What is Apo-Oxcarbazepine?

Oxcarbazepine belongs to the group of medications known as antiepileptics. It is used to control epilepsy in adults and children over 6 years of age. It is used alone or in combination with other medications for a particular type of epilepsy called partial seizures.

Seizures are caused by the uncontrolled spreading of electrical activity across the brain. Oxcarbazepine works by controlling this electrical activity.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

The usual dose of oxcarbazepine for adults ranges from 300 mg to 600 mg twice a day, but some people may need up to 1,200 mg twice a day. The maximum dose is 1,200 mg twice a day.

For children over 6 years of age, the dose is based on body weight and is taken in divided doses, twice per day.

Oxcarbazepine may be taken with or without food.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

If you are using the liquid form of oxcarbazepine, shake the bottle of liquid well before measuring a dose. Use an oral syringe to measure each dose of the liquid, as it gives a more accurate measurement than household teaspoons.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children. The liquid can be used for 7 weeks after opening the bottle (unless the expiry date on the package shows an earlier date), after which it should be discarded.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you are allergic to oxcarbazepine or any ingredients of the medication.

People with fructose intolerance should not take the liquid formulation.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal pain (mild)
  • acne
  • anxiety
  • constipation
  • difficulty concentrating
  • dizziness, drowsiness, or fatigue
  • hair loss
  • headache
  • nausea
  • problems with walking, speech, or coordination
  • trembling
  • skin rash (if there is no blistering or peeling and the rash is not covering a large area)
  • vomiting

Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abdominal pain (moderate to severe)
  • double vision or other vision changes
  • flu-like symptoms
  • nervousness, confusion, or feeling unusually emotional
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
  • signs of infection (e.g., fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
  • signs of liver problems (e.g., pale stools, dark urine, abdominal pain, itchy skin, yellow eyes or skin, or decreased appetite)
  • signs of low sodium in the blood (e.g., nausea, headache, weakness, sluggishness, confusion, or a general “ill” feeling)
  • signs of systemic lupus erythematosus (e.g., red blotchy rash mainly on the face, with or without fatigue, fever, nausea)
  • symptoms of underactive thyroid gland (e.g., dry skin, constipation, weight gain, fatigue, aches, pains and stiffness, intolerance to cold, depression, memory problems)
  • thoughts of suicide or self-harm

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reactions: About 25% to 30% of people who are allergic to the epilepsy medication carbamazepine will also be allergic to oxcarbazepine. If you have had an allergic reaction to carbamazepine, talk to your doctor before taking oxcarbazepine.

Birth control: Oxcarbazepine, like other anticonvulsants, may reduce the effectiveness of birth control pills. Women taking oxcarbazepine should use an alternative, non-hormonal birth control method such as condoms. If you become pregnant while taking this medication, contact your doctor immediately.

Blood counts: This medication can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

Drowsiness/reduced alertness: Oxcarbazepine may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how this medication affects you.

Heart conditions: The safety of using this medication if you have a heart condition has not been determined. If you have a heart condition, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Hypersensitivity syndrome: A severe allergic reaction called hypersensitivity syndrome has occurred for some people with the use of oxcarbazepine. This reaction involves a number of organs in the body and may be fatal if not treated quickly. Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.

Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Rarely, oxcarbazepine has been reported to cause inflammation of the liver and liver failure which has in cases, caused death. This medication may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low sodium: Oxcarbazepine may cause low sodium levels. Get immediate medical attention if you notice the symptoms of very low sodium, such as nausea, headache, weakness, sluggishness, confusion, or a general feeling of being unwell.

Osteoporosis: Long term use of medications to treat seizures may cause weakened or brittle bones. Discuss with your doctor whether any special monitoring or supplements are needed.

Severe skin reactions: Oxcarbazepine can cause serious skin reactions. If you have symptoms of a serious skin reaction, such as blistering or peeling of the skin, stop taking the medication and seek immediate medical attention.

Stopping medication: If this medication is stopped abruptly, the risk of seizures may increase. Talk to your doctor or pharmacist about how this medication should be safely stopped.

Suicidal thoughts and behaviour: Some people taking anti-seizure medications may have suicidal thoughts or behaviour. If this happens to you or you notice this in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Thyroid problems: Some people taking this medication develop changes in the function of their thyroid. Symptoms of these changes include feeling cold all the time, fatigue, weight loss, without a change in your diet or amount of exercise you get, or feeling emotional. Contact your doctor if you experience these symptoms.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Oxcarbazepine can also contribute to folic acid deficiency. Talk to your doctor about folic acid supplements before and during pregnancy.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking oxcarbazepine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 6 years of age.

Seniors: Seniors may require lower doses of this medication. Do not change the way you are taking the medication without consulting your doctor.

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