Vomiting oxcarbazepine

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. 

Two doses of oxcarbazepine have been compared in a double-blind, parallel-group, randomized trial in patients with uncontrolled partial-onset epilepsy who had previously taken carbamazepine monotherapy (10). After two open phases in 143 patients, 96 were randomized to oxcarbazepine 300 or 2400 mg/day for 126 days. The time to meet an exit criterion was significantly in favor of oxcarbazepine 2400 mg/day. In aU, 24 of the 47 non-rando-mized patients withdrew because of an adverse event, most commonly dizziness, ataxia, headache, nansea, vomiting, or fatigne. Three withdrew becanse of laboratory abnormalities, one each with leukopenia, hjrponatre-mia, and hjrperglycemia. Headache, dizziness, and nansea were the only adverse events that occurred in more than 10% in either gronp. Similar adverse events were reported in the randomized patients, but none withdrew. 

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. 

A 10-year-old boy with refractory epilepsy developed symptoms and signs of oxcarbazepine toxicity (vomiting, drowsiness, hyperkinesia, ataxia, and nystagmus) after two doses of clarithromycin 250 mg. The symptoms resolved on withdrawal of the clarithromycin. 

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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