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

>
> 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.


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

3.5 stars Rating 3.4 out of 5 from 89 criticisms.
Vote Distribution: 12 – 7 – 2 – 9 – 30 – 29


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 Rates 3.9 out of 5 from 55 value judgments.
Vote Distribution: 3 – 1 – 2 – 6 – 25 – 18



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14.4  Discussion board

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



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15.  References

  1. Trileptal (oxcarbazepine) Full US Prescribing Information

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. We 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 we write these damn things. 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. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)


Last modified on Thursday, 27 March, 2014 at 20:49:27 by SomeMedCriticPage Author Date created
“Trileptal (oxcarbazepine): a Synopsis for the Educated Consumer.” by Jerod Poore is copyright © Jerod Poore Published online 2011/03/14
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Trileptal, and all other drug names on this page and used throughout the site, are a trademark of someone else.

will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. 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. It may of changed hands by the time you finished reading this article.




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