Drugs Q & A

Oxcarbazepine Vs. Carbamazepine: Which is Better?

Epilepsy is a brain condition that causes repeated episodes of sudden, brief changes in the brain’s electrical activity. These changes cause various types of symptoms.

Epileptic episodes are called seizures or convulsions. During a seizure, brain cells fire uncontrollably at up to four times their normal rate. Seizures temporarily affect the way a person behaves, moves, thinks, or feels.

There are many seizure medications that are now available. For 70% of patients with epilepsy, drugs can control seizures. However, they can’t cure epilepsy, and most people will need to continue taking medications.

An accurate diagnosis of the type of epilepsy (not just the type of seizure, because most seizure types occur in different types of epilepsy) a person has is very important in choosing the best treatment. The type of medication prescribed will also depend on several factors specific to each patient, such as which side effects can be tolerated, other illnesses they may have, and which delivery method is acceptable.

What is Carbamazepine?

Carbamazepine is a prescription drug. It comes in five oral forms: immediate-release tablet, extended-release tablet, extended-release capsule, chewable tablet, and suspension. It also comes in an intravenous (IV) form. Carbamazepine oral tablet is available as the brand-name drugs Tegretol, Tegretol XR, and Epitol. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

Carbamazepine belongs to a class of drugs called anticonvulsants. A class of drugs refers to medications that work similarly. It’s not completely known how this drug treats epilepsy or trigeminal nerve pain. It is known to block sodium currents in your brain and body. This helps to reduce abnormal electrical activity between your nerve cells.

Carbamazepine is used to treat two conditions:

•        certain types of seizures caused by epilepsy, these seizures include:

o       partial seizures

o       generalized tonic-clonic (grand mal) seizures

o       mixed seizure patterns, which include the seizure types listed here or other partial or generalized seizures

•        trigeminal neuralgia, a condition that causes facial nerve pain

What is oxcarbazepine?

Oxcarbazepine is a prescription drug, it is a chemical analog of carbamazepine that has a different metabolic profile that blocks sodium channels to stop seizures from spreading to the rest of the brain. It may also act on potassium and calcium in the brain to stop seizures.

Oxcarbazepine is used to treat partial seizures in people with epilepsy. The drug comes as an oral extended-release tablet, immediate-release tablet, and suspension.

Oxcarbazepine oral tablet is available as the brand-name drugs Trileptal and Oxtellar XR. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

The immediate-release tablet may be used alone or as part of a combination therapy with other medications to treat seizures. The extended-release tablet is always used with other medications.

Oxcarbazepine Vs. Carbamazepine

According to studies, the main advantage of oxcarbazepine arises from avoidance of the formation of carbamazepine-epoxide, the compound that is responsible for many of the adverse events experienced during carbamazepine treatment. Oxcarbazepine is better than carbamazepine because it follows a different metabolic pathway, which results in several clinical advantages.

Compared to other anti-epileptic drugs which are generally metabolized via the cytochrome P450 system, Oxcarbazepine has a reduced propensity for involvement in drug-drug interactions owing to its primarily reductive metabolism.

However, a systematic review, of three studies in which oxcarbazepine and carbamazepine treatment were compared directly reported that both drugs appear to be equally effective and to cause side effects equally often. But significantly fewer patients on carbamazepine developed nausea or vomiting during treatment.

Frequently Asked Questions about Oxcarbazepine

Does oxcarbazepine cause weight loss?

Both weight loss and weight gain are listed as side effects caused by oxcarbazepine. A study showed that children with seizures on oxcarbazepine alone showed significant weight gain. This medication has many side effects, such as loss of appetite, abdominal pain, etc., which can cause weight loss.

Does oxcarbazepine cause hair loss?

Hair loss or alopecia is one of the lesser-known side effects of oxcarbazepine. It occurs very rarely as a result of this drug. If you experience hair fall as a side effect, it is generally less severe.

How long does oxcarbazepine stay in your system?

Oxcarbazepine gets converted to licarbazepine during its metabolism in the liver. Licarbazepine is responsible for decreasing seizures. The half-life of oxcarbazepine is 1-5 hours, and the half-life of licarbazepine is 8-10 hours. Half-life is the time the body takes to eliminate half the drug.

Will oxcarbazepine affect getting pregnant?

There is not enough data that confirm the effects of oxcarbazepine on fertility. A study had inconclusively shown the results of this drug on the fetus. Few animal studies showed birth defects in animals exposed to oxcarbazepine during pregnancy.

Is oxcarbazepine a benzo?

No, oxcarbazepine is not a benzo (Benzodiazepine). It belongs to the class of drugs called anticonvulsants.

Is oxcarbazepine a narcotic?

No, it is not a narcotic. Narcotics are used to provide pain relief. Even though oxcarbazepine can provide relief for nerve pain, it is not considered a narcotic.

Is oxcarbazepine like Xanax?

Xanax (alprazolam) is a medication used to treat anxiety and panic disorders. It belongs to a group of drugs called benzodiazepines. Oxcarbazepine reduces the effects and the blood levels of Xanax. Therefore, it is useful in treating patients with benzodiazepine withdrawals.

Can divalproex sodium and oxcarbazepine be taken together?

Both are anticonvulsant drugs that can treat seizures. Divalproex sodium is also used for manic episodes and migraines. There are many drug interactions with both of these drugs. Therefore, it is essential to inform your doctor before taking one of them with the other.

How does oxcarbazepine cause urinary incontinence?

Urinary incontinence is not a known side effect of oxcarbazepine. It can cause other related side effects like urinary tract infections, excess urination, blood in urine, etc.

How does oxcarbazepine work for trigeminal neuralgia?

Trigeminal neuralgia is a condition that causes sudden and unilateral pain along the trigeminal nerve. Oxcarbazepine blocks the over-firing of the nerves and stabilizes the excited nerve membranes. Therefore, it can treat trigeminal neuralgia with fewer side effects.

Is oxcarbazepine a mood stabilizer?

Yes, oxcarbazepine can treat mood disorders like bipolar disorder. It is used during a manic episode of bipolar disorder and to prevent future manic episodes of bipolar disorder. One of the off-label uses of this drug is to stabilize the mood.

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