0

Home > Drug Category > Antiepileptic Medication > Trileptal Suspension and Equivalent

Trileptal Suspension (Oxcarbazepine) Information

Trileptal Suspension (oxcarbazepine oral suspension) is a prescription liquid antiepileptic drug (AED) used as the first-line treatment for certain seizure disorders. It is structurally a keto-analog of carbamazepine and is particularly useful for patients, including pediatric patients, who have difficulty swallowing the tablet form. It is approved for the treatment of Partial Seizures (simple, complex, and secondarily generalized) in adults and children, both as monotherapy and adjunctive therapy. The suspension formulation provides equivalent bioavailability to the tablet form. Oxcarbazepine is rapidly and completely metabolized by hepatic enzymes into its principal active metabolite, monohydroxy derivative (MHD). MHD is responsible for the drug's therapeutic effect. The primary mechanism of action involves the blocking of voltage-sensitive sodium channels, which stabilizes hyperexcited neuronal membranes, restricts high-frequency neuronal firing, and limits the spread of seizure activity. Oxcarbazepine and MHD do not cause autoinduction and have a minimal effect on the induction of other liver enzymes compared to carbamazepine. MHD has an elimination half-life of approximately nine to ten hours.

Trileptal Suspension Side Effects

The side effect profile for the suspension mirrors that of the tablet, with typical effects often being neurological and dose-dependent. The most frequently reported side effects include dizziness, drowsiness (somnolence), diplopia (double vision or blurred vision), ataxia (unsteadiness), nausea, vomiting, and fatigue. Since the suspension is often used in children, caution should be exercised when dosing to minimize potential central nervous system (CNS) effects. Other common effects may include difficulty concentrating and abdominal pain.

However, more serious side effects can occur. If any of the following symptoms are experienced, a patient should seek immediate medical attention:

• Anaphylaxis and Angioedema: Rapid, severe allergic reactions involving swelling of the face, throat, or tongue.

• Hypersensitivity Reactions/DRESS: Symptoms may include fever, rash, joint pain, and swelling of the lymph nodes, indicating a potential reaction in major organs, which can lead to Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).

• Hyponatremia (Low Sodium): A risk for all oxcarbazepine formulations, often requiring monitoring of serum sodium. Symptoms include severe headache, confusion, malaise, or a worsening of seizures.

• Severe Dermatologic Reactions: There is a risk of rare but severe skin reactions, including Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). Patients of Asian descent should be screened for the HLA-B*1502 allele.

• Suicidal Thoughts and Behaviour: As an AED, it carries a warning for increased risk of suicidal ideation and actions.

Trileptal Suspension Precautions

Trileptal Suspension is contraindicated in patients with a known hypersensitivity to oxcarbazepine or any of its inactive ingredients. Caution is advised for patients with a known history of carbamazepine hypersensitivity, as about twenty-five percent may have cross-reactivity. Due to the significant risk of hyponatremia, serum sodium levels must be monitored before and during the first three months of treatment. Patients of Asian descent should be screened for the HLA-B*1502 allele. This medication can decrease the effectiveness of hormonal contraceptives, and women should be advised to use alternative or high-dose estrogen methods. The drug should be tapered gradually if discontinuation is required to prevent rebound seizures. Caution is advised for patients with renal impairment, as a dose reduction may be needed due to the renal excretion of the active metabolite, MHD. The suspension must be shaken well before use and measured with the provided oral dosing syringe to ensure accurate dosing.

Do I need a prescription to order Trileptal Suspension?

Yes, a prescription is required from your physician to order Trileptal Suspension.