side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more

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> Trileptal


US brand name: Trileptal
Generic name: oxcarbazepine

Other Form: Oral suspension

Class: Antiepileptic Drug (AED)/Anticonvulsant (AC)

1.  Other Brand Names

  • Oxrate (India)
  • Timox (Germany)
  • Trileptin (Israel)

2.  FDA Approved Uses of Trileptal

Monotherapy (used by itself) or adjunctive therapy (used with other meds) for adults with partial seizures. Adjunctive therapy only for kids with partial seizures.

3.  Off-Label Uses of Trileptal

4.  Trileptal’s pros and cons

Pros: Having a much lower side effect profile than Tegretol and it’s really just as useful for almost as many things. In time it will be tried for just about everything, not just epilepsy, bipolar disorder and neuropathic pain. Its side effect profile is also lower than Topamax.

Cons: A lack of US studies or interest by Novartis or something to get this med approved for as many seizure types as its older brother Tegretol may prevent you from getting it. The jury is still out if it really is as effective for everything as Tegretol. Wacky hyponatremia side effect (not enough salt in your blood - just like the creature from first aired episode of Star Trek!) could force you to eat potato chips all the time. Hey, wait, maybe that’s a pro!

5.  Trileptal’s Side Effects

5.1  Typical Side Effects

Those common for anticonvulsants. Like all meds that hit your temporal lobe, you’ll feel tired, confused, uncoordinated, even somewhat drunk and disoriented. You’ll have problems with your memory, have a hard time thinking and things will just seem really strange. And it figures that a med good for treating headaches will just give people bad headaches. For the most part these will pass, or at least they won’t be so bad, within a couple of weeks. Or a month. And, of course, they’ll come back when your dosage goes up. But they usually won’t be as bad or last as long the next time around. Unless you’re getting way more Trileptal than you should be. Of the three temporal lobe-affecting meds, Trileptal seems to have the lowest side effect profile. So these effects are either less likely to hit you or they won’t hit you as badly. If you’re switching from Tegretol you may not even experience any of these if you’ve dealt with them already.

5.2  Not So Common Side Effects

Hyponatremia - not enough salt in your blood. Time to stock up on potato chips and other salty snacky goodness! Also photosensitivity. While all anticonvulsants and antipsychotics make you more sensitive to sunlight, Tegretol and Trileptal are just the worst when it comes to turning you into a vampire.

5.3  Freaky Rare Side Effects

Crisis in the rotation of the eyeballs and renal calculus (Whenever our kidneys have to do advanced math, it’s a crisis). “Renal calculus” is fancy doctor-speak for kidney stones. Rare, but not all that freaky.

6.  Interesting Stuff Your Doctor Probably Won’t Tell You

  • Trileptal works better for boys than girls for bipolar disorder. At least it did in that one small study.
  • Hyponatremia, the significant lowering of sodium in the bloodstream, can be a problem. You may be required to supplement your sodium intake. I’m serious about the potato chips.
  • The jury is still out if Trileptal really is as effective as Tegretol - for whatever you’re taking it for - so you may have to take Tegretol instead.
  • As an enzyme-inducing AED, albeit a mild one, Trileptal will sap your body of vitamin D, folic acid, and maybe even calcium. So ask your doctor about tests for vitamin D and calcium levels and supplements. You should probably take 400–1,000mcg of folic acid in any event, but no more than that, otherwise it might interfere with how well Trileptal works.


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7.  Trileptal’s Dosage and How to Take Trileptal

For epilepsy and bipolar disorder the standard recommendation has you starting at two 300mg doses a day, increasing by 300mg a day every three days until you hit 1200mg a day. After that it all depends on symptoms. You should find your proper dosage somewhere between 1200 and 2400mg a day.

My suggestion for bipolar disorder and as an add-on for partial seizures is starting at 300mg a day in two 150mg doses and increasing by 150mg a day every week until your symptoms stop and/or you hit 900mg a day. After that you can go up or down 300mg a day, as required, until you find your sweet spot between 900 and 2400mg a day. You have to be seriously seizing or flipping out to want to go up any faster. Take it slow and easy, get used to the med to avoid the worst of the side effects.
If you’re taking Trileptal for generalized seizures or as monotherapy for partial seizures it’s between you and your doctor.

8.  How Long Trileptal Takes to Work

While you’ll probably start feeling something once you hit a steady state, the odds are you won’t really be getting any benefit until you’re at 900mg a day.

9.  Trileptal’s Half-Life & Average Time to Clear Out of Your System

Although enzyme-inducing drug, Trileptal has pretty linear pharmacokinetics. It does a double metabolism, but they’re both short, two and nine hours. It’s the active metabolite produced that does all the work. Trileptal is out of your system completely in two to three days.

10.  Days to Reach a Steady State

Usually two to three days.

11.  Shelf life

  • Tablets: 3 years.
  • Oral Solution: 3 years, 7 weeks after opening.

12.  How to Stop Taking Trileptal

Your doctor should be recommending that you reduce your dosage by 150–300mg a day every three days, based on the 2 and 9 hour half-lives, if not more slowly than that.

Like any anticonvulsant, if you’ve been taking Trileptal for more than a couple months and you’re up to or above 900mg a day (give or take, depending on other meds you might be taking) you just can’t stop cold turkey if you’re not at the therapeutic dosage for another anticonvulsant that is known to work for you, otherwise you risk partial-complex, absence seizures or even tonic-clonic (AKA grand mal) seizures, despite your never having had a seizure disorder before! The risk is worse if you’re taking a lithium variant, and/or most antidepressants, especially Wellbutrin (bupropion hydrochloride).

If you’ve worked your way up to a particular dosage, it’s usually best to spend this many days at the next lowest dosage before going down the next lowest dosage before that and so forth. This is the least sucky way to avoid problems when stopping any neurological / psychiatric medication. Presuming you have the option of slowly tapering off them.

13.  Comments

Trileptal is the newish & improved (more or less) version of Tegretol. At least, we think it’s improved. It has a much lower side effect profile - although it still encourages you to stay inside and watch sports on TV to deal with the side effects of photosensitivity and hyponatremia - a monthly blood test isn’t required as with Tegretol, Trileptal has much less of an effect on oral contraceptives, other estrogen supplements, and Lamictal; although Lamictal is so temperamental a drug-drug interaction can’t be ruled out. Those are big improvements, right? But there’s still a question of efficacy for epilepsy, bipolar and all the off-label uses that Tegretol enjoys. Trileptal has had plenty of time to get approved for all the things Tegretol is approved for. What’s the hold up? Is it that there’s just a bigger profit margin in pushing anticonvulsants off-label with a nod and a wink from the pharm reps? Norvartis must have thought so, as they gambled on that, lost, and ended up paying $422.5 million for that mistake. Oops.

If Tegretol is indicated for you, for either epilepsy or bipolar, ask about Trileptal if it’s available where you live. Its better response rate could just be due to better med compliance as the side effects don’t suck as much donkey dong, but that’s still a damn good reason to take Trileptal instead of Tegretol. If it doesn’t work as well as expected it’s pretty easy to switch between the two meds. 300mg of Trileptal = 200mg of Tegretol. The PI sheets are full of information about switching between the two.

But when it comes to straightforward pain, especially the special hells that are glossopharyngeal neuralgia and trigeminal neuralgia Tegretol kicks the asses of all other treatments.


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14.  Trileptal Ratings, Reviews, & Other Sites of Interest

Trileptal Ratings & Reviews Page.

14.1  Rate Trileptal

Give your overall impression of Trileptal on a scale of 0 to 5. Detailed ratings and reviews are available on the Trileptal Ratings & Reviews Page.

Get all critical about Trileptal

4 stars Rating 3.7 out of 5 from 41 criticisms.
Vote Distribution: 4 – 3 – 2 – 3 – 11 – 18


14.2  Rate this article

If you’re still feeling judgmental as well as just mental1, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.

Get all judgmental about the Trileptal (oxcarbazepine) Synopsis

4 stars Rating 3.8 out of 5 from 28 value judgments.
Vote Distribution: 2 – 1 – 1 – 3 – 11 – 10


14.3  Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, check for drug-drug interactions

Trileptal’s Full US Prescribing Information / PI Sheet

UK Summary of Product Characteristics
New Zealand Data Sheet
New Zealand Consumer Medicine Information

Drugs.com’s drug-drug and drug-food interaction checker

It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.



14.4  Discussion board

If you have any questions not answered here, please see the Crazymeds Trileptal discussion board.


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15.  Bibliography

PDR: Physicians’ Desk Reference 2010 64th edition

Instant Psychopharmacology 2nd Edition Ronald J. Diamond M.D. © 2002. Published by W.W. Norton

Primer of Drug Action 12th edition by Robert M. Julien Ph.D., Claire D. Advokat, Joseph Comaty © 2011 Published by Worth Publishers.

Partial Seizure Disorders Mitzi Waltz © 2001. Published by O’Reilly & Associates.

Healing Anxiety & Depression Daniel G. Amen, M.D., and Lisa C. Routh, M.D. © 2003. Published by G.P. Putnam’s Sons.

Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series) © 2007 An imprint of Elsevier.


1 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!


If you have any questions not answered here, please see the Crazymeds Trileptal discussion board. I welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why I write these damn things. I’m frustrated enough as it is. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds.


Last modified on Thursday, 27 March, 2014 at 20:49:27 by SomeMedCriticPage Author: JerodPooreDate created Monday, 14 March, 2011 at 17:08:51

Trileptal by JerodPoore is copyright © 2011 JerodPoore


Trileptal, and all other drug names on this page and use throughout the site, are a trademark of someone else. Look on the the PI sheet or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing.




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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.



All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazymeds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]

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