Oxcarbazepine Side Effects

Medically reviewed by Drugs.com. Last updated on Nov 4, 2024.

Applies to oxcarbazepine: oral suspension, oral tablet, oral tablet extended release.

Serious side effects of oxcarbazepine

Along with its needed effects, oxcarbazepine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking oxcarbazepine:

More common side effects

• change in vision
• change in walking or balance
• clumsiness or unsteadiness
• cough
• crying
• dizziness
• double vision
• false sense of well-being
• feeling of constant movement of self or surroundings
• fever
• mental depression
• sensation of spinning
• sneezing
• sore throat
• uncontrolled back-and-forth or rolling eye movements

Less common side effects

• agitation
• awkwardness
• bloody or cloudy urine
• blurred vision
• bruising
• confusion about identity, place, and time
• decreased urination
• difficulty with focusing the eyes
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fast or irregular heartbeat
• frequent falls
• frequent urge to urinate
• headache
• hoarseness
• increased thirst
• loss of consciousness
• memory loss
• muscle cramps
• pain or burning while urinating
• pain or tenderness around the eyes or cheekbones
• problems with coordination
• shaking or trembling of the arms, legs, hands, and feet
• seizures
• skin rash
• stuffy or runny nose
• tightness in the chest
• trouble with walking
• troubled breathing
• unusual feelings
• unusual tiredness or weakness

Rare side effects

• anxiety
• bleeding or crusting sores on the lips
• burning feeling in the chest or stomach
• chest pain
• chills
• hives or welts, itching
• irritability
• joint pain
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
• muscle pain or weakness
• purple spots on the skin
• rectal bleeding
• redness, blistering, peeling, or loosening of the skin
• restlessness
• sores, ulcers, or white spots in the mouth or on the lips
• stomach upset
• swelling of the legs
• swollen glands

Incidence not known

• black, tarry stools
• bloating
• constipation
• dark urine
• decrease in height
• decreased awareness or responsiveness
• difficulty swallowing
• dry skin and hair
• fainting
• feeling cold
• hair loss
• hostility
• indigestion
• loss of appetite
• loss of consciousness
• muscle stiffness or twitching
• nausea
• pain in the back, ribs, arms, or legs
• pains in the stomach, side, or abdomen, possibly radiating to the back
• pounding, slow heartbeat
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• rapid weight gain
• severe sleepiness
• swelling of the face, ankles, or hands
• swollen, painful, or tender lymph glands in the neck, armpit, or groin
• unusual bleeding or bruising
• unusual drowsiness, dullness, or feeling of sluggishness
• vomiting
• weight gain
• yellow eyes or skin

Other side effects of oxcarbazepine

Some side effects of oxcarbazepine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

• burning feeling in the chest or stomach
• sleepiness or unusual drowsiness
• stomach pain

Less common side effects

• acne
• back pain
• belching
• bloody nose
• change in your sense of taste
• diarrhea
• difficulty with speaking
• dryness of the mouth
• feeling of warmth and redness of the face, neck, arms, and occasionally chest
• heartburn
• increased sweating
• increased urination
• itching of the vagina
• trouble sleeping

For healthcare professionals

Applies to oxcarbazepine: oral suspension, oral tablet, oral tablet extended release.

General adverse events

The most commonly observed side effects were dizziness, somnolence, diplopia, fatigue, nausea, vomiting, ataxia, abnormal vision, abdominal pain, tremor, dyspepsia, abnormal gait, headache, balance disorder, and asthenia. In clinical trials in children aged 1 month to 4 years, the most commonly reported side effect was somnolence.

The side effects most commonly associated with discontinuation of oxcarbazepine included dizziness, vomiting, nausea, diplopia, and somnolence.^[Ref]

Nervous system

• Very common (10% or more): Abnormal gait, ataxia, dizziness, headache, nystagmus, somnolence, tremor
• Common (1% to 10%): Abnormal coordination, abnormal EEG, amnesia, ataxia, balance disorder, convulsions aggravated, cranial injury not otherwise specified, dysmetria, gait disturbance, hypoesthesia, impaired concentration, involuntary muscle contractions, speech disorder, taste perversion
• Frequency not reported: Aura, depressed level of consciousness, dystonia, extrapyramidal disorder, hemiplegia, hyperreflexia, hyperkinesia, hyporeflexia, hypokinesia, hypotonia, migraine, muscle hypertonia, neuralgia, oculogyric crisis, paralysis, syncope, tinnitus^[Ref]

The pattern of seizures following oxcarbazepine discontinuation suggests a rebound phenomenon rather than a loss of therapeutic efficacy.^[Ref]

Psychiatric

• Common (1% to 10%): Abnormal thinking, agitation, anxiety, apathy, confusion, depression, insomnia, emotional lability, nervousness
• Frequency not reported: Aggressive reaction, anguish, anxiety, aphasia, delirium, delusion, dysphonia, euphoria, hysteria, manic reaction, panic disorder, paroniria, personality disorder, psychosis, stupor, suicidal behavior and ideation^[Ref]

Pooled analyses of 199 placebo-controlled clinical trials of 11 different antiepileptic drugs lasting a median of 12 weeks showed that patients receiving antiepileptic drugs had approximately twice the risk of suicidal behavior or ideation (0.43%) compared to patients receiving placebo (0.22%). The increased risk of suicidal behavior and suicidal ideation was observed as early as one week after starting the antiepileptic drug and continued through 24 weeks.^[Ref]

Dermatologic

• Common (1% to 10%): Acne, alopecia, bruising, increased sweating, purpura, rash
• Uncommon (0.1% to 1%): Urticaria
• Very rare (less than 0.01%): Angioedema, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome)
• Frequency not reported: Contact dermatitis, eczema, erythematous rash, facial rash, folliculitis, genital pruritus, heat rash, maculopapular rash, photosensitivity reaction, psoriasis, purpura, skin procedure, vitiligo
• Postmarketing reports: Acute generalized exanthematous pustulosis (AGEP)^[Ref]

Patients with the Human Leukocyte Antigen (HLA) allele B*1502 or HLA-A*3101 may be at an increased risk for Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The presence of the HLA-A*3101 allele may also increase the risk for drug rash with eosinophilia (DRESS), or less severe acute generalized exanthematous pustulosis (AGEP) and maculopapular rash.

Rare cases of angioedema have been reported in patients after taking the first or subsequent doses of oxcarbazepine.^[Ref]

Hypersensitivity

• Common (1% to 10%): Allergy
• Very rare (less than 0.01%): Hypersensitivity (including multi-organ hypersensitivity), anaphylactic reactions
• Frequency not reported: Drug rash with eosinophilia and systemic symptoms (DRESS)^[Ref]

Rare cases of anaphylaxis have been reported in patients after taking the first or subsequent doses of oxcarbazepine.

Multi-organ hypersensitivity is generally characterized by signs and symptoms such as abnormal liver function tests, rash, and fever. Other organs or symptoms that may be affected include the blood and lymphatic system (e.g., lymphadenopathy, eosinophilia, leucopenia, splenomegaly), liver (e.g., abnormal liver function tests, hepatitis), muscles and joints (e.g., joint swelling, myalgia, arthralgia), nervous system (e.g., hepatic encephalopathy), kidney (e.g., proteinuria, interstitial nephritis, renal failure), and lungs (e.g., dyspnea, pulmonary edema, asthma, bronchospasms, interstitial lung disease).^[Ref]

Gastrointestinal

• Very common (10% or more): Abdominal pain, nausea, vomiting
• Common (1% to 10%): Constipation, diarrhea, dyspepsia, dry mouth, gastritis, rectum hemorrhage, toothache, upper abdominal pain
• Frequency not reported: Biliary pain, blood in stool, cholelithiasis, colitis, duodenal ulcer, dysphagia, enteritis, eructation, esophagitis, flatulence, gastric ulcer, gingival bleeding, gum hyperplasia, hematemesis, hemorrhoids, right hypochondrium pain, retching, sialoadenitis, stomatitis, ulcerative stomatitis, dental oral procedure
• Postmarketing reports: Pancreatitis^[Ref]

Cardiovascular

• Common (1% to 10%): Chest pain, generalized edema, hot flushes, hypotension, leg edema
• Very rare (less than 0.01%): Arrhythmia, atrioventricular block, hypertension
• Frequency not reported: Bradycardia, cardiac failure, cerebral hemorrhage, palpitation, postural hypotension, precordial chest pain, tachycardia^[Ref]

Genitourinary

• Common (1% to 10%): Urinary tract infection, micturition frequency, vaginitis
• Frequency not reported: Decreased/increased libido, dysuria, female reproductive procedure, intermenstrual bleeding, leukorrhea, menorrhagia, micturition frequency, polyuria, priapism, renal pain, urinary tract pain^[Ref]

Hematologic

• Common (1% to 10%): Lymphadenopathy
• Uncommon (0.1% to 1%): Leucopenia
• Very rare (less than 0.01%): Agranulocytosis, aplastic anemia, bone marrow depression, neutropenia, pancytopenia, thrombocytopenia^[Ref]

Hepatic

• Uncommon (0.1% to 1%): Increased blood alkaline phosphatase, increased hepatic enzymes
• Very rare (less than 0.01%): Hepatitis
• Frequency not reported: Increased GGT, increased serum transaminase^[Ref]

Immunologic

• Common (1% to 10%): Infection, viral infection
• Frequency not reported: Systemic lupus erythematosus^[Ref]

Metabolic

• Common (1% to 10%): Anorexia, hyponatremia, thirst, weight increase
• Frequency not reported: Decrease in T4 with unclear clinical significance, hyperglycemia, hypocalcemia, hypoglycemia, hypokalemia, hypothyroidism, increased appetite, tetany, weight decrease
• Postmarketing reports: Increased amylase, increased lipase^[Ref]

Hyponatremia associated with signs and symptoms such as seizures, confusion, depressed level of consciousness, encephalopathy, vision disorders, vomiting, nausea, and folic acid deficiency have been reported very rarely.^[Ref]

Musculoskeletal

• Common (1% to 10%): Back pain, muscle weakness, sprains and strains
• Frequency not reported: Musculoskeletal procedure
• Postmarketing reports: Decreased bone mineral density, osteopenia, osteoporosis and fractures (long-term therapy)^[Ref]

Ocular

• Very common (10% or more): Abnormal accommodation, abnormal vision, diplopia
• Common (1% to 10%): Blurred vision, visual impairment/disturbance
• Frequency not reported: Cataract, conjunctival hemorrhage, eye edema, hemianopia, mydriasis, photophobia, scotoma, xerophthalmia^[Ref]

Other

• Very common (10% or more): Fatigue, vertigo
• Common (1% to 10%): Asthenia, drug intolerance, earache, ear infection not otherwise specified, falling down not otherwise specified, feeling abnormal, fever
• Frequency not reported: Feeling drunk, malaise, otitis externa, ptosis, rigors^[Ref]

Renal

• Frequency not reported: Renal calculus^[Ref]

Respiratory

• Very common (10% or more): Upper respiratory tract infection
• Common (1% to 10%): Bronchitis, chest infection, coughing, epistaxis, nasopharyngitis, pneumonia, pharyngitis, rhinitis, sinusitis
• Frequency not reported: Asthma, dyspnea, hiccup, laryngismus, pleurisy^[Ref]

Further information

Oxcarbazepine side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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