What are the side effects of oxcarbazepine?

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From the Guidelines

Oxcarbazepine can cause several side effects, including dizziness, drowsiness, and allergic skin reactions, and patients should be aware of these potential effects before starting treatment. The side effects of oxcarbazepine are significant and can impact a patient's quality of life, morbidity, and mortality. According to a recent study 1, patients receiving oxcarbazepine treatment may experience dizziness, which can disturb daily activities, and this side effect can be minimized by taking the medication at bedtime.

Common Side Effects

  • Dizziness
  • Drowsiness
  • Headache
  • Nausea
  • Vomiting
  • Double vision
  • Fatigue
  • Unsteadiness when walking

Serious Side Effects

  • Hyponatremia (low sodium levels), which may cause confusion, increased seizures, or severe weakness
  • Allergic skin reactions such as rash or hives
  • Rarely, severe cutaneous adverse reactions like Stevens-Johnson syndrome, particularly in the Han Chinese population, which can be reduced by implementing HLA-B*15:02 screening before initiating treatment 1

Other Considerations

  • Oxcarbazepine can interact with hormonal contraceptives, potentially reducing their effectiveness
  • Blood monitoring may be needed periodically to check sodium levels, especially during the first few months of treatment
  • Cognitive effects like difficulty concentrating or memory problems can occur in some patients

It is essential to weigh the benefits and risks of oxcarbazepine treatment and to individualize the dosage and treatment plan for each patient, as the extent of satisfaction with the treatment is subjective and individualized 1. If severe side effects occur, patients should contact their healthcare provider immediately rather than stopping the medication abruptly, as sudden discontinuation can trigger seizures.

From the FDA Drug Label

What are the possible side effects of oxcarbazepine tablets? Oxcarbazepine tablets may cause other serious side effects including: • trouble concentrating • problems with your speech and language • feeling confused • feeling sleepy and tired • trouble with walking and coordination • seizures that can happen more often or become worse, especially in children The most common side effects of oxcarbazepine tablets include: • dizziness • sleepiness • double vision • tiredness • nausea • vomiting • problems with vision • trembling • problems with walking and coordination (unsteadiness) • rash

The side effects of oxcarbazepine include dizziness, sleepiness, double vision, tiredness, nausea, vomiting, problems with vision, trembling, problems with walking and coordination, and rash. Additionally, oxcarbazepine may cause trouble concentrating, problems with speech and language, feeling confused, feeling sleepy and tired, trouble with walking and coordination, and seizures that can happen more often or become worse, especially in children 2.

  • Serious side effects may include anaphylactic reactions, angioedema, cross hypersensitivity reaction to carbamazepine, serious dermatological reactions, suicidal behavior and ideation, multi-organ hypersensitivity, and hematologic events 2.
  • Patients should be advised to report any side effects to their healthcare provider immediately.

From the Research

Side Effects of Oxcarbazepine

The side effects of oxcarbazepine are primarily related to the central nervous system and the gastrointestinal system. Some of the most common side effects include:

  • Dizziness 3, 4, 5, 6, 7
  • Headache 3, 4
  • Diplopia (double vision) 3, 5, 7
  • Ataxia (loss of coordination) 3
  • Nausea and vomiting 3, 4, 5, 6, 7
  • Fatigue 5, 7
  • Somnolence (drowsiness) 4, 6, 7
  • Rash (skin adverse reaction) 5, 6

Less Common Side Effects

Some less common side effects of oxcarbazepine include:

  • Hyponatremia (low sodium levels in the blood) 3, 4, 5, 6, 7
  • Neurotoxicity 7
  • Cutaneous hypersensitivity reactions 7
  • Cardiotoxicity (rare) 7
  • Agranulocytosis or aplastic anemia (not reported) 7

Special Considerations

It is essential to monitor patients taking oxcarbazepine for the development of hyponatremia, neurotoxicity, or cutaneous hypersensitivity reactions 7. Additionally, oxcarbazepine has a lower propensity for drug interactions compared to older antiepileptic drugs, but it can still interact with certain medications, such as phenytoin and oral contraceptives 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Oxcarbazepine, an antiepileptic agent.

Clinical therapeutics, 2001

Research

[Adverse effects of oxcarbazepine].

Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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