Serious side effects of oxcarbazepine are rare. It is important to be aware of possible reactions and what to do if they happen. Call your provider's office right away if any of these problems occur.
Allergic Reactions: If you have signs of an allergic reaction - such as a rash, itchiness, swelling or difficulty breathing - call your doctor immediately or go to an emergency room.
- Tell your provider if you have ever had an allergic reaction to carbamazepine or eslicarbazepine. You could have a similar reaction to oxcarbazepine.
Hyponatremia: There is a small chance that you may develop a low sodium or salt level in your blood when taking oxcarbazepine (called hyponatremia).
- It is more likely to happen in older adults, but can happen in people at any age.
- It is more likely to happen within the first few months of taking the medicine, but can happen at any time.
- You may need to have blood tests to check levels of sodium or salt.
- Symptoms of hyponatremia may include:
- Decreased urination
- More seizures
- Tired, lack of energy
- Oxcarbazepine may cause these symptoms and not be related to low sodium. Or they may be related to another medicine or health problem. Call your provider if any of these symptoms happen.
Severe skin reactions: Oxcarbazepine may cause rare but serious skin reactions, such as Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). These conditions may start with a fever and flu-like symptoms. Then a rash develops. Ulcers or lesions of the mucous membranes may be seen and develop into painful blisters blisters.
- Report any fever or rash to a health care provider, as this can be a life-threatening condition.
- These types of skin reactions happen most commonly in the second or third week after starting the medicine. Though it can happen at other times too.
- Serious skin reactions are more common in people with a particular type of gene, called "HLA-B*1502 allele. (An allele is a form of a gene that is found on a chromosome. Alleles are involved in deciding whether certain traits passed on from a parent to a child will occur. The tendency to severe drug reactions can be one of these traits.)
- This gene is found in people with ancestry or family lines from broad areas of Asia, including South Asian Indians. People who are Chinese, Thai, Filipino, Malyasian, and Korean may have an increased risk for these skin reactions with oxcarbazepine.
- People at risk should be tested for the HLA-B*1502 allele before starting oxcarbazepine. If you test positive, you should avoid using this medicine unless your provider and you decide the benefits are work the risks.
Suicidal thoughts and behavior: In 2008, the Food and Drug Administration (FDA) reviewed data from drug studies that showed a possible relation between many seizure medications (called antiepileptic drugs or AEDs) and suicidal thoughts and behavior. These thoughts and behavior are called suicidality. According to an FDA Alert, among the patients with epilepsy in these drug studies, more had symptoms of suicidality than people taking a placebo or inactive substance - 3.5 of 1,000 people taking an AED had suicidality compared to 1 of 1,000 people taking a placebo.
- Taking seizure medicines may increase the risk of having suicidal thoughts or actions.
- Do not make any changes to the medicines taken without first talking to the prescribing health care provider.
- Pay close attention to any day-to-day changes in mood, behavior and actions. These changes can happen very quickly so it is important to be mindful of any sudden differences.
- Be aware of common warning signs that might be a signal for risk of suicide. Some of these are:
- Talking or thinking about wanting to hurt yourself or end your life
- Withdrawing from friends and family
- Becoming depressed or having your depression get worse
- Becoming preoccupied with death and dying
- Giving away prized possessions
- Contact your health care provider before stopping any seizure medicine. This could possibly lead to worsening of seizures and mood.
Multi-organ hypersensitivity: This is a serious rare drug reaction that has been seen with oxcarbazepine.
- Typically it starts with a fever, rash, and/or swollen lymph nodes.
- Other body organs may become involved, for example the liver, kidneys, blood, heart or muscles.
- An increase in certain blood cells called eosinophils may be seen. Eosinophils are a type of white blood cells.
- If any of these symptoms or signs occur, get immediate medical help. A rash does not need to occur to be a drug reaction.
- Oxcarbazepine may need to be stopped if no other cause for the symptoms is found. Make sure the doctor treating your seizures is aware of the reaction and is involved in decisions about your seizure medication.