Oxcarbazepine XR
OXTELLAR XR
What it isExtended-release sodium-channel anticonvulsant for partial-onset seizures (OXTELLAR XR, 2012).
Why this oneSmoother release reduces peak-related dizziness and simplifies dosing versus immediate-release oxcarbazepine.
What limits itTake once daily on an empty stomach (food spikes exposure); not bioequivalent mg-for-mg with IR. Monitor sodium for hyponatremia; CYP3A4 induction can reduce hormonal contraception.
FDA-approved for
- seizures (partial-onset) (2012)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Partial-onset seizures | Adults | 600 mg PO once daily | 1200–2400 mg once daily | 2400 mg/day |
| Partial-onset seizures | Peds 6–<17 yr | 8–10 mg/kg once daily (not to exceed 600 mg in first week) | By weight: 900 mg/day (20–29 kg), 1200 mg/day (29.1–39 kg), 1800 mg/day (>39 kg) |
Titration Increase at weekly intervals (adults 600 mg/day increments; peds 8–10 mg/kg increments)
Renal CrCl <30 mL/min: start 300 mg/day and titrate slowly; end-stage renal disease on dialysis: use immediate-release oxcarbazepine instead
Hepatic Mild-to-moderate: no adjustment; severe: not recommended (not evaluated)
Instructions
- Swallow tablets whole; do not cut, crush, or chew
- Take once daily on an empty stomach (≥1 h before or ≥2 h after meals)
- Withdraw gradually to reduce risk of increased seizures/status epilepticus
Contraindications
- Known hypersensitivity to oxcarbazepine, any component of Oxtellar XR, or to eslicarbazepine acetate (reactions have included anaphylaxis and angioedema)
Cautions
- Hyponatremia (monitor sodium)
- Anaphylaxis and angioedema
- Cross-hypersensitivity to carbamazepine (~25–30%)
- Serious dermatologic reactions (SJS/TEN; increased risk with HLA-B*1502)
- Suicidal behavior and ideation
- DRESS/multi-organ hypersensitivity
- Hematologic reactions
- Risk of seizure aggravation
- Gradual withdrawal required
Adverse reactions
- Dizziness
- Somnolence
- Headache
- Balance disorder
- Tremor
- Vomiting
- Diplopia
- Asthenia
- Fatigue
Pregnancy May cause fetal harm; structurally related to carbamazepine; associated with craniofacial (oral clefts) and cardiac (VSD) malformations
Lactation Oxcarbazepine and active metabolite (MHD) present in human milk; effects on infant unknown
NO BOXED WARNINGS
Principal riskHyponatremia, more than carbamazepine
Classes and tags
Clinical profile
Mechanism of action: Oxcarbazepine XR ballicule
Open Oxcarbazepine XR in the interactive console ↗
Memory aids: mascots and interaction avatars
Trileptal trashes sodium → hyponatremia is common
