Pharmacology of Oxcarbazepine (Trileptal) ; Mechanism of action, Pharmacokinetics, Uses, Effects

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Oxcarbazepine, marketed under the brand name Trileptal, is an antiepileptic medication used to treat partial-onset seizures. Here's an overview of its pharmacology:

Mechanism of Action
Voltage-Sensitive Sodium Channel Blockade: Oxcarbazepine and its active metabolite, 10-monohydroxy metabolite (MHD), block voltage-sensitive sodium channels. This action stabilizes hyperexcited neuronal membranes, inhibits repetitive neuronal firing, and reduces the propagation of synaptic impulses, which helps prevent the spread of seizures2.

Indications
Partial-Onset Seizures: Oxcarbazepine is indicated for use as monotherapy or adjunctive therapy in the treatment of partial-onset seizures in adults and pediatric patients.

Dosage and Administration
Immediate-Release Formulation: The typical starting dose for adults is 300 mg twice daily, with gradual increases based on clinical response and tolerability.

Extended-Release Formulation: The starting dose for adults is 600 mg once daily, with gradual increases based on clinical response and tolerability.

Adverse Effects
Common Side Effects: Include dizziness, drowsiness, headache, nausea, and vomiting2.

Serious Side Effects: Include hyponatremia (low sodium levels), hypersensitivity reactions, and increased risk of suicidal thoughts and behaviors3.

Pharmacokinetics
Absorption: Oxcarbazepine is rapidly absorbed after oral administration and extensively metabolized to its active metabolite, MHD3.

Metabolism: Oxcarbazepine is metabolized in the liver to MHD, which is responsible for most of its antiepileptic activity2.

Excretion: The metabolites are primarily excreted in the urine.

Half-Life: The elimination half-life of oxcarbazepine is approximately 2 hours, while the half-life of MHD is about 9 hours

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Pharmacology of Oxcarbazepine (Trileptal) ; Mechanism of action, Pharmacokinetics, Uses, Effects

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