Pharmacokinetics

Oxcarbazepine is rapidly absorbed and rapidly converted to its active metabolite, 10,11-dihydro-10-hydroxy-carbamazepine ( DHC), by a non-inducible cytosolic enzyme in the liver. The half-life of the parent compound is 1 to 3 h, while the half-life of DHC is between 8 and 11 h. The peak plasma concentration of DHC is reached approximately 8 h after ingestion. Plasma protein binding is 40 to 60 per cent for both oxcarbazepine and DHC. Almost all the drug is excreted in the urine as the glucuronide conjugate of DHC. Oxcarbazepine appears to induce only the cytochrome P-450 IIIA isoenzyme, which is involved in the metabolism of oestrogens and calcium-channel blockers (see later). The drug does not induce or inhibit other liver enzymes, resulting in far fewer drug interactions than carbamazepine. (26> Patients with renal impairment may have reduced clearance of the drug, and therefore are likely to benefit from dosage reduction. (27,)

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