How does it work?

This medicine contains the active ingredient oxcarbazepine, which is a medicine used to treat epilepsy. It works by stabilising electrical activity in the brain. The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly. When abnormally rapid and repetitive electrical signals are released in the brain, the brain becomes over-stimulated and normal function is disturbed. This can result in fits or seizures. Oxcarbazepine prevents epileptic fits by preventing the excessive electrical activity in the brain. It is thought to achieve this by preventing sodium from entering nerve cells when they begin to fire rapid and repetitive electrical signals. A build up of sodium in the nerve cells is necessary for the electrical signal to build up and be passed on to other nerve cells. As oxcarbazepine prevents this, it helps stabilise the electrical activity in the brain. Preventing the build-up of the electrical signal also prevents the release of a neurotransmitter called glutamate from the nerve cells in the brain. Neurotransmitters are chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells. Glutamate is a neurotransmitter that acts as a natural 'nerve-exciting' agent. It is released when electrical signals build up in nerve cells and subsequently excites more nerve cells. It is thought to play a key role in causing epileptic seizures. Reducing the release of glutamate from the nerve cells in the brain is another way in which oxcarbazepine may help stabilise the electrical activity in the brain and prevent epileptic fits. Oxcarbazepine is related to carbamazepine, and is also used by specialists as a mood stabiliser for treating people with the psychiatric illness, bipolar affective disorder (manic depression). This is an unlicensed use of oxcarbazepine. It is not fully understood how it works as a mood stabiliser, but is thought to be to do with the reduction of glutamate activity in the brain.

What is it used for?

Mood stabiliser in bipolar affective disorder (unlicensed use)

Partial seizures, with or without generalised tonic-clonic seizures

Warning!

This medicine may rarely cause a decrease in the normal amounts of blood cells in the blood. For this reason, if you experience any unexplained bruising, purple spots, bleeding, sore throat, mouth ulcers, high temperature (fever), feeling tired or general illness, you should consult your doctor immediately so that blood tests can be carried out to check for this.

You should not suddenly stop taking this medicine unless your doctor tells you otherwise.

This medicine may cause skin rashes and you should consult your doctor if you develop a rash, skin peeling, itching, or other unexplained skin reaction while taking this medicine.

This medicine can sometimes cause liver problems. Consult your doctor promptly if you develop unexplained itching, yellowing of the skin or eyes, unusually dark urine, nausea and vomiting, abdominal pains, loss of appetite or flu-like symptoms.

This medicine may cause low blood sodium levels (hyponatraemia), which can result in drowsiness, confusion, muscle twitching or convulsions. Consult your doctor if you develop any of these symptoms while taking this medicine.

This medicine may cause fatigue and dizziness. If affected, caution is required when driving or operating machinery due to the possible reduction in physical and/or mental ability.

This medicine is not recommended for children under six years of age.

25 to 30 percent of people who have experienced an allergic reaction (eg a severe skin reaction) to carbamazepine, may also experience an allergic reaction to oxcarbazepine. However, allergic reactions can also occur in people without a history of of carbamazepine allergy. Consult your doctor if you think you have experienced an allergic reaction, as you may need to stop taking this medicine.

You should exercise caution if you drink alcohol while taking this medicine, as this may increase the risk of drowsiness.

People with impaired kidney function and people taking other medicines that can reduce blood sodium levels (see below for further details) should have regular tests to monitor the amount of sodium in their blood while taking this medicine.

This medicine may decrease the effectiveness of hormonal contraceptives. It is recommended that women of childbearing age should therefore use an additional non-hormonal form of contraception, eg condoms, to prevent pregnancy.

Use with caution in

Decreased kidney function

Defect of the heart's electrical message pathways resulting in decreased function of the heart (heart block)

Elderly people

Heart failure

History of allergy to carbamazepine

Irregular heart beats (arrhythmias)

Low blood sodium levels (hyponatraemia)

Severely decreased liver function

Not to be used in

Breastfeeding

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

It is very important for women with epilepsy to talk to the doctor responsible for their epilepsy treatment before becoming pregnant. Antiepileptic medicines are associated with an increased risk of developmental disorders and malformations in the baby. However, stopping antiepileptic treatment during pregnancy runs the risk of the mother having seizures, which can harm both the mother and the foetus. This risk may be higher than that from continuing the medication. It is important that all the risks and benefits of treatment are weighed up. Seek medical advice from your doctor.

This medicine passes into breast milk and women taking this medicine should therefore not breastfeed. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Headache

Fatigue

Agitation

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain

Visual disturbances

Dizziness

Acne

Inflammation of the liver (hepatitis)

Chronic inflammatory disease which affects the skin and various internal organs (systemic lupus erythematosus)

Shaky movements and unsteady walk (ataxia)

Low blood sodium level (hyponatraemia)

Unstable moods (emotional lability)

Hair loss (alopecia)

Sleepiness (somnolence)

Weakness or loss of strength (asthenia)

Skin reactions such as rash and itch

Concentration or memory difficulties

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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