As with other antiepileptic drugs, oxcarbazepine should be tapered gradually over several weeks to avoid rebound seizures. Dosage and administration
The usual starting dose of oxcarbazepine is 300 mg daily, and the dose is increased by 300 mg daily every few days as the patient tolerates (see Table.! for dosage forms). The recommended dosage is 600 to 1200 mg/day, given in two or three divided doses. However, doses up to 5400 mg/day have been used. The dose should be halved in patients with severe renal impairment. Patients can be converted from carbamazepine to oxcarbazepine by gradually replacing each 200 mg of carbamazepine with 300 mg of oxcarbazepine, and then titrating to clinical efficacy and tolerability. However, some clinicians prefer to stop carbamazepine abruptly, then immediately start the full dose of oxcarbazepine. Therapeutic blood levels have not been established, and therefore oxcarbazepine is titrated to efficacy and tolerability.
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