Last update: Dec. 16, 2018

Oxcarbazepine

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

A derivative of carbamazepine with a very similar chemical structure and therapeutic action. It is rapidly and extensively metabolised to licarbazepine (MHD), its active metabolite.

It is excreted in breast milk in clinically insignificant amounts (Chen 2017, Lutz 2007, Bulau 1988) and no problems have been observed in infants whose mothers have taken it (Lutz 2007, Tomson 2007, Eisenschenk 2006, Gentile 2003, Bulau 1988). Plasma levels in these infants were very low, less than 5% of maternal plasma levels (Öhman 2009, Lutz 2007).

Carbamazepine (see specific information) is considered compatible with breastfeeding by the American Academy of Pediatrics (AAP 2001) and thus appears on the list of WHO essential medicines (WHO/UNICEF 2002).

Given the proven benefits of breastfeeding and despite the fact that there is a lack of reports on the safety of oxcarbazepine, several expert authors consider it safe to take during breastfeeding (Uguz 2016, Reimers 2014, Davanzo 2013, Bar-Oz 2000).

Furthermore, as an integral and important part of the experience of motherhood, the American Academy of Neurology and the American Academy of Pediatrics advise that mothers undergoing anti-epileptic treatment can breastfeed (Pack 2006).

Plasma levels of oxcarbazepine and its metabolite MHD decrease slightly during pregnancy and increase significantly in the immediate postpartum period. Therefore, close monitoring of these levels is required to adjust the dosage of the drug (Mazzucchelli 2006)


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Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

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Other names

Oxcarbazepine in other languages or writings:

Groups

Oxcarbazepine belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Oxcarbazepine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 252 daltons
Protein Binding 40 %
Tmax 5 hours
T1/2 2 - 9 hours
M/P ratio 0,5 - 0,7 -
Theoretical Dose 0,43 - 1,56 mg/Kg/d
Relative Dose 1,5 - 1,7 %

References

  1. Crettenand M, Rossetti AO, Buclin T, Winterfeld U. [Use of antiepileptic drugs during breastfeeding : What do we tell the mother?] Nervenarzt. 2018 Abstract
  2. Chen CY, Li X, Ma LY, Wu PH, Zhou Y, Feng Q, Cui YM. In Utero Oxcarbazepine Exposure and Neonatal Abstinence Syndrome: Case Report and Brief Review of the Literature. Pharmacotherapy. 2017 Abstract
  3. Uguz F, Sharma V. Mood stabilizers during breastfeeding: a systematic review of the recent literature. Bipolar Disord. 2016 Abstract
  4. Reimers A. New antiepileptic drugs and women. Seizure. 2014 Abstract Full text (link to original source) Full text (in our servers)
  5. Davanzo R, Dal Bo S, Bua J, Copertino M, Zanelli E, Matarazzo L. Antiepileptic drugs and breastfeeding. Ital J Pediatr. 2013 Abstract Full text (link to original source) Full text (in our servers)
  6. Rapcencu AE, Lindhout D, Bulk S. Frequently asked questions on epilepsy, pregnancy and lactation: a EURAP-NL report. Seizure. 2012 Abstract Full text (link to original source) Full text (in our servers)
  7. Öhman I, Tomson T. Pharmacokinetics of oxcarbazine in neonatal period and during lactation. Epilepsia. 2009;50 (Suppl 4):239. Abstract E700. 2009 Full text (link to original source) Full text (in our servers)
  8. Lutz UC, Wiatr G, Gaertner HJ, Bartels M. Oxcarbazepine treatment during breast-feeding: a case report. J Clin Psychopharmacol. 2007 Abstract
  9. Tomson T, Palm R, Källén K, Ben-Menachem E, Söderfeldt B, Danielsson B, Johansson R, Luef G, Ohman I. Pharmacokinetics of levetiracetam during pregnancy, delivery, in the neonatal period, and lactation. Epilepsia. 2007 Jun;48(6):1111-6. Epub 2007 Mar 22. Abstract Full text (link to original source) Full text (in our servers)
  10. Pack AM. Therapy insight: clinical management of pregnant women with epilepsy. Nat Clin Pract Neurol. 2006 Abstract
  11. Mazzucchelli I, Onat FY, Ozkara C, Atakli D, Specchio LM, Neve AL, Gatti G, Perucca E. Changes in the disposition of oxcarbazepine and its metabolites during pregnancy and the puerperium. Epilepsia. 2006 Abstract Full text (link to original source) Full text (in our servers)
  12. Eisenschenk S. Treatment with oxcarbazepine during pregnancy. Neurologist. 2006 Abstract
  13. Montouris G. Safety of the newer antiepileptic drug oxcarbazepine during pregnancy. Curr Med Res Opin. 2005 Abstract Full text (link to original source) Full text (in our servers)
  14. Tomson T. Gender aspects of pharmacokinetics of new and old AEDs: pregnancy and breast-feeding. Ther Drug Monit. 2005 Abstract
  15. Gentile S. Oxcarbazepine in pregnancy and lactation. Clin Drug Investig. 2003 Abstract
  16. Bar-Oz B, Nulman I, Koren G, Ito S. Anticonvulsants and breast feeding: a critical review. Paediatr Drugs. 2000 Mar-Apr;2(2):113-26. Review. Abstract
  17. Bülau P, Paar WD, von Unruh GE. Pharmacokinetics of oxcarbazepine and 10-hydroxy-carbazepine in the newborn child of an oxcarbazepine-treated mother. Eur J Clin Pharmacol. 1988 Abstract

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