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Posted by Pharmacist Nguyen Le Thuy Dung - Clinical Pharmacist - Vinmec Central Park International General Hospital
Trileptal contains the active ingredient oxcarbazepine, which is used to treat epilepsy in children and adults. In Vietnam, Trileptal is circulated in the form of 300mg film-coated tablets and 60mg/ml oral suspension.
1. Indications for use of the drug Trileptal 300mg Trileptal drug contains the active ingredient oxcarbazepine, which is a seizure medicine for children and adults. Accordingly, Trileptal is indicated as follows:
For adults: Trileptal is used as monotherapy or in combination in the treatment of partial seizures. For children 4 years of age and older: Trileptal is used as monotherapy in partial seizures with seizures. For children 2 years of age and older: Trileptal is used in combination for the treatment of patients with partial seizures.
2. Dosage, how to use Trileptal 2.1. Dosage, how to use Trileptal Start with a dose of 600mg / day divided into 2 times. The dose can be increased to a maximum of 600mg/day with an interval of 1 week. The maximum dose used for trileptal is 2400 mg/day.
Combination therapy: start with a dose of 600mg/day divided into 2 times. The dose may be increased to a maximum of 600 mg/day according to clinical response and the interval between 2 dose increases is 1 week. Maximum dose: 1200mg/day. Conversion to monotherapy: Initiate trileptal at 600 mg/day in 2 divided doses and initiate a reduction in the concomitant antiepileptic drug dose within 3-6 weeks. The maintenance dose of trileptal should be achieved after 2-4 weeks and the maximum dose of trileptal is 2400 mg/day. Initiation of monotherapy: start with 600 mg/day in 2 divided doses. The dose may be increased by 300 mg/day every 3 days up to 1200 mg/day.
Trileptal 300mg là một thuốc điều trị động kinh cho trẻ em và người lớn
2.2. For children Initiation of treatment (children aged 4-16 years): Start trileptal at a dose of 8-10mg/kg/day in 2 divided doses. Increase by 5mg/kg/day every 3 days until the recommended dose is reached:
| Cân nặng (kg) | Liều duy trì Trileptal/ngày (mg) |
| 20 đến < 25 | 600-900 |
| 25 đến < 35 | 900-1200 |
| 35 đến < 45 | 900-1500 |
| 45 đến < 55 | 1200-1800 |
| 55 đến < 65 | 1200-2100 |
Table 1: Recommended maintenance dose of Trileptal monotherapy for children 4-16 years of age.
Combination therapy (children from 4-16 years old): use Trileptal at a dose of 8-10mg/kg (not more than 600mg/day) divided into 2 times. The maintenance dose of Trileptal should be achieved within 2 weeks and according to the child's weight:
| Cân nặng (kg) | Liều duy trì Trileptal/ngày (mg) |
| 20 đến 29 | 900 |
| 29.1 đến 39 | 1200 |
| > 39 | 1800 |
Table 2: The recommended maintenance dose of Trileptal in combination therapy for children 4-16 years of age.
Combination therapy (children aged 2-4 years):
For patients < 20 kg, start with a dose of 16-20 mg/kg divided into 2 times/day For patients > 20 kg, start with a dose of 8-10 mg/ kg (max: 600mg/day) divided into 2 times. The maintenance dose of Trileptal should be achieved over 2-4 weeks and the maximum should not exceed 60mg/kg/day.
Conversion to monotherapy: (children aged 4-16 years): Initiate trileptal at a dose of 8-10 mg/kg/day in 2 divided doses and reduce the dose of concomitant antiepileptic drugs within 3-6 weeks. . Increase trileptal dose to a maximum of 10 mg/kg/day every 1 week to achieve maintenance dose. Weight-dependent maintenance doses are shown in Table 1.
3. How to use Trileptal With Trileptal tablet form, there is a notch on the tablet, so it can be broken into two halves to help patients swallow the pill easier. It should be noted that the time of taking the drug does not depend on the meal.
For young children or patients who cannot swallow, Trileptal suspension should be used.
4. Caution when using Trileptal According to research, about 25-30% of patients who have ever had a hypersensitivity reaction to carbamazepine may be sensitive to Trileptal. Serious skin reactions such as Steven Johnson, toxic epidermal necrolysis (Lyell) or erythema multiforme have been reported in patients receiving trileptal, although very rarely. Oxcarbazepine should not be used in HLA-B*1502-positive patients unless the benefits outweigh the risks. Hypothyroidism is a rare adverse reaction to trileptal. Thyroid function should be assessed prior to initiation of therapy and thyroid function periodically monitored when Trileptal is used in children. Similar to other epilepsy medications, Trileptal slightly increases the risk of suicidal behavior and intentions. Patients should be monitored and a physician should be consulted if these signs are present. In addition, patients should not suddenly stop taking the drug, but should gradually reduce the dose as prescribed by the treating doctor to reduce the risk of increasing the frequency of seizures.
Thời điểm dùng thuốc Trileptal 300mg không phụ thuộc bữa ăn
5. Undesirable effects when taking Trileptal Some unwanted side effects during taking Trileptal can be mentioned as:
Common effects: (> 10% of patients) drowsiness, headache , dizziness, double vision, nausea, vomiting, double vision,... Common effects (from 1-10% of patients): weight gain, hyponatremia, ataxia, tremor, attention disorder, lost memory . Uncommon effects (1 per thousand-1%): leukopenia, urticaria Very rare effects: steven johnson syndrome, hepatitis toxic epidermal necrolysis, increased amylase, increased lipase 6. Drug interactions Some drug interactions occur during the use of the drug:
Hormonal contraceptives: When using Trileptal with hormonal contraceptives, it may make the contraceptive ineffective. It is recommended that you use non-hormonal methods of contraception when using Trileptal. Alcohol: may increase the side effects of drowsiness when taken with trileptal
7. Should Trileptal be used for pregnant and lactating women? For pregnant women: Although data are limited, the use of Trileptal has been observed to cause serious fetal malformations such as left ventricular septal defect, atrioventricular septal defect, cleft palate. cleft lip, Down syndrome ....However, stopping the use of effective antiepileptic drugs can aggravate the disease, harmful to both mother and fetus. Therefore, the use of Trileptal during pregnancy should be weighed together by the physician and patient regarding the risks and benefits.
For nursing women: Trileptal and its metabolites are excreted in human milk. The effect on infants exposed to trileptal via breast milk is unknown. Therefore, the drug should not be used during breastfeeding.
In summary, Trileptal contains the active ingredient oxcarbazepine, which is an epilepsy medication for children and adults. To use effectively and avoid side effects, patients need to strictly follow the instructions of the doctor or pharmacist.
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