Generic Name and Formulations:
Eslicarbazepine acetate 200mg+, 400mg, 600mg+, 800mg+; (+) scored tabs.
Indications for APTIOM:
Monotherapy or adjunctive treatment of partial-onset seizures.
Initially 400mg once daily; for some patients, may initiate at 800mg once daily if need for seizure reduction outweighs an increased risk of adverse reactions. Increase dose in weekly increments of 400–600mg, based on response and tolerability, to maintenance dose of 800–1600mg once daily. Patients on monotherapy: consider 800mg once daily if 1200mg/day not tolerated. Patients on adjunctive therapy: consider 1600mg/day if 1200mg/day is inadequate. Moderate and severe renal impairment (CrCl <50mL/min): reduce doses by 50%.
<4yrs: not established. Give once daily. Dose increase should be based on response and tolerability, no more than once per week. 4–17yrs (11–21kg): initial and max titration increment: 200mg/day; maintenance: up to 400–600mg/day; (22–31kg): initial and max titration increment: 300mg/day; maintenance: up to 500–800mg/day; (32–38kg): initial and max titration increment: 300mg/day; maintenance: up to 600–900mg/day; (>38kg): initial and max titration increment: 400mg/day; maintenance: up to 800–1200mg/day. Moderate and severe renal impairment (CrCl <50mL/min): reduce doses by 50%.
Hypersensitivity to oxcarbazepine.
Increased risk of suicidal thinking or behavior; monitor for clinical worsening or unusual changes. Discontinue if serious dermatologic reactions or DRESS/multiorgan hypersensitivity, anaphylaxis, angioedema occurs. Measure serum sodium and chloride levels during therapy and esp. if hyponatremia symptoms develop. Monitor for neurological adverse reactions (esp. in elderly). Monitor LFTs at baseline; discontinue if jaundice or evidence of significant liver injury occurs. Severe hepatic impairment: not recommended. Avoid abrupt cessation. Pregnancy. Nursing mothers.
Avoid adjunctive therapy with oxcarbazepine. Antagonized by carbamazepine, phenobarbital, phenytoin, and primidone; monitor and adjust dose. May potentiate phenytoin, clobazam, omeprazole. May antagonize simvastatin, lovastatin. May decrease effectiveness of oral contraceptives; use additional non-hormonal forms. May affect thyroid function tests. Caution with other drugs known to decrease serum sodium. Monitor INR when given with warfarin.
Dizziness, somnolence, nausea, headache, diplopia, vomiting, fatigue, vertigo, ataxia, blurred vision, tremor; hyponatremia, liver injury; rare: serious skin reactions (eg, SJS, TEN), DRESS/multiorgan hypersensitivity, anaphylaxis, angioedema, blood dyscrasias (discontinue if occur).
To enroll in the North American Antiepileptic Drug Pregnancy Registry call (888) 233-2334.
Tabs 200mg, 400mg—30; 600mg—60, 90; 800mg—30, 90
Psychiatry Advisor Articles
- ACOG Update: Marijuana Use Discouraged During Pregnancy, Breastfeeding
- Asenapine Prevents Recurrence of Mood Events in Bipolar Disorder
- Depression Profiles in Patients With Type 1 Diabetes vs Type 2 Diabetes
- No Evidence of Personality Changes Prior to Developing Cognitive Impairment, Dementia
- Retirement Saving Behavior Associated With Psychological Distress
- CBT, Acceptance Commitment Therapy Helpful for Those With Chronic Pain
- Suicidal Behavior, Thoughts Associated With Perfectionist Tendencies
- Physicians Spend Nearly 6 Hours on EHR Tasks Per Day
- Depression Reduced by Social Belonging, Feelings of Inclusion
- Sleep Disturbance May Be Causal Factor in Psychotic Experiences
- Cardiovascular Risk Management May Slow Neurocognitive Decline in HIV
- Maintenance rTMS for Treatment-Resistant Depression
- New Study Compares Opioid Dependence Relapse Treatments
- Increase Use of Nursing Home for Patients With Cognitive Impairment Category
- Venlafaxine XR Safe, Effective in Treating Generalized Anxiety Disorder