Nausea oxcarbazepine

Oxcarbazepine Sedation Dizziness Ataxia Nausea Rash Hyponatremia... 

The most frequently reported side effects are dizziness, nausea, headache, diarrhea, vomiting, upper respiratory tract infections, constipation, dyspepsia, ataxia, and nervousness. It generally has fewer side effects than pheny-toin, valproic add, or carbamazepine. Hyponatremia has been reported in up to 25% ofpatients and is more likely in the elderly. About 25% to 30% of patients who have had a rash with carbamazepine will have a cross-reaction with oxcarbazepine. 

The safety and efficacy of oxcarbazepine 300 and 2400 mg/day have been studied in patients with refractory partial epilepsy in a double-blind, randomized trial (8). Dizziness, fatigue, somnolence, and nausea, mostly transient and mild to moderate, were the most frequent adverse events. 

Oxcarbazepine. Oxcarbazepine (10,11-dihydro-10-oxo-5i -dibenz [6,/] azepine-5-car-boxamide or 10,ll,dihydro-10-oxo carbamazepine, 12) was designed to avoid the dose-dependent side effects noted in some patients (e.g., nausea, headache, dizziness, ataxia, diplopia) and to minimize enzyme induction and drug-drug interactions displayed by carbamazepine (195,196). As shown previously (Fig. 6.3), the change in structure results in a difference in metabolism. Although both carbamazepine and oxcarbazepine are ultimately converted to the inactive trans diol, oxcarbazepine does not form the active 10,11-epoxide intermediate, but does form the active 10-hydroxy metabolite MHD (197). The mechanism of action of oxcarbazepine is very similar... 

I Adverse Effects. Oxcarbazepine has dose-related adverse effects of dizziness, sedation, headache, ataxia, fatigue, vertigo, abnormal vision, diplopia, nausea, vomiting, and abdominal pain. Hyponatremia has been reported in up to 3% of patients. 

Patients with hypersensitivity reactions to carbamazepine can be expected to show cross-sensitivity (e.g., rash) or related problems to oxcarbazepine. The improved toxicity profile for oxcarbazepine when compared to CBZ may result from absence of the epoxide or CBZ-iminoquinone metabolites (47). The most common side effects are headache, dizziness, nystagmus, blurred vision, somnolence, nausea, ataxia, and fatigue. The Incidence of adverse effects has been related to elevated serum MHD concentrations (52). Adverse effects on cognitive status, hyponatremia, and serious dermatological reactions have been reported, as has hyponatremia (53). 

A double-blind, randomised study in 8 healthy subjects found that oxcarbazepine 300 to 600 mg every 12 hours, given with felbamate 600 to 1200 mg every 12 hours for 10 days had no effect on the plasma levels of the major aetive metabolite of oxcarbazepine (monohydroxyoxcar-bazepine). However, the levels of dihydroxyoxcarbazepine (a minor, inactive metabolite) were reduced, and the maximum serum levels of oxearbazepine were reduced, by about 20%. Although these changes were eonsidered to be elinically irrelevant, the incidence of some adverse ef-feets (dizziness, somnolence, nausea, diplopia) rose during concurrent use. ... 

Oxcarbazepine (1000-2400 mg/day) and divalproex sodium (750-2000 mg/day) have been compared in a 12 week, randomized, double-blind pilot study in 60 patients with acute mania [218 ]. ITie median time to symptomatic remission of and the relapse rate did not differ. There were 22 adverse events in those who took oxcarbazepine group compared with 56 in those who took divalproex. The most common adverse events with oxcarbazepine were nausea (n = 5), dizziness (3), vomiting (4), sedation (3), and dyspepsia (3). 

Drug dosage regimens The efficacy and tolerability of an oral oxcarbazepine loading dose of 30 mg/kg was assessed in 40 adolescent and adult patients. The most common adverse effect was dizziness, followed by nausea/ vomiting, nystagmus, ataxia, and diplopia. Most of these adverse effects occurred shortly after administration, and did not correlate with plasma levels of the medication [113 ]. 

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