Oxcarbazepine (Trileptal)

Anticonvulsantprescriptionoral · inferred

Keto-analogue of carbamazepine and a prodrug rapidly reduced to its active metabolite 10-monohydroxy derivative (MHD/licarbazepine). Blocks voltage-gated sodium channels and modulates calcium currents. Used for partial seizures and off-label for bipolar disorder and trigeminal neuralgia. Does not undergo epoxide metabolism, giving it a cleaner side-effect profile than carbamazepine. Less CYP enzyme induction than carbamazepine but can cause hyponatremia.

Projected serum levels — 300 mg, twice daily

Oxcarbazepine (Trileptal) (precursor)

Maintenance schedule: 300 mg twice daily (oral).

Modeled steady state after ~1 days: peak ≈ 216 mg, trough ≈ 0.000 mg body load. Population-based estimate over 15 days for a 300 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category: Anticonvulsant
Route modeled: Oral
Model confidence: inferred
Half-life: 9.3 h
Common dose: 300 mg
Suggested maximum: 2.4k mg/day
Reference dose range: 150–2.4k mg (single dose)
Suggested cadence: twice daily
Validated against: 600 mg oral — Cmax 6.4 mg/L at 4.5 h

Documented interactions

danger
Esomeprazole (Nexium) + Oxcarbazepine (Trileptal) CYP inhibition
Oxcarbazepine (Trileptal) reversible_inhibitor of CYP2C19 predicted to change Esomeprazole (Nexium) AUC by ~2.07x
danger
Lansoprazole (Prevacid) + Oxcarbazepine (Trileptal) CYP inhibition
Oxcarbazepine (Trileptal) reversible_inhibitor of CYP2C19 predicted to change Lansoprazole (Prevacid) AUC by ~2.07x
danger
Omeprazole (Prilosec) + Oxcarbazepine (Trileptal) CYP inhibition
Oxcarbazepine (Trileptal) reversible_inhibitor of CYP2C19 predicted to change Omeprazole (Prilosec) AUC by ~2.27x
danger
Voriconazole (Vfend) + Oxcarbazepine (Trileptal) CYP inhibition
Oxcarbazepine (Trileptal) reversible_inhibitor of CYP2C19 predicted to change Voriconazole (Vfend) AUC by ~2.11x
warning
Azithromycin (Z-Pack / Zithromax) + Oxcarbazepine (Trileptal) QTc prolongation
Azithromycin (Z-Pack / Zithromax) and Oxcarbazepine (Trileptal) both prolong cardiac repolarisation (l type calcium channel and herg). Combined risk of QTc prolongation and torsades de pointes.
warning
Ciprofloxacin (Cipro) + Oxcarbazepine (Trileptal) QTc prolongation
Ciprofloxacin (Cipro) and Oxcarbazepine (Trileptal) both prolong cardiac repolarisation (l type calcium channel and herg). Combined risk of QTc prolongation and torsades de pointes.

Serum checks 251 modeled interaction pairings for oxcarbazepine (trileptal) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

A randomized, controlled clinical trial of oxcarbazepine versus phenytoin in children and adolescents with epilepsy Guerreiro MM et al. · Epilepsia, 1997 DOI
Multicenter RCT demonstrating oxcarbazepine was as effective as phenytoin for partial and generalized seizures in children, with significantly fewer adverse events and no need for blood monitoring.
Pharmacokinetics and metabolism of oxcarbazepine and its active metabolite May TW et al. · Therapeutic Drug Monitoring, 2003 DOI
Comprehensive PK study establishing rapid conversion of oxcarbazepine to MHD (parent half-life ~2h), MHD half-life of 8-10 hours, and linear pharmacokinetics across the therapeutic dose range.
Oxcarbazepine in bipolar disorder: a critical review of the literature Vasudev A et al. · Bipolar Disorders, 2011 DOI
Systematic review of 19 studies found moderate evidence supporting oxcarbazepine as adjunctive therapy for acute mania, with limited but promising data for bipolar depression.

3 published studies referenced in the app, each with a plain-language summary.