Home Drug Guide Eslicarbazepine Acetate

Drug Guide

Generic Name

Eslicarbazepine Acetate

Brand Names Aptiom

Classification

Therapeutic: Anticonvulsant, Antiepileptic drug

Pharmacological: Voltage-gated sodium channel blocker

FDA Approved Indications

Partial-onset seizures

Mechanism of Action

Eslicarbazepine acetate inhibits voltage-gated sodium channels, stabilizing neuronal membranes and reducing seizure activity.

Dosage and Administration

Adult: Start with 400 mg once daily, titrate gradually up to a maximum of 1200 mg/day based on response and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; dose adjustments may be necessary based on renal function.

Renal Impairment: Reduce dose in patients with significant renal impairment; consult prescribing information.

Hepatic Impairment: Use with caution; no specific dosing recommendations available.

Pharmacokinetics

Absorption: Well absorbed with oral administration.

Distribution: Widely distributed; approximately 40% plasma protein binding.

Metabolism: Metabolized primarily via hydrolysis to eslicarbazepine, with minor metabolism via CYP3A4.

Excretion: Excreted mainly in urine.

Half Life: Approximately 13-20 hours, allowing once-daily dosing.

Contraindications

Hypersensitivity to eslicarbazepine or related drugs.

Precautions

Use with caution in patients with a history of hematologic disorders, hypersensitivity reactions, or dịhormonal interactions.
Monitor for signs of hypersensitivity and blood dyscrasias.
Adjust dose in renal impairment; not studied in severe hepatic impairment.

Adverse Reactions - Common

Dizziness (Common)
Drowsiness (Common)
Nausea (Common)
Vomiting (Common)

Adverse Reactions - Serious

Hematologic reactions (e.g., leukopenia, anemia) (Uncommon)
SJS/TEN (Stevens-Johnson Syndrome / Toxic Epidermal Necrolysis) (Rare)
Aseptic meningitis (Rare)

Drug-Drug Interactions

Increases in other CNS depressants may enhance sedation.
CYP3A4 inhibitors or inducers may alter eslicarbazepine levels.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor seizure frequency, blood counts, hepatic and renal function.

Diagnoses:

Risk for injury due to dizziness or somnolence.
Risk for bleeding (hematologic effects).

Implementation: Administer once daily with or without food. Monitor for adverse effects and adherence.

Evaluation: Assess seizure control and monitor for adverse reactions regularly.

Patient/Family Teaching

Take medication exactly as prescribed.
Avoid alcohol and CNS depressants unless approved by healthcare provider.
Report signs of allergic reactions, skin rash, or unusual bleeding.
Do not stop medication abruptly.

Special Considerations

Black Box Warnings:

Serious hypersensitivity reactions, including SJS/TEN and toxic epidermal necrolysis.
Aseptic meningitis has been reported.

Genetic Factors: Genetic variations in drug metabolism may influence response.

Lab Test Interference: Can cause hyponatremia; monitor serum sodium.

Overdose Management

Signs/Symptoms: Dizziness, drowsiness, ataxia, gastrointestinal symptoms, atrioventricular block in severe cases.

Treatment: Supportive care, activated charcoal if indicated, maintain airway; hemodialysis may be considered in severe cases.

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable under recommended storage conditions for the duration of the expiration date.