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Oxcarbazepine (Trileptal) has been approved by the FDA as monotherapy or adjuvant therapy for treating partial-onset and generalized tonic-clonic seizures in adults and children older than 6 years. It also has mood stabilizing properties and is prescribed for treatment of bipolar disorders. Oxcarbazepine is less toxic than carbamazepine.

Oxcarbazepine is a prodrug, which is metabolized in the liver to form 10-hydroxycarbamazepine (MHD). MHD is the pharmacologically active compound that accumulates in plasma. Peak concentration is reached 5.5 +/-2.3 hours after dosing. The circulating half life is 8-12 hours. Clearance is reduced in individuals with renal insufficiency and increased in pregnancy.

Therapeutic drug monitoring can be helpful in establishing an individual’s optimal plasma concentration for controlling seizures without toxicity.

A wide range of serum concentrations, 3-35 ug/mL, have been effective in seizure treatment. Toxic side effects are more common when serum concentration exceeds 35 ug/mL.

Specimen requirement is one green top or red top tube of blood.

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