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Antiepileptic — Sodium Channel Blocker

Oxcarbazepine

Brand names: Trileptal

Oxcarbazepine is an antiepileptic used for focal (partial-onset) seizures. It is structurally related to carbamazepine but causes fewer enzyme-mediated drug interactions.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Adults : Initiate with a dose of 600 mg/day, given twice a day • Adjunctive Therapy: Maximum increment of 600 mg/day at approximately weekly intervals. The recommended daily dose is 1,200 mg/day ( 2.1 ) • Conversion to Monotherapy: Withdrawal concomitant over 3 to 6 weeks; reach maximum dose of oxcarbazepine oral suspension in 2 to 4 weeks with increments of 600 mg/day at weekly intervals to a recommended daily dose of 2,400 mg/day ( 2.2 ) • Initiation of Monotherapy: Increments of 300 mg/day every third day to a dose of 1,200 mg/day ( 2.3 ) • Initiate at one-half the usual starting dose and increase slowly in patients with a creatinine clearance < 30 mL/min ( 2.7 ) Pediatrics : Initiation …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-11-18. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It and its active metabolite block voltage-gated sodium channels, stabilising hyperexcited neuronal membranes and reducing the spread of seizure activity.

Prescribing in practice

  • Hyponatraemia is common — check sodium before starting and during treatment, particularly in older people, those on other sodium-lowering drugs, or if symptoms such as confusion, headache or worsening seizures occur.
  • There is cross-hypersensitivity (including rash) with carbamazepine, and a risk of serious skin reactions such as Stevens-Johnson syndrome that is higher with certain HLA genotypes in susceptible populations.
  • It reduces the effectiveness of hormonal contraception, so advise additional or alternative contraceptive measures.

Monitoring

Check serum sodium at baseline and periodically, especially if symptomatic; monitor seizure control, skin reactions, and mood or suicidal ideation as with all antiepileptics.

Counselling the patient

  • Report any rash promptly, and seek urgent help for blistering, mouth ulcers or peeling skin.
  • Hormonal contraception may not work reliably — use additional contraception and discuss alternatives.
  • Report headache, nausea, confusion or worsening seizures, which can signal a low sodium level.

Evidence & guidelines

Licensed and guideline-recognised option for focal seizures (NICE NG217).

Reference: NICE NG217 (Epilepsies in children and adults); MHRA Oxcarbazepine Safety Update; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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