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Trileptal Disease Interactions

There are 8 disease interactions with Trileptal (oxcarbazepine).

Major

Anticonvulsants (applies to Trileptal) depression

Major Potential Hazard, Moderate plausibility.

Antiepileptic drugs can increase depression and suicidal thoughts or behaviors in patients receiving these drugs for any indication. Patients should be monitored for the emergence or worsening of depression, suicidal thoughts and unusual changes in mood or behavior. Caregivers and family should be alert for the emergence or worsening of symptoms. Behaviors of concern should be reported immediately to the healthcare providers.

References

  1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
  2. "Product Information. Depakene (valproic acid)." Abbott Pharmaceutical (2001):
  3. "Product Information. Depakote (divalproex sodium)." Abbott Pharmaceutical (2001):
  4. "Product Information. Lamictal (lamotrigine)." Glaxo Wellcome (2001):
  5. "Product Information. Magnesium Sulfate (magnesium sulfate)." Abbott Pharmaceutical (2001):
  6. "Product Information. Trileptal (oxcarbazepine)." Novartis Pharmaceuticals (2001):
  7. "Product Information. Vimpat (lacosamide)." UCB Pharma Inc (2008):
  8. "Product Information. Banzel (rufinamide)." Eisai Inc (2008):
  9. "Product Information. Aptiom (eslicarbazepine)." Sunovion Pharmaceuticals Inc (2013):
View all 9 references
Major

Anticonvulsants (applies to Trileptal) liver disease

Major Potential Hazard, Moderate plausibility.

Most anticonvulsants are primarily metabolized by the liver. Metabolic activity may be decreased in patients with liver disease, resulting in elevated drug levels and increased risk of toxicity. Therapy with anticonvulsants should be administered cautiously in patients with mild and moderate liver impairment. Therapy with these drugs is mostly not recommended in patients with severe liver impairment. Caution is also advised when treating patients with a history of liver disease, since the use of some anticonvulsants has been associated with hepatotoxicity. Baseline and periodic evaluation of liver function is recommended. Therapy should be discontinued and not readministered if evidence of liver damage is observed and felt to be drug-related.

References

  1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
  2. "Product Information. Banzel (rufinamide)." Eisai Inc (2008):
  3. "Product Information. Aptiom (eslicarbazepine)." Sunovion Pharmaceuticals Inc (2013):
  4. "Product Information. Oxtellar XR (oxcarbazepine)." Supernus Pharmaceuticals Inc (2014):
View all 4 references
Major

Anticonvulsants (applies to Trileptal) renal dysfunction

Major Potential Hazard, Moderate plausibility.

Most anticonvulsants are primarily excreted by the kidney. The plasma clearance may be decreased and the half-life prolonged in patients with impaired renal function. Therapy with anticonvulsants should be administered cautiously in patients with significant renal dysfunction. In most cases it is recommended to adjust the dosage in patients with CrCl <50 mL/min to half the usual starting dose and then increase slowly to achieve the desired clinical response. The renal function should be monitored regularly in patients receiving therapy.

References

  1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
  2. "Product Information. Trileptal (oxcarbazepine)." Novartis Pharmaceuticals (2001):
  3. "Product Information. Banzel (rufinamide)." Eisai Inc (2008):
  4. "Product Information. Aptiom (eslicarbazepine)." Sunovion Pharmaceuticals Inc (2013):
View all 4 references
Moderate

Anticonvulsants (applies to Trileptal) hyponatremia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hypothyroidism, Adrenal Insufficiency, Congestive Heart Failure, Renal Dysfunction, Fluid Retention, Cirrhosis, Polydipsia, SIADH

Some anticonvulsants can cause clinically significant hyponatremia (Na < 125 mmol/L). Therapy with these drugs should be administered cautiously in patients with conditions predisposing to hyponatremia, such as SIADH, use of diuretics or drugs associated with inappropriate antidiuretic hormone secretion, adrenal insufficiency, hypothyroidism, primary polydipsia, and edema (e.g., due to liver cirrhosis, congestive heart failure, or nephrotic syndrome). Serum sodium levels should be monitored during maintenance therapy, and patients should be monitored for signs and symptoms possibly indicating hyponatremia such as nausea, malaise, headache, lethargy, confusion, obtundation, and increase in seizure frequency or severity. If hyponatremia occurs, conservative measures such as fluid restriction, a reduction in dosage, or discontinuation of therapy will usually suffice.

References

  1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
  2. "Product Information. Trileptal (oxcarbazepine)." Novartis Pharmaceuticals (2001):
  3. "Product Information. Aptiom (eslicarbazepine)." Sunovion Pharmaceuticals Inc (2013):
Moderate

Antiepileptics (applies to Trileptal) suicidal tendency

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Depression, Psychosis

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs across multiple indications in either monotherapy or adjunctive therapy for a median treatment duration of 12 weeks (up to a maximum of 24 weeks) showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. The estimated rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% for 16,029 placebo-treated patients, representing an increase of approximately 1 case for every 530 patients treated. There were 4 suicides in AED-treated patients and none in placebo-treated patients, although the number is too small to establish any causal relationship. The increased risk of suicidal thoughts or behavior was observed as early as 1 week after starting AEDs and persisted for the duration of treatment assessed. The risk did not vary substantially by age (5 to 100 years) in the clinical trials analyzed. Therapy with AEDs should be administered cautiously in patients with depression or other psychiatric disorders. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. For clinically significant or persistent symptoms, a dosage reduction or treatment withdrawal should be considered. If patients have symptoms of suicidal ideation or behavior, treatment should be discontinued.

References

  1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
  2. "Product Information. Klonopin (clonazepam)." Roche Laboratories (2001):
  3. "Product Information. Dilantin (phenytoin)." Parke-Davis (2001):
  4. "Product Information. Cerebyx (fosphenytoin)." Parke-Davis (2001):
  5. "Product Information. Mysoline (primidone)." Elan Pharmaceuticals (2001):
  6. "Product Information. Lyrica (pregabalin)." Pfizer U.S. Pharmaceuticals Group (2005):
  7. "Product Information. Sabril (vigabatrin)." Lundbeck Inc (2009):
  8. "Product Information. Potiga (ezogabine)." GlaxoSmithKline (2011):
  9. "Product Information. Qsymia (phentermine-topiramate)." Vivus Inc (2012):
  10. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  11. "Product Information. Briviact (brivaracetam)." UCB Pharma Inc (2016):
  12. "Product Information. Diacomit (stiripentol)." Biocodex USA (2018):
  13. "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC (2018):
  14. "Product Information. Fintepla (fenfluramine)." Zogenix, Inc (2020):
  15. "Product Information. Ztalmy (ganaxolone)." Marinus Pharmaceuticals, Inc (2022):
View all 15 references
Moderate

Aromatic antiepileptic drugs (applies to Trileptal) arrhythmias

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Cardiovascular Disease

Aromatic antiepileptic drugs such as phenytoin, carbamazepine, and oxcarbazepine, inhibit voltage- gated sodium channels and reduce membrane excitability in neurons and muscle and can be associated with cardiovascular effects. Individual agents have demonstrated AV heart block, including second and third-degree block following treatment. This occurred generally, but not solely in patients with underlying EKG abnormalities or risk factors for conduction abnormalities. Therapy with these agents should be considered and administered cautiously in patients with a history of cardiovascular disease and conduction abnormalities.

References

  1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
Moderate

Oxcarbazepine (applies to Trileptal) blood dyscrasias

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts

Rare events of pancytopenia, leukopenia, and agranulocytosis have been reported in patients treated with oxcarbazepine during postmarketing observations. Discontinuation of the drug should be considered if any evidence of these hematologic events develop. Therapy with oxcarbazepine should be administered with caution in patients with preexisting blood dyscrasias and/or bone marrow depression. Complete blood counts, including platelets and possibly reticulocytes and serum iron, should be performed prior to initiating therapy and regularly during therapy.

References

  1. "Product Information. Oxtellar XR (oxcarbazepine)." Supernus Pharmaceuticals Inc (2014):
Moderate

Oxcarbazepine (applies to Trileptal) thyroid dysfunction

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Thyroid Disease

Decreased values for thyroid function tests, especially T4 have been observed with the administration of oxcarbazepine. This should be taken into account in patients with thyroid disorders.

References

  1. "Product Information. Trileptal (oxcarbazepine)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Oxtellar XR (oxcarbazepine)." Supernus Pharmaceuticals Inc (2014):

Trileptal drug interactions

There are 548 drug interactions with Trileptal (oxcarbazepine).

Trileptal alcohol/food interactions

There is 1 alcohol/food interaction with Trileptal (oxcarbazepine).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.