Trileptal, Oxtellar XR

Written by Helen Marshall, BPharm, MRPharmS
Medically reviewed by Victor Nguyen, PharmD, MBA
Updated on June 20, 2023

This article describes oxcarbazepine’s uses, side effects, and more. You’ll also find some coupon options to help save on the cost of oxcarbazepine.

The Food and Drug Administration (FDA) approves prescription drugs such as oxcarbazepine for certain conditions. Approved uses for oxcarbazepine are described below.

Use for seizures

Doctors may prescribe oxcarbazepine oral tablet and oral suspension for treating focal onset seizures in people with epilepsy. It’s used for this purpose in adults and children ages 2 years and older. It’s usually prescribed as a long-term treatment.

Focal onset seizures are also called partial seizures. They start in one part of the brain and can cause different symptoms depending on the part of the brain affected. A seizure typically lasts 1–2 minutes.

With focal onset seizures, you may have muscle twitching, stiffness, or weakness. Or you may have repetitive movements, such as unusual facial movements. You may also have strange sensations, or changes in your vision, smell, or taste. During a seizure, you may be aware of the seizure and your surroundings, or you may lose awareness.

Oxcarbazepine is taken every day to help reduce the number of focal onset seizures you have.

For adults and children ages 4 years and older, oxcarbazepine may be prescribed on its own or together with other antiepileptic drugs (AEDs). For children ages 2–4 years, it’s prescribed with other AEDs.

Below you’ll find answers to a few commonly asked questions about oxcarbazepine.

Can oxcarbazepine be used for bipolar disorder, trigeminal neuralgia, or sleep?

Yes, oxcarbazepine may be used for bipolar disorder or trigeminal neuralgia, but these are off-label uses of the drug. With off-label use, a drug is prescribed for a use that’s not approved by the Food and Drug Administration (FDA).

For bipolar disorder, which is a type of mood disorder, oxcarbazepine may be used to treat manic episodes. (With manic episodes, you experience extreme excitement or high energy.) The drug may also be used as a mood stabilizer to help prevent manic episodes in people with bipolar disorder. For trigeminal neuralgia, a nerve condition, oxcarbazepine may be used to relieve the severe facial pain this condition causes.

Oxcarbazepine is typically only prescribed for bipolar disorder or trigeminal neuralgia if other medications haven’t worked. To learn more about using oxcarbazepine for these conditions, talk with your doctor.

Oxcarbazepine is not prescribed for sleep. The medication commonly causes sleepiness, but it’s not suitable for use as a sleep aid. Talk with your doctor or pharmacist if you’re interested in taking a sleep aid.

What brand names are available for oxcarbazepine?

The brand-name version of oxcarbazepine oral tablet and oral suspension is called Trileptal.

Oxcarbazepine is also available as the brand-name drug Oxtellar XR, which is an extended-release tablet.* Generic versions of Oxtellar XR are not currently available.

If you’re interested in taking a brand-name version of oxcarbazepine, talk with your doctor.

* Extended-release tablets release their active drug slowly over time.

Is oxcarbazepine similar to carbamazepine?

Yes, oxcarbazepine is similar to carbamazepine (Tegretol, Carbatrol, others). These drugs have similar chemical structures. They’re both used to treat focal onset seizures in people with epilepsy. But there are some differences between them.

For example, carbamazepine is also approved to treat other types of seizures. And it’s approved for bipolar disorder and trigeminal neuralgia. However, it interacts with more medications than oxcarbazepine. It may also cause more side effects than oxcarbazepine.

To learn more about how oxcarbazepine compares with carbamazepine, talk with your doctor.

Does oxcarbazepine come as extended-release oral tablets?

No, generic oxcarbazepine doesn’t come as extended-release (ER)* oral tablets. It only comes as immediate-release (IR)* oral tablets and oral suspension. Oxtellar XR, a brand-name version of oxcarbazepine, comes as ER oral tablets. But generic versions of Oxtellar XR are not currently available.

If you’re interested in learning more about Oxtellar XR, talk with your doctor or pharmacist.

* ER tablets release their active drug slowly over time. IR tablets release their active drug all at once.

How does oxcarbazepine work? And how long does it take to start working?

Oxcarbazepine helps prevent focal onset seizures, also called partial seizures, in people with epilepsy. A focal onset seizure happens when there’s a sudden surge of electrical activity inside the nerve cells in one part of the brain. The surge makes the nerve cells send inappropriate messages to other parts of the body. This causes the symptoms of the seizure.

Oxcarbazepine works by stopping electrical activity building up in the nerve cells in your brain. This helps prevent surges that can cause focal onset seizures.

Oxcarbazepine starts working soon after you start taking it, but you might not notice this. Over time, you should notice that you’re having fewer seizures.

If you’d like to know more about how oxcarbazepine works, talk with your doctor or pharmacist.

Oxcarbazepine may cause mild or serious side effects. More common mild side effects of oxcarbazepine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about oxcarbazepine’s side effects, ask your doctor or pharmacist. You can also read the prescribing information* for oxcarbazepine.

* To view oxcarbazepine’s prescribing information, see the “Article resources” section.

Mild side effects

More common mild side effects reported with oxcarbazepine are listed below. These side effects may differ based on the form of oxcarbazepine you take.

This article doesn’t include all possible mild side effects of the drug. To learn more about oxcarbazepine’s side effects based on the form, see the prescribing information* for oxcarbazepine.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Mild side effects of oxcarbazepine oral tablet and oral suspension include:

• dizziness
• sleepiness
• changes in vision, such as seeing double
• nausea and vomiting
• mild allergic reaction†

* To view oxcarbazepine’s prescribing information, see the “Article resources” section.
† For details about this side effect, see the “Interactions and warnings for oxcarbazepine” section.

Serious side effects

Serious side effects of oxcarbazepine are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about oxcarbazepine’s side effects, see the prescribing information* for oxcarbazepine.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

Oxcarbazepine’s serious side effects include:

• low sodium levels
• blood cell problems, such as low levels of white blood cells
• serious skin reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis
• suicidal thoughts or behavior
• drug reaction with eosinophilia and systemic symptoms (DRESS), also known as multi-organ hypersensitivity, which is a rare type of drug reaction that may be fatal
• severe allergic reaction†

* To view oxcarbazepine’s prescribing information, see the “Article resources” section.
† For details about this side effect, see the “Interactions and warnings for oxcarbazepine” section.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Below, you’ll find information about oxcarbazepine’s possible interactions and warnings.

Interactions of oxcarbazepine

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take oxcarbazepine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription and over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for oxcarbazepine” section just below.

Warnings for oxcarbazepine

Some people should not take oxcarbazepine, and others should take it cautiously.

Oxcarbazepine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether oxcarbazepine is a safe option for you.

Ask your doctor about specific warnings for oxcarbazepine, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Oxcarbazepine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to oxcarbazepine or any of its ingredients, your doctor will likely not prescribe oxcarbazepine. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to oxcarbazepine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of oxcarbazepine

You should not take more oxcarbazepine than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much oxcarbazepine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and oxcarbazepine

Information about oxcarbazepine and pregnancy and breastfeeding is described below.

Oxcarbazepine and pregnancy

There are risks to taking oxcarbazepine during pregnancy. But there are also risks with having unmanaged epilepsy while pregnant. (Keep in mind that oxcarbazepine is used for treating focal onset seizures in people with epilepsy.)

If you’re planning a pregnancy or can become pregnant, talk with your doctor about seizure treatment options during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether or not you should take oxcarbazepine during pregnancy.

Oxcarbazepine and breastfeeding

It’s not known whether oxcarbazepine should be taken while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before taking this medication.

This article describes oxcarbazepine’s uses and side effects, ways to save on cost, and more. Let your doctor know if you have questions about oxcarbazepine or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Will I take oxcarbazepine with other antiepileptic drugs?
• Can oxcarbazepine affect my birth control?
• Does oxcarbazepine have any long-term side effects?

• Beydoun A, et al. (2020). Current role of carbamazepine and oxcarbazepine in the management of epilepsy. https://www.sciencedirect.com/science/article/pii/S1059131120303368
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Oxcarbazepine film-coated tablets, for oral use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/3e0f8d9f-7659-4524-8f93-6200314356c8/spl-doc
• Oxcarbazepine oral suspension. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/62ab716b-f05f-454d-95b3-1a382cdf7226/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.