Adult: As monotherapy or adjunctive therapy: Initially, 600 mg daily in 2 divided doses, may increase if necessary in max increments of 600 mg daily at wkly intervals. Maintenance dose: 600-1,200 mg daily or up to 2,400 mg daily in adjunctive therapy or in refractory patients switched from other antiepileptics.
Child: ≥6 yr 8-10 mg/kg daily in 2 divided doses, may increase if necessary in increments of 10 mg/kg daily at wkly intervals. Maintenance dose: 30 mg/kg daily in adjunctive therapy. Max: 46 mg/kg/day.
|CrCl (ml/min)||Dosage Recommendation|
|<30||Initially, 300 mg daily, increased at wkly intervals or longer.|
Special Populations: Pharmacogenomics: Human leukocyte antigen B (HLA-B) variant allele HLA-B*15:02 is associated with the development of serious cutaneous adverse reactions [e.g. Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)] to aromatic anticonvulsants (e.g. carbamazepine, lamotrigine, phenytoin, phenobarbital). The prevalence of this allele has been estimated in 6.9% of East Asians, 5.5% of Oceanians, 4.6% of South/Central Asians, <1% of Japanese, <2.5% of Koreans, rare in Africans, and <1% of African Americans, Middle Easterners, Caucasians, Hispanic/South Americans. Patients who are positive to HLA-B*15:02 allele may have greater risk of developing SJS/TEN when treated with oxcarbazepine. CPIC strongly recommends avoiding use of oxcarbazepine, and cautiously consider alternative aromatic anticonvulsant therapy in these patients. Consider genetic screening prior to initiation of therapy. The latency period for SJS/TEN is short with continuous dosing of approx 4-28 days, and ADR usually occur within 3 months of use. Therefore, if patient previously used oxcarbazepine consistently for more than 3 months without incidence of SJS/TEN, cautiously consider use of oxcarbazepine in the future. However, tolerance to oxcarbazepine is not indicative of tolerance to other aromatic anticonvulsants.