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Tips for tapering off Trileptal (oxcarbazepine)

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Altostrata

AKA Trileptal, Oxtellar XR

 

As with all psychiatric drugs, oxcarbazepine must be tapered for safe discontinuation.

 

We recommend a 10% taper per month, based on the last dosage you took. If you get withdrawal symptoms from a 10% taper, go down by smaller amounts. See Important topics in the Tapering forum, particularly http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

Oxcarbazapine contributes to many drug-drug conflicts via the P450 liver enzymes pathways. P450 cyp conflicts are among the easiest of adverse effect sources to identify.

 

For example, oxcarbazpine speeds the metabolization of diazepam and other benzodiazepines, see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1885026/  Lowering the blood level of a benzodiazepine may have the effect of reducing the benzo dosage, causing withdrawal symptoms from the benzo.

 

This Drug Interactions Checker http://www.drugs.com/drug_interactions.html is partly based on P450 conflcts. If you are taking any other drugs with oxcarbazine, put them all in the Drug Interactions Checker to see which is causing the most problems. This will indicate which to taper first.

 

Oxcarbazapine may have many side effects, including gut distress and arrhythmia, see Trileptal adverse effects

 

With its active metabolite, oxcarbazapine has a fairly short half-life of 7-20 hours.

From FDA information http://www.drugs.com/pro/trileptal.html, oxcarbazepine comes in

- 150 mg tablets that are scored (you can split the tablets)
- a liquid form:
 

Quote
300 mg/5 mL (60 mg/mL) Oral Suspension: off-white to slightly brown or slightly red suspension. Available in amber glass bottles containing 250 mL of oral suspension. Supplied with a 10 mL dosing syringe and press-in bottle adapter.

Bottle containing 250 mL of oral suspension……………………………………………………………NDC 0078-0357-52

Store Trileptal oral suspension in the original container. Shake well before using.

Use within 7 weeks of first opening the bottle.

Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature].

 

 

More information about oxycarbazapine https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4c5c86c8-ab7f-4fcf-bc1b-5a0b1fd0691b

 

Taper by splitting tablets

Oxcarbazepine tablets are scored, that means they're meant to be split. But since a quarter of a tablet (37.5mg) is the lowest dose you can get with a tablet, tapering with the liquid would be a lot easier, particularly at lower dosages.

 

Use a digital scale to weigh doses
If you cannot get the liquid and you are very sensitive to dosage reductions, you may wish to weigh tablet fragments, see Using a digital scale to measure doses

 

Tapering by using the liquid

The NDC number NDC 0078-0357-52 is the ordering number. Give the NDC number to your doctor.

 

Using a combination of tablets and liquid

Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.

 

If your doctor prescribes liquid and tablets at the same time, most likely, he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.

Edited by Altostrata
updated

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