bottom to the surface. This work allowed understanding the dispersion of target compounds and deserved further development for a better acknowledgement of vulnerability at local scales.

trileptal normal dosage 2015-09-30

New antiepileptic drugs (AED) have generally a good pharmacokinetic profile. Their mode of action remains imperfectly known. Gabapentin (GBP), oxcarbazepine (OCBZ), topiramate (TPM), vigabatrin (VGB) and tiagabine (TGB) are mostly effective for partial seizures; lamotrigine (LTG) is efficacious for both partial and generalized seizures, it is also active in treatment of Lennox-Gastaut syndrome for which felbamate (FBM) is also effective. West syndrome often responds to VGB. The tolerance of the new AED is generally satisfactory but some serious, late side-effects have become apparent. Because of such possible toxicity, of the cost and of the remaining uncertainties about indications, the new AED are used mostly as add- Cymbalta Effective Dose on therapy for epilepsies resistant to conventional AED or as secondary monotherapy following withdrawal of other drugs used as monotherapy. Some new AED (LTG, GBP, TPM, OCBZ) have proved equal or sometimes superior to conventional agents.

trileptal reviews seizures 2015-02-01

A structured literature search led to selection of one article providing the highest level of evidence currently available to answer our clinical question Allegra 30 Mg : a recent cohort study. The primary results of this study were based on comparisons of several AEDs to topiramate as a reference drug for any indication (including epilepsy), and identified gabapentin, lamotrigine, oxcarbazepine, tiagabine, and valproate as increasing risk of suicidality. A secondary analysis using carbamazepine as the reference drug failed to show statistically significant differences. A subgroup analysis of patients with epilepsy revealed an increased risk of suicidality in patients taking gabapentin as compared with those taking carbamazepine (relative risk, 13.92; 95% confidence interval, 1.82-106.38).

trileptal medication 2015-03-25

25-OHD levels were lower in each drug-treated group (OXC, 19.4+/-2.3 pg/ml; CBZ, 20.4+/-2.4) than in the controls (27.5+/-2.8) (ANOVA, p=0.052). This difference was significant for the OXC group (p<0.05). PTH, BAP, and NTX did not differ significantly among groups. OCLN levels were somewhat elevated in the OXC group (2.79+/-0.47 ng/ml) and more clearly and significantly elevated in the CBZ Ponstel Pill group (3.63+/-0.36) compared with controls (2.38+/- 0.41) (p=0.053). Because the data were very similar between OXC and CBZ groups, they were combined to increase statistical power. The combined drug-treatment group had significantly higher BAP (p=0.02) and lower 25-OHD (p=0.015) than did controls. The latter remained significant even after accounting for the confounding effects of age on 25-OHD levels (p<0.05). No significant differences were found after CBZ patients were switched to OXC.

trileptal oxcarbazepine medication 2017-01-01

111 (74%) of the total 150 Astelin Tablet children showed a positive EEG change suggestive of epileptogenic activity and of which 75 (67.56%) were females and 36 (32.43%) were male, majority of children were in the age of group of 9-12 years. Temporal wave discharges were 39 (35.13%) of the total abnormal EEG's. All the children were started on AEDs and those with abnormal EEG showed 100% response to treatment while 27 (18%) children with normal EEG also responded to treatment. Twelve (8%) children did not have any improvement in symptoms.

trileptal overdose death 2015-10-28

TCAs, SNRIs, and the AEDs gabapentin and pregabalin are the best adjuvant analgesics for neuropathic pain. For patients who are intolerant to or who experience pain unresponsive to the above medications, one can consider therapy with carbamazepine, oxcarbazepine, valproic acid, topiramate, or lacosamide. However, as these agents are associated with more Flonase Otc Dosage side effects and lower rates of efficacy, expert consultation is strongly recommended.

trileptal overdose 2016-12-05

In June 2005 a team of experts participated in a workshop with the objective of reaching agreement on the place of valproate use in the treatment of paediatric epilepsy patients. A general "consensus of the meeting" was that the initiation of antiepileptic drug (AED) treatment should be based on a seizure-syndromic approach in children. Participants of the meeting also agreed that valproate is currently the AED with the broadest spectrum across all types Avapro Generic Pictures of seizures and syndromes. Its superiority has been shown over almost 40 years of clinical experience. The best results are seen in idiopathic generalized epilepsy with or without photosensitivity, idiopathic focal and symptomatic generalized tonic-clonic seizures (GTCS). Evidence supports the use of valproate, ethosuximide and lamotrigine in absence epilepsies and the use of carbamazepine, lamotrigine, oxcarbazepine, phenytoin, topiramate, valproate and phenobarbital for primary GTCS. For new AEDs trials have been undertaken to define their therapeutic role but studies comparing their role to 'old' broad-spectrum drugs in specific syndromes are missing. Experts concluded that intravenous (i.v.) valproate is a useful agent in the treatment of non-convulsive status epilepticus (SE). There is an easy transition to oral treatment following i.v. valproate use. The discussion also concluded that, despite the lack of studies, valproate is an interesting, underutilized alternative in convulsive SE but more controlled studies are needed. The side effects of valproate use are well documented. Its effect on cognition and behaviour is more favourable than many of the other AEDs which is an important consideration in children. Overall, the clinical consensus of the meeting was that valproate's well established therapeutic properties far outweigh the negative side effects. Contraindication or withdrawal should be assessed individually.

trileptal tab 2017-11-04

Acetone enhances the anticonvulsant effects of several AEDs such as VPA, CBZ, LTG, and PB without affecting their pharmacokinetic and side-effect profiles.