Is Oxcarbazepine compatible with breastfeeding? Do we have alternatives for Oxcarbazepine?

Oxcarbazepine

July 16, 2017 (Very Low Risk)

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 (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)


See below the information of these related products:

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Writings

  • οξυκαρβαζεπίνη (Greek)
  • أوكسكاربازيبين (Arabic)
  • Окскарбазепин (Cyrillic)
  • 奥卡西平 (Chinese)
  • オキサカルバゼピン (Japanese)
  • C15H12N2O2 (Molecular formula)
  • GP-47680 (Experimental code/s)
  • KIN-493 (Experimental code/s)

Drug trade names

References

  1. Uguz F, Sharma V. Mood stabilizers during breastfeeding: a systematic review of the recent literature. Bipolar Disord. 2016Abstract
  2. Reimers A. New antiepileptic drugs and women. Seizure. 2014Abstract Full text (link to original source) Full text (in our servers)
  3. Davanzo R, Dal Bo S, Bua J, Copertino M, Zanelli E, Matarazzo L. Antiepileptic drugs and breastfeeding. Ital J Pediatr. 2013Abstract Full text (link to original source) Full text (in our servers)
  4. Rapcencu AE, Lindhout D, Bulk S. Frequently asked questions on epilepsy, pregnancy and lactation: a EURAP-NL report. Seizure. 2012Abstract Full text (link to original source) Full text (in our servers)
  5. 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)
  6. Lutz UC, Wiatr G, Gaertner HJ, Bartels M. Oxcarbazepine treatment during breast-feeding: a case report. J Clin Psychopharmacol. 2007Abstract
  7. 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. 2007Abstract Full text (link to original source) Full text (in our servers)
  8. 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. 2006Abstract Full text (link to original source) Full text (in our servers)
  9. Eisenschenk S. Treatment with oxcarbazepine during pregnancy. Neurologist. 2006Abstract
  10. Pack AM. Therapy insight: clinical management of pregnant women with epilepsy. Nat Clin Pract Neurol. 2006Abstract
  11. Tomson T. Gender aspects of pharmacokinetics of new and old AEDs: pregnancy and breast-feeding. Ther Drug Monit. 2005Abstract
  12. Montouris G. Safety of the newer antiepileptic drug oxcarbazepine during pregnancy. Curr Med Res Opin. 2005Abstract Full text (link to original source) Full text (in our servers)
  13. Gentile S. Oxcarbazepine in pregnancy and lactation. Clin Drug Investig. 2003Abstract
  14. Bar-Oz B, Nulman I, Koren G, Ito S. Anticonvulsants and breast feeding: a critical review. Paediatr Drugs. 2000Abstract
  15. 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. 1988Abstract