How does oxcarbazepine work in the brain. What are the proper dosing and storage instructions for oxcarbazepine. How effective is oxcarbazepine in treating various types of seizures. What should patients know about potential side effects and drug interactions.

Understanding Oxcarbazepine: Mechanism of Action and Efficacy

Oxcarbazepine is a crucial anticonvulsant medication used in the treatment of epilepsy. Its primary function is to control seizures by modulating the electrical activity in the brain. But how exactly does this medication work?

Oxcarbazepine primarily acts on sodium channels in brain cells. These channels are responsible for the propagation of electrical signals between neurons. By blocking these sodium channels, oxcarbazepine helps prevent the abnormal firing of neurons that can lead to seizures. While the exact mechanism is not fully understood, this action is believed to be the key to its anticonvulsant properties.

Clinical studies have demonstrated the efficacy of oxcarbazepine in treating various types of seizures. In comparative trials, it has shown comparable effectiveness to other established anticonvulsants such as carbamazepine, phenytoin, and valproic acid. These studies have focused on its use in both focal and generalized tonic-clonic seizures, showing promising results in both adults and children.

Oxcarbazepine vs. Other Anticonvulsants

• As effective as carbamazepine in controlling focal and tonic-clonic seizures
• Comparable to phenytoin and valproic acid in adults with focal or generalized tonic-clonic seizures
• Similar efficacy to phenytoin in reducing seizure frequency in children

Is oxcarbazepine suitable for all types of seizures? While it has shown broad efficacy, its effectiveness can vary depending on the individual and the specific type of epilepsy. Healthcare providers often consider oxcarbazepine as both a primary treatment option and as an add-on therapy in cases where other medications have not provided adequate seizure control.

Proper Administration and Dosage Guidelines for Oxcarbazepine

Adhering to the prescribed dosage and administration guidelines is crucial for the effectiveness of oxcarbazepine. The medication comes in various forms, including immediate-release tablets, extended-release tablets, and a liquid suspension, each with specific instructions for use.

Immediate-Release Tablets (Trileptal)

• Swallow whole; do not break, crush, or chew
• Can be taken with or without food, but consistency is key
• Typically prescribed for twice-daily dosing

Extended-Release Tablets (Oxtellar XR)

• Take once daily at the same time each day
• Swallow whole; do not break, crush, or chew
• Take on an empty stomach, 1 hour before or 2 hours after a meal

Liquid Suspension

• Typically taken twice daily
• Shake well before measuring each dose
• Use an accurate measuring device, not a regular teaspoon
• Can be taken directly or mixed with a small amount of water

How should patients handle missed doses of oxcarbazepine? If a dose is missed, it should be taken as soon as remembered, unless it’s nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. It’s crucial to avoid doubling up on doses to make up for a missed one.

Storage and Handling of Oxcarbazepine Medication

Proper storage of oxcarbazepine is essential to maintain its effectiveness and safety. Here are the key guidelines for storing this medication:

• Keep in the original container at room temperature
• Protect from heat, moisture, and light
• Store out of reach of children
• Use liquid form within 7 weeks of opening the bottle

Why is proper storage so important? Improper storage can lead to degradation of the medication, potentially reducing its effectiveness or even causing harmful effects. By following these guidelines, patients can ensure that their medication remains safe and effective throughout its intended use period.

Metabolism and Excretion of Oxcarbazepine in the Body

Understanding how oxcarbazepine is processed by the body is crucial for both healthcare providers and patients. The metabolism of this medication primarily occurs in the liver, while its excretion is handled by the kidneys.

The liver metabolizes oxcarbazepine into its active form, known as the 10-monohydroxy derivative (MHD). This metabolite is responsible for much of the therapeutic effect of the medication. The kidneys then work to eliminate both the original compound and its metabolites from the body.

How does this metabolic process affect dosing? For individuals with kidney problems, the elimination of oxcarbazepine may be slower, potentially leading to an accumulation of the drug in the body. As a result, these patients may require lower doses or less frequent administration to avoid potential side effects.

Similarly, patients with severe liver problems should exercise caution, particularly with the extended-release formulation of oxcarbazepine. The altered metabolism in these cases could affect the drug’s effectiveness and safety profile.

Considerations for Special Populations

• Patients with kidney problems may need dose adjustments
• Those with severe liver issues should avoid extended-release formulations
• Regular monitoring may be necessary for patients with compromised liver or kidney function

Side Effects and Potential Risks of Oxcarbazepine Therapy

While oxcarbazepine is generally well-tolerated, like all medications, it can cause side effects. Being aware of these potential effects can help patients and healthcare providers manage treatment more effectively.

Common Side Effects

• Dizziness
• Drowsiness
• Headache
• Nausea
• Vomiting
• Double vision
• Fatigue

Less Common but Serious Side Effects

• Hyponatremia (low sodium levels)
• Allergic reactions
• Suicidal thoughts or behaviors
• Severe skin reactions

Can these side effects be managed? Many side effects are mild and tend to diminish over time as the body adjusts to the medication. However, patients should always report persistent or severe side effects to their healthcare provider. In some cases, dosage adjustments or additional treatments may be necessary to manage these effects.

It’s particularly important to monitor for signs of hyponatremia, which can include confusion, headache, nausea, and in severe cases, seizures. Regular blood tests may be recommended to check sodium levels, especially in the early stages of treatment.

Drug Interactions and Precautions with Oxcarbazepine

Oxcarbazepine can interact with various other medications, potentially altering their effectiveness or increasing the risk of side effects. Understanding these interactions is crucial for safe and effective treatment.

Common Drug Interactions

• Other anticonvulsants (e.g., carbamazepine, phenytoin)
• Oral contraceptives
• Calcium channel blockers
• Certain antidepressants

How do these interactions affect treatment? In some cases, oxcarbazepine may decrease the effectiveness of other medications, such as oral contraceptives. This can have significant implications for women of childbearing age who rely on these methods for birth control. Conversely, some medications may alter the levels of oxcarbazepine in the body, potentially affecting its efficacy or increasing the risk of side effects.

Special Precautions

Certain groups of patients require special consideration when using oxcarbazepine:

• Pregnant women or those planning pregnancy
• Breastfeeding mothers
• Elderly patients
• Individuals with a history of allergic reactions to carbamazepine

Why are these precautions necessary? The safety of oxcarbazepine during pregnancy and breastfeeding is not fully established, and the potential risks must be weighed against the benefits. Elderly patients may be more susceptible to certain side effects and may require closer monitoring. Additionally, individuals with a known allergy to carbamazepine may have an increased risk of allergic reactions to oxcarbazepine due to their structural similarity.

Monitoring and Follow-up Care for Patients on Oxcarbazepine

Regular monitoring is an essential aspect of oxcarbazepine therapy. This helps ensure the medication’s effectiveness and allows for early detection of any potential issues.

Key Monitoring Parameters

• Seizure frequency and severity
• Blood sodium levels
• Liver and kidney function tests
• Complete blood count
• Medication levels in the blood (in some cases)

How often should these tests be performed? The frequency of monitoring can vary depending on individual circumstances. Typically, more frequent testing is done at the start of treatment or after dosage changes, with less frequent monitoring once the patient is stable on the medication.

Patients should maintain open communication with their healthcare providers, reporting any changes in their condition, new symptoms, or concerns about their treatment. This collaborative approach helps optimize the effectiveness of oxcarbazepine therapy while minimizing potential risks.

Long-term Considerations

For many patients, oxcarbazepine is a long-term treatment. As such, it’s important to consider the following:

• Regular follow-up appointments to assess treatment efficacy
• Periodic reevaluation of the need for continued therapy
• Monitoring for any long-term effects on bone health or other systems
• Adjusting treatment plans as needed based on changes in the patient’s overall health or life circumstances

By maintaining vigilant monitoring and follow-up care, healthcare providers can ensure that patients receive the maximum benefit from oxcarbazepine therapy while minimizing potential risks and complications.

Oxcarbazepine Basic Seizure Medication | Epilepsy Foundation

How to take and store Oxcarbazepine?

How to Take:

Take oxcarbazepine exactly as your health care provider prescribes it. Do not change your dose without talking to your provider first. Stopping a seizure medicine suddenly can cause seizures that will not stop (status epilepticus).

• Check the number of tablets and the strength of the pills you get from the pharmacy. If your provider changes your dose, the strength of your pills may be different. 
• For the immediate release form of oxcarbazepine or Trileptal, swallow the tablets whole. Do not break, crush or chew them. 
  • Take the medicine with or without food, but try to take it the same way each time. 
• For the extended release tablets (Oxtellar XR), take the medicine once a day at the same time every day. Swallow the tablets whole. Do not break, crush or chew them. 
  • It can be taken with water or another liquid.  
  • Take it on an empty stomach about 1 hour before a meal or 2 hours after a meal. 
• For the liquid form, it is generally taken 2 times a day. It can be taken with or without food. 
  • Always check the bottle for the amount of liquid to take and the strength. The strength of the liquid is written as mg per ml. Liquid oxcarbazepine is given as 300 mg per 5 ml, which means there is 60 mg in every ml. 
  • Shake the bottle well before you measure a dose. 
  • Always use an accurate measuring spoon or syringe to make sure the amount is correct. Do not use a regular teaspoon. 
  • After measuring the liquid, drink it directly from the measuring spoon or mix it with a small amount of water and drink it right away. 
• Take only the amount that your provider tells you to take. If you take an extra dose, call your provider for advice. If you take a larger number of pills or overdose, call the poison control center (800-222-1222) or call your hospital emergency room.  

How to Store:

• Keep and store oxcarbazepine tablets and liquid in their original container at room temperature. 
• Keep them away from heat, moisture and light.
• Keep all medicines out of reach of children. 
• The liquid should be used within 7 weeks of opening the bottle. 

What if I forget?

Taking the right amount of seizure medicine on time every day is the most important way to control seizures. Try these steps to help you remember when to take seizure medicine. 

• If you miss a dose, take it as soon as you remember it. If it is almost time for the next dose, skip the missed dose and go back to your usual schedule. 
• Avoid taking 2 doses at the same time or taking extra doses.
• If you are not sure about what to do, call your health care provider’s office for advice. Do your best to follow their directions. 
• To avoid missed doses, use a pillbox or set an alarm on your watch or phone.  
• Write down any missed doses in your seizure calendar. Share this with your health care provider at each visit. 

How does Oxcarbazepine affect the brain?

Brain cells normally talk to each other using electrical signals and chemicals. Seizures can happen when the brain cells are not working or firing normally or working faster than normal. Sodium channels are like gates in brain cells that help to spread electrical activity from one cell to another. 

Oxcarbazepine may block sodium channels in the brain to prevent seizures. The exact way the drug works is not fully known. 

How does the body digest Oxcarbazepine?

How the body absorbs, disgests and breaks down or gets rid of a medicine or food is called metabolism. The way the body metabolizes a medicine affects how often it must be taken. This process can also affect how often you must take a medicine and if it will interact with other medicines. If a person has liver or kidney problems, a person’s metabolism may be affected. 

The liver metabolizes oxcarbazepine and the kidneys remove it from the body. 

• People with kidney problems may need to take a lower dose of oxcarbazepine or take it less often. 
• People with severe liver problems should not take the extended release form of oxcarbazepine. 

How well does the Oxcarbazepine work?

• Not all seizure medicines work for everyone. Your health care provider may try a series of seizure medicines or combinations of medicines to find one that works best for you. 
• Oxcarbazepine has been tested when used alone to see how well it works to control focal and tonic-clonic seizures. 
  • In one trial, oxcarbazepine was as helpful as carbamazepine. 
  • Two studies that compared phenytoin, valproic acid, and oxcarbazepine found that oxcarbazepine worked as well as the other seizure medicines for adults with focal or generalized tonic-clonic seizures.  
  • In another study, oxcarbazepine and phenytoin were similar in reducing the number of focal or generalized tonic-clonic seizues in children with epilepsy. 
• Oxcarbazepine has been studied as an add on medicine (when given with other seizure medicines). These studies show that this drug reduces seizures and may be given safely with other seizure medicines. 

What are the most common side effects of Oxcarbazepine?

The most common side effects reported in clinical trials were related to stomach or gastrointestinal symptoms, the nervous system, and vision. These side effects may include:

• Dizziness
• Double vision
• Headache
• Low sodium or salt levels in the bloodstream
• Nausea, upset stomach, indigestion
• Rash
• Tired, sleepy, or drowsy
• Trembling of hands
• Trouble walking
• Trouble with coordination
• Vomiting

Some tips:

• Tell your health care provider if you notice any of these problems. The amount of medicine or when you take it may be changed to help lessen some side effects. 
• Do not stop taking oxcarbazepine or change the amount you take without your provider’s advice. 
• If you have just started taking oxcarbazepine (or started taking a larger amount), you may feel tired, drowsy, or uncoordinated. Be careful when driving or doing any activities that require attention or could be dangerous.  
• Do not drink alcohol with this medicine. 

What are the most serious side effects of Oxcarbazepine?

Serious side effects of oxcarbazepine are rare. It is important to be aware of possible reactions and what to do if they happen. Call your provider’s office right away if any of these problems occur. 

Allergic Reactions: If you have signs of an allergic reaction – such as a rash, itchiness, swelling or difficulty breathing – call your doctor immediately or go to an emergency room. 

• Tell your provider if you have ever had an allergic reaction to carbamazepine or eslicarbazepine. You could have a similar reaction to oxcarbazepine. 

Hyponatremia: There is a small chance that you may develop a low sodium or salt level in your blood when taking oxcarbazepine (called hyponatremia).

• It is more likely to happen in older adults, but can happen in people at any age. 
• It is more likely to happen within the first few months of taking the medicine, but can happen at any time. 
• You may need to have blood tests to check levels of sodium or salt. 
• Symptoms of hyponatremia may include:
  • Confusion
  • Cramps
  • Dizziness
  • Decreased urination
  • Headaches
  • More seizures
  • Nausea
  • Swelling
  • Tired, lack of energy
  • Vomiting
• Oxcarbazepine may cause these symptoms and not be related to low sodium. Or they may be related to another medicine or health problem. Call your provider if any of these symptoms happen. 

Severe skin reactions: Oxcarbazepine may cause rare but serious skin reactions, such as Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). These conditions may start with a fever and flu-like symptoms. Then a rash develops. Ulcers or lesions of the mucous membranes may be seen and develop into painful blisters blisters. 

• Report any fever or rash to a health care provider, as this can be a life-threatening condition.
• These types of skin reactions happen most commonly in the second or third week after starting the medicine. Though it can happen at other times too. 
• Serious skin reactions are more common in people with a particular type of gene, called “HLA-B*1502 allele. (An allele is a form of a gene that is found on a chromosome. Alleles are involved in deciding whether certain traits passed on from a parent to a child will occur. The tendency to severe drug reactions can be one of these traits.)
  • ​This gene is found in people with ancestry or family lines from broad areas of Asia, including South Asian Indians. People who are Chinese, Thai, Filipino, Malyasian, and Korean may have an increased risk for these skin reactions with oxcarbazepine.  
  • People at risk should be tested for the HLA-B*1502 allele before starting oxcarbazepine. If you test positive, you should avoid using this medicine unless your provider and you decide the benefits are work the risks. 

Suicidal thoughts and behavior: In 2008, the Food and Drug Administration (FDA) reviewed data from drug studies that showed a possible relation between many seizure medications (called antiepileptic drugs or AEDs) and suicidal thoughts and behavior. These thoughts and behavior are called suicidality. According to an FDA Alert, among the patients with epilepsy in these drug studies, more had symptoms of suicidality than people taking a placebo or inactive substance – 3.5 of 1,000 people taking an AED had suicidality compared to 1 of 1,000 people taking a placebo.

• Taking seizure medicines may increase the risk of having suicidal thoughts or actions.
• Do not make any changes to the medicines taken without first talking to the prescribing health care provider.
• Pay close attention to any day-to-day changes in mood, behavior and actions. These changes can happen very quickly so it is important to be mindful of any sudden differences.
• Be aware of common warning signs that might be a signal for risk of suicide. Some of these are:
  • Talking or thinking about wanting to hurt yourself or end your life
  • Withdrawing from friends and family
  • Becoming depressed or having your depression get worse
  • Becoming preoccupied with death and dying
  • Giving away prized possessions
• Contact your health care provider before stopping any seizure medicine. This could possibly lead to worsening of seizures and mood. 

Multi-organ hypersensitivity: This is a serious rare drug reaction that has been seen with oxcarbazepine.

• Typically it starts with a fever, rash, and/or swollen lymph nodes.
• Other body organs may become involved, for example the liver, kidneys, blood, heart or muscles.
• An increase in certain blood cells called eosinophils may be seen. Eosinophils are a type of white blood cells.
• If any of these symptoms or signs occur, get immediate medical help. A rash does not need to occur to be a drug reaction.
• Oxcarbazepine may need to be stopped if no other cause for the symptoms is found. Make sure the doctor treating your seizures is aware of the reaction and is involved in decisions about your seizure medication.

What else is Oxcarbazepine used for?

Some medications are found to be helpful for conditions other than the ones approved by the FDA. This is called off-label use. Oxcarbazepine has been used to treat the following conditions off-label:

• A type of facial pain called trigeminal neuralgia (tic douloureux)
• Bipolar disorder (also called manic-depression) 
• Migraines
• Peripheral neuropathy (pain caused by nerve damage)
• Sexual function

Who should not take Oxcarbazepine?

• People should not take oxcarbazepine if they are allergic to it or any of its inactive ingredients.
• People who may be at risk for the HLA-B*1502 allele should be tested for this allele before starting oxcarbazepine. This allele occurs more frequently in certain groups of people – such as Chinese, Thai, Filipino, Malaysian, and Korean. People who test positive for the HLA-B*1502 allele should avoid using oxcarbazepine unless your doctor and you decide the benefits outweigh the risks.
• If you have severe liver problems, the extended release form of oxarbazepine is not recommended.
• If you have kidney problems, tell your health care provider. A lower dose of the medicine may be needed so it does not build up to an unsafe level in your body.

Can Oxcarbazepine be taken with other medicines?

Some medicines may affect how another medicine works in your body. When this happens, the choice and amount of medicine needs to be adjusted carefully. 

Oxcarbazepine can interact with:

• Seizures medicines such as phenytoin, carbamazepine, phenobarbital, lamotrigine, and perampanel
• Certain antidepressants
• Antiviral medicines
• Hormonal contraceptives or birth control 

Women taking oxcarbazepine and a hormonal form of birth control should talk to their doctors about other forms of birth control to prevent pregnancy.

Tell your health care providers and pharmacist about all prescription medicines, over-the-counter medicines, vitamins, and other supplements or products you are taking. If you take a drug that may interact with oxcarbazepine, ask if blood tests or other monitoring is needed. 

What are the effects of Oxcarbazepine on Children?

• Oxcarbazepine is used to treat focal (partial) seizures and generalized tonic-clonic seizures in children, ages 4 to 16 years old. It can be used alone or with another seizure medicine. 
• It is also used with other seizure medicines for focal seizures in children ages 2 to 15 years. 
• The dose of oxcarbazepine used in children is based on weight. The recommended doses may be larger in children than in adults because of differences in how children and adults break down medicines. 

If a woman takes Oxcarbazepine during pregnancy will it hurt the baby?

Effect of seizure medicines during pregnancy: In the United States, the FDA assigns each medication to a Pregnancy Category according to whether it has been proven to be harmful in pregnancy. Oxcarbazepine is listed in Pregnancy Category C. This means that caution is advised, but the benefits of the medicine may outweigh the potential risks.

• Talk to your health are providers if you are pregnant or plan to become pregnant.
• The risk of birth defects is generally higher in children of women who:
  • Take more than one seizure medicine at the same time 
  • Have a family history of birth defects

All women who are capable of becoming pregnant should take at least 0.4 mg (400 mcg) each day of the vitamin called folic acid (also called folate). This vitamin is thought to help prevent birth defects affecting the brain and spinal cord, called neural tube defects. The most common of these is known as spina bifida.  

• Women at high risk of having a child with a birth defect (such as those with a birth defect in a previous pregnancy or taking certain seizure medicines) may be asked to take 4 mg (4,000 mcg) daily before and during pregnancy.  
• Talk to your health care provider about using folic acid and how much to take.
• Start taking this vitamin before you become pregnant. 

Seizures during pregnancy: Some women may have more seizures during pregnancy, because of hormone changes and how seizure medicine is handled by your body. 

• Talk to your health care provider before pregnancy about seizures and if medicine changes may be needed.
• Know when to check blood levels of medicine during and after pregnancy.
• The dose of seizure medicine may need to be adjusted during and after pregnancy. 

Breastfeeding:  Oxcarbazepine is found in breast milk, but it is not likely to cause side effects in babies who are breastfed, especially when the infant is over 2 months old. 

• If you choose to breastfeed, check the baby for drowsiness and keep track of their weight gain and development, especially in younger infants or if you are taking more than one seizure medicine.  
• Talk to your health care team about any concerns that arise and the benefits and risks of breastfeeding. 

Contraception: Oxcarbazepine can lower the amount of some hormonal forms of birth control. This may make the contraceptive or birth control less effective. A woman taking oxcarbazepine and some forms of hormonal birth control may be at greater risk for pregnancy. 

• Tell your health care team and pharamcist if you are taking hormonal birth control such as the pill, injection, or patch. 
• Consider using a barrier type of contraception (such as condoms, cervical caps, diaphrams) or a non-hormonal IUD. 

What are the effects of Oxcarbazepine on Seniors

• Oxcarbazepine appears to be as safe in older adults (65 years and older) as in younger adults.
• The dose of oxcarbazepine in older adults may need to be adjusted. When people are older than 65 to 70, their kidneys usually don’t work as well as younger people. Since the kidneys are involved in clearing the body of oxcarbazepine, the medicine may stay in the body longer. 
  • Starting oxcarbazepine at a lower dose and increasing it more slowly may be needed. 
• People of all ages may develop side effects, such as nausea, vomiting, dizziness and drowsiness. Some seniors may be more sensitive to side effects like these. Hyponatremia or low blood sodium may happen more often in older adults taking oxcarbazepine. 
• Report any changes or side effects to your health care team. Some symptoms like dizziness or drowsiness may lead to falls and accidents. 

What are the dose ranges for Oxcarbazepine?

The best amount is the amount that completely controls seizures without causing side effects. This depends on many factors, which are different for every individual. 

Adults usually are told to start by taking 300 to 600 milligrams (mg) per day, divided into two doses. After about a week, the doctor probably will suggest taking a higher dose. The recommended dosage for most adults is 600 to 1,200 mg per day when oxcarbazepine is used alone. Higher dosages may be necessary when it used with other seizure medicines.

Patients with poor kidney function generally should take only half as much. This also applies to many seniors, too.

Those who have been taking another seizure medicine may be told to continue to take it in the same way as before, or the amount of the other medicine may gradually be reduced over several weeks to months. If the plan is to continue taking another medicine along with oxcarbazepine, blood tests may be needed to check the level of the other medication. Oxcarbazepine sometimes causes it to change.

Read the package insert of Oxcarbazepine

In the United States, companies that manufacture medicines are required to publish certain kinds of information about each product. This document is commonly known as a “package insert” because it is usually included with each package of the medicine.

You can also read these documents (also called “prescribing information”) online. The U.S. package insert for Trileptal (oxcarbazepine) is found at:

• http://www.pharma.us.novartis.com/product/pi/pdf/trileptal.pdf

Some of the information may differ in other countries.

Learn how to read a package insert here.

Read About Oxcarbazepine studies

Side Effects, Dosage, Uses, and More

Highlights for oxcarbazepine

1. Oxcarbazepine oral tablet is available as brand-name drugs and as a generic drug. Brand names: Trileptal and Oxtellar XR.
2. Oxcarbazepine comes as an oral extended-release tablet, immediate-release tablet, and suspension.
3. Oxcarbazepine oral tablet is used to treat a type of seizure, called a partial seizure, in people with epilepsy.

• Serious skin reactions: This drug may cause life-threatening allergic reactions. These are called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These reactions may cause severe damage to your skin or internal organs. Your risk may be higher if you have Asian ancestry with a genetic risk factor. Your doctor may test you to see if you have the HLA-B*1502 allele. If your results from this test are positive, you may be at risk for developing these serious skin reactions. However, you can still have these reactions without the genetic risk factor. Call your doctor right away if you have any of these symptoms while taking this drug:
• skin rash
• hives
• sores in your mouth
• blistering or peeling of your skin
• Suicidal thoughts: This drug may increase your risk of suicidal thoughts. Your risk may be higher if you already have a mood disorder, such as depression or anxiety. Call your doctor right away if you have any of these symptoms, especially if they are new or worse, or if they worry you:
• thoughts about suicide or dying
• attempts to commit suicide
• new or worsened depression
• new or worsened anxiety
• feeling agitated or restless
• panic attacks
• new or worsened irritability

Oxcarbazepine is a prescription drug. It comes as an oral extended-release tablet, immediate-release tablet, and suspension.

Oxcarbazepine oral tablet is available as the brand-name drugs Trileptal and Oxtellar XR. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

The immediate-release tablet may be used alone or as part of a combination therapy with other medications to treat seizures. The extended-release tablet is always used with other medications.

Why it’s used

Oxcarbazepine is used to treat partial seizures in people with epilepsy.

Don’t suddenly stop this drug

• Don’t suddenly stop taking this drug unless your doctor tells you to. Doing so may cause you to have more severe seizures. If your doctor is stopping your treatment with oxcarbazepine, your dosage will be slowly lowered to reduce your risk of having more seizures.

Was this helpful?

How it works

Oxcarbazepine belongs to a class of drugs called antiepileptic medications. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

It isn’t known exactly how this drug works to stop seizures. It may block sodium channels to stop seizures from spreading to the rest of the brain. It may also act on potassium and calcium in the brain to stop seizures.

Oxcarbazepine oral tablet may cause drowsiness. It can also slow your thinking and reaction time. You shouldn’t drive, use machinery, or do similar tasks that require alertness until you know how this drug affects you.

This drug can also cause other side effects.

More common side effects

The more common side effects of oxcarbazepine depend on the drug form.

• Side effects for all forms of the drug include:
• dizziness
• sleepiness
• nausea
• vomiting
• eye problems, such as double vision, blurred vision, or cataracts
• trembling
• problems with walking and coordination (unsteadiness)
• Oxcarbazepine immediate-release tablets may also cause the following:
• skin rash
• infections, especially in children
• stomach pain
• upset stomach
• Oxcarbazepine extended-release tablets may also cause the following:
• headache
• weakness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Low sodium levels in your blood. Symptoms can include:
• nausea
• tiredness
• lack of energy
• headache
• confusion
• more frequent or more severe seizures
• Allergic reactions or serious problems (multi-organ hypersensitivity) that affect your organs and other parts of your body, such as the liver or blood cells. Symptoms can include:
• fever, swollen glands, or sore throat that don’t go away or that come and go
• skin rash
• swelling of your face, eyes, lips, or tongue
• trouble swallowing or breathing
• hives
• painful sores in your mouth or around your eyes
• yellowing of your skin or the whites of your eyes
• unusual bruising or bleeding
• severe tiredness or weakness
• severe muscle pain
• frequent infections or infections that don’t go away
• Suicidal thoughts or actions. Symptoms can include:
• thoughts about suicide or dying
• attempts to commit suicide
• new or worsened depression
• new or worsened anxiety
• feeling agitated or restless
• panic attacks
• trouble sleeping (insomnia)
• new or worsened irritability
• anger
• acting aggressive or violent
• acting on dangerous impulses
• an extreme increase in activity and talking (mania)
• other unusual changes in behavior or mood
• Serious skin reactions. Oxcarbazepine may cause life-threatening allergic skin reactions. These are called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These may cause severe damage to your skin and internal organs. Your risk may be higher if you have Asian ancestry with a genetic risk factor. If you’re Asian, your doctor may test you for this genetic factor. You can still have these reactions without the genetic risk factor. Call your doctor right away if you have any of these symptoms:
• skin rash
• hives
• sores in your mouth, nose, or eyes
• blistering or peeling of your skin
• Serious blood disorders. Oxcarbazepine may cause a decrease in all types of blood cells, or just white blood cells. Symptoms can include:
• bruising more easily
• bleeding from your nose, or your gums after brushing your teeth
• blood in your urine
• blood in your stool, which may appear either bright red or dark and tarry
• increased infections
• longer illnesses as compared to normal
• tiredness

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Oxcarbazepine oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with oxcarbazepine are listed below.

Oral birth control pills

Taking oxcarbazepine with oral birth control pills makes the pills less effective. This means you may get pregnant even though you’re taking birth control pills. You should use a second form of birth control while you’re taking oxcarbazepine, such as a condom. Examples of these oral birth control pills include:

• birth control pills that contain ethinylestradiol
• birth control pills that contain levonorgestrel

Parkinson’s disease drugs

Transdermal selegiline can not be taken with oxcarbazepine. Taking them together could lead to side effects that could be life-threatening. These side effects include a high blood pressure crisis, seizures, coma, or heart collapse.

Seizure drugs

Taking oxcarbazepine with phenytoin increases phenytoin levels in your blood. This raises your risk of side effects from phenytoin. Your doctor may decrease your dosage of phenytoin if you take it with oxcarbazepine.

Certain seizure drugs decrease the level of oxcarbazepine in your body. If you take oxcarbazepine with these drugs, oxcarbazepine may not work as well to treat your seizures. Your doctor may increase your dosage of oxcarbazepine if you take it with these drugs. Examples of these drugs include:

• carbamazepine
• phenobarbital

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

Many people who are allergic to carbamazepine are also allergic to this drug. Tell your doctor if you’re allergic to carbamazepine.

Oxcarbazepine may cause allergic reactions. Symptoms can include:

• swelling of your face, eyes, lips, or tongue
• painful sores in the mouth or nose, or around the eyes
• trouble swallowing or breathing
• skin rash
• hives

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction warning

You shouldn’t drink alcohol while taking oxcarbazepine. Alcohol can worsen certain side effects from the drug, such as sleepiness or dizziness.

Warnings for people with certain health conditions

For people with liver problems: Your doctor won’t need to change your oxcarbazepine dosage if you have mild or moderate liver problems. If you have severe liver problems, your doctor may monitor your oxcarbazepine usage more closely.

For people with kidney problems: This drug is removed from your body by your kidneys. If you have severe kidney damage (creatinine clearance less than 30 mL/minute), your doctor may give you a lower dosage, and increase the dosage slowly. This can help prevent too much of the drug from building up in your body and causing side effects.

Warnings for other groups

For pregnant women: This drug is a category C pregnancy drug. That means two things:

1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. This drug should be used during pregnancy only if the potential benefit justifies the potential risk.

For women who are breastfeeding: This drug passes into breast milk and can cause serious effects in a child who is breastfed. You and your doctor may need to decide if you’ll take this drug or breastfeed.

When to call the doctor

• Call your doctor if your seizures get worse or if you have any new types of seizures while taking this drug.

Was this helpful?

For seniors: As you age, your kidneys may not work as well as they once did. Your body may process this drug more slowly. Your doctor may start you on a lowered dosage so that too much of this drug doesn’t build up in your body. Or they may prescribe a different drug to treat your seizures. Too much of the drug in your body can be dangerous. Your kidney function (creatinine clearance) should be checked before you start taking this drug.

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Drug forms and strengths

Generic: Oxcarbazepine

• Form: oral immediate-release tablet
• Strengths: 150 mg, 300 mg, 600 mg

Brand: Trileptal

• Form: oral immediate-release tablet
• Strengths: 150 mg, 300 mg, 600 mg

Brand: Oxtellar XR

• Form: oral extended-release tablet
• Strengths: 150 mg, 300 mg, 600 mg

Dosage for seizures (epilepsy)

Immediate-release tablets

Adult dosage (ages 17–64 years)

• When taking oxcarbazepine alone to treat seizures:
• The maximum dosage is 1,200 mg taken by mouth two times per day.
• Your doctor may have you start with 300 mg taken two times per day. Your doctor may then increase your total daily dosage by 300 mg every 3 days to a dosage of 1,200 mg/day (600 mg two times per day).
• When taking oxcarbazepine with other medications to treat seizures:
• The maximum dosage is 600 mg taken by mouth two times per day.
• Start with 300 mg taken two times per day. Each week, your doctor may increase your total daily dosage by no more than 600 mg.
• If you’re taking dosages over 1,200 mg per day, you doctor should monitor you closely for side effects during dosage increases.
• When switching from another seizure medication to oxcarbazepine alone:
• The maximum dosage is 1,200 mg taken by mouth two times per day.
• You may start with 300 mg of oxcarbazepine taken twice per day. At the same time, your doctor may start to reduce the dosage of your other seizure drug(s). It may take three to six weeks to be completely off your other seizure drug(s). Your doctor should monitor you closely during this overlapping time period.
• Each week, your doctor may increase your total daily dosage by no more than 600 mg.

Child dosage (ages 4–16 years)

Your child’s dosage will be based on their weight. It will also be based on whether they’re switching from one seizure medication to another.

Child dosage (ages 2–3 years)

Your child’s dosage will be based on their weight.

Child dosage (ages 0–1 year)

This drug is not recommended for children younger than 2 years.

Senior dosage (ages 65 years and older)

Oxcarbazepine is removed from your body through your kidneys. As you age, your kidneys may not work as well as they used to. If you have kidney problems, your doctor may start you at half of the standard starting dosage (300 mg per day) and increase your dosage slowly.

Extended-release tablets

Adult dosage (ages 18–64 years)

• When taking this drug with other medications to treat seizures:
• The recommended dosage is 1,200–2,400 mg taken by mouth once per day.
• Each week, your doctor may increase your total daily dosage by no more than 600 mg.

Child dosage (ages 6–17 years)

Your child’s dosage will be based on their weight.

Child dosage (ages 0–5 years)

This drug is not recommended for children younger than 6 years.

Senior dosage (ages 65 years and older)

Your doctor may want to start at a lower dosage (300 mg or 450 mg per day). Your doctor may increase your dosage each week by 300–450 mg per day until you’re at a dosage that’s working to control your seizures.

Special dosage considerations

People with kidney problems: If you have severe kidney damage (creatinine clearance less than 30 mL/minute), your doctor may start you at half of the usual starting dosage of the immediate-release tablet (300 mg per day) and increase it slowly.

For the extended-release tablet, your doctor may increase your dosage once per week by 300–450 mg per day until the dosage is working for you.

Dosage warnings

• If you’re using higher doses (higher than 1,200 mg per day) of the immediate-release tablets, your doctor should monitor you closely during dosage increases.
• Your dosage will decrease as you age since your body gets rid of the drug more slowly as you age.
• If your doctor wants to switch you from immediate-release tablets (Trileptal) to the extended-release form (Oxtellar XR), you may need a higher dosage.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always talk to your doctor or pharmacist about dosages that are right for you.

Oxcarbazepine is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: This may cause serious problems, such as having more seizures, or seizures that don’t stop.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: Your doctor will treat any symptoms you’re having. These could include tremors, lack of coordination, double vision or trouble seeing, drowsiness, slowed heart rate, or coma.

If you think that you’ve taken too much of this drug, call your doctor or local poison control center. If the symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, wait and only take one dose at that time. Never try to catch up by taking two doses at once. This could cause dangerous side effects.

How to tell this drug is working: You should have fewer seizures.

Keep these considerations in mind if your doctor prescribes oxcarbazepine for you.

General

• Take the extended-release form without food. If you don’t take these tablets on an empty stomach, you may be more likely to have side effects. Food causes higher levels of the medication to build up in your blood.
• The immediate-release tablet can be taken with or without food.
• Take the extended-release form one time per day. Take it at least 1 hour before or 2 hours after a meal.
• Don’t cut, crush, or chew the extended-release tablets.

Storage

• Store oxcarbazepine at room temperature between 59°F and 86°F (15°C and 30°C).
• Don’t freeze oxcarbazepine.
• Keep it away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t harm your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Before starting and during your treatment with oxcarbazepine, your doctor will check your:

• kidney function
• liver function
• sodium levels
• complete blood count
• thyroid function

You and your doctor should also watch for the following:

• seizure frequency
• serious skin reactions
• suicidal thoughts and behaviors

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses./span>

rating of top-7 substitutes according to the KP version with instructions for use, doctors’ reviews, prices

In pharmacies you can find Carbamazepine from different domestic manufacturers. All drugs are available in tablets with regular and prolonged action, which contain 200 or 400 mg of carbamazepine.

Long-acting preparations have the designation “retard” in the name. Prolonged action means that after taking the tablet, carbamazepine is released slowly and constantly, so its concentration in the blood remains stable, without sharp drops and rises. Prolonged dosage forms should be taken less frequently than usual – for example, not 3, but 2 times a day.

Conventional and prolonged preparations of carbamazepine have anticonvulsant, antimanic, antipsychotic effects, reduce pain in neuralgia. They are used for the treatment and prevention of:

• epilepsy;
• psychoses;
• diabetic neuropathy with pain;
• trigeminal neuralgia.

is contraindicated in people with hypersensitivity to carbamazepine, atrioventricular block, porphyria ¹ . A doctor may prescribe it to pregnant and lactating women, but only if the benefit to the mother outweighs the possible risk to the child.

List of top 7 analogues according to the KP version

Periodic absence of the drug in pharmacies makes patients look for a replacement, so we have selected possible analogues and substitutes. Analogues contain the same active ingredient, and substitutes are drugs with a different active ingredient, but a similar therapeutic effect.

Important! These drugs should only be taken if seriously indicated and prescribed by a doctor. Substituting one drug for another on your own can be harmful to your health. Our material is for informational purposes only and is not a guide to action.

Zeptol

The Indian analogue has a prolonged action and is available in the form of round brown tablets with a dosage of 200 and 400 mg. The drug is indicated for use in epilepsy, idiopathic trigeminal and glossopharyngeal neuralgia, alcohol withdrawal syndrome, acute manic states ² .

It has an anticonvulsant and antidepressant effect, helps to reduce the frequency and intensity of epileptic seizures, reduce pain in trigeminal neuralgia, and prevent exacerbations in bipolar affective disorder. Can be used to treat children over 4 years of age.

Contraindications : hepatic porphyria, hypersensitivity to carbamazepine and other components of the drug, concomitant use of MAO inhibitors and lithium preparations, history of episodes of hematopoiesis suppression, atrioventricular blockade ² .

Tegretol CR

The original long-acting drug is available as red-orange or brick-orange tablets containing carbamazepine 200 and 400 mg.

It belongs to antiepileptic drugs. It is prescribed for epilepsy, trigeminal and glossopharyngeal neuralgia, alcohol withdrawal, diabetic neuropathy, and for the prevention of manic-depressive disorders. With alcohol withdrawal syndrome, the drug helps to reduce tremor, gait disturbances, increased excitability ³ .

Contraindications : individual intolerance, atrioventricular block, a history of acute intermittent porphyria or episodes of hematopoiesis suppression, concomitant use of MAO inhibitors.

Finlepsin retard

The drug contains carbamazepine and is available in 200 and 400 mg tablets. This is a long-acting drug that provides a stable concentration of the active substance in the blood. It has antiepileptic, neurotropic and psychotropic effects and is indicated for epilepsy, trigeminal and glossopharyngeal neuralgia, convulsions in multiple sclerosis, for the treatment and prevention of psychosis.

Contraindications : individual hypersensitivity to carbamazepine and tricyclic antidepressants, atrioventricular blockade, hepatic porphyria, simultaneous use with MAO inhibitors, a history of episodes of hematopoiesis suppression, children under 4 years of age.

Depakine Chrono

This substitute contains valproic acid, an antiepileptic drug that has a muscle relaxant and sedative effect, helps relieve convulsions and spasms. The drug is used for different types of epilepsy in adults and children over 6 years of age. Among the indications for use: the treatment of generalized epileptic seizures, the prevention and treatment of bipolar affective disorders, the treatment of Lennox-Gastaut syndrome and partial epileptic seizures.

Contraindications : hypersensitivity to valproic acid, children under 6 years of age, acute and chronic hepatitis, hepatic porphyria, severe disorders of the liver and pancreas. There are other contraindications.

Trileptal

It also belongs to substitutes, this antiepileptic drug contains oxcarbazepine, a substance similar in structure and action to carbamazepine. The tool is available in the form of tablets of light green, yellow and pink color with a dosage of 150, 300 and 600 mg.

The drug has a pronounced anticonvulsant effect and can be used to reduce the severity and frequency of epileptic seizures in children and adults.

Contraindications : hypersensitivity to the components of the drug and eslicarbazepine, children under 3 years of age (for tablets).

Vimpat

This substitute is available in tablets with different dosage options: 50, 100, 150 and 200 mg. The active ingredient of the drug is lacosamide, a substance with anticonvulsant action. The drug is used for monotherapy or additional therapy for convulsive seizures, tonic-clonic seizures in children over 4 years old, adolescents and adults ⁵ .

Contraindications : hypersensitivity to the components of the drug, atrioventricular blockade of Ⅱ and Ⅲ degree, children under 4 years of age.

Lamictal

The active ingredient of the drug is lamotrigine, a substance with antiepileptic action. It is used to treat and prevent epileptic seizures in adults and children over 3 years of age. In addition, the drug helps prevent episodes of depression and mania in patients with bipolar affective disorder ⁶ . In bipolar disorder, the drug is prescribed to patients over 18 years of age. Release form – tablets with a dosage of 25, 50 and 100 mg.

Contraindications: hypersensitivity to components, children under 3 years of age.

How to choose an analogue of

– Currently, many drugs with the active substance carbamazepine are registered – says neurologist Olga Pylaeva . – The drugs that were registered first and have undergone serious clinical trials are called original drugs.

A few years after the entry into the market of original drugs, registration of analogues – copies or generics – begins. They do not undergo such serious and lengthy clinical trials – they are simply compared with the original in several ways. Analogues contain the same active substance carbamazepine, but differ in the set of excipients and production technology.

Popular Questions and Answers

The disappearance of carbamazepine preparations from pharmacies has become a serious problem for many people. Against this background, interest in possible substitutes has grown significantly. Neurologist Olga Pylaeva answers the most popular questions about Carbamazepine analogues.

When can analogues be used?

– All carbamazepine preparations are prescribed for similar indications, for example, for the same types of seizures and forms of epilepsy. However, the drug is always prescribed by a doctor! After all, as mentioned above, analogue drugs are not strictly the same. In addition, patients have individual reactions in terms of efficacy and tolerability.

What happens if you switch to analogue?

– Much depends on the indications for which the main drug was prescribed and which analogue was chosen as an alternative. Unfortunately, an unsuccessful replacement of the drug can lead to a worsening of the condition. For example, to the breakdown of remission, if there have been no attacks for a long time. The frequency of seizures may increase, or side effects may appear. However, in any case, it is better to switch to an analogue than to stop treatment altogether.

Carbamazepine is fundamentally different from other antiepileptic drugs. If it is not possible to get a drug with the substance carbamazepine, you have to transfer the patient to a drug of another group. However, these recommendations should only be given by the attending physician. The patient cannot independently replace it with another drug, it is extremely dangerous for health. Self-treatment for epilepsy is unacceptable!

Sources:

1. Carbamazepine. Instructions for use.
2. Zeptol. Instructions for use.
3. Tegretol CR. Manufacturer’s instructions.
4. Trileptal. Instructions for use.
5. Wimpat. Instructions for use.
6. Lamictal. Instructions for use

Take a blood test in Putilkovo, prices from 235 ₽ at the DNAOM Laboratory

By type

By biomaterial

For whom

Organs

By disease

Comprehensive programs

• All

• Blood
  • Swabs and scrapings
  • Urine
  • Kal
  • ejaculate
  • Saliva
  • Sputum
  • secret of the prostate
  • Hair
  • Nails
  • Eyelashes
  • abortive material
  • Aspirate from the uterine cavity
  • Liquor
  • Bile
  • synovial fluid
  • Kidney, urinary, gallbladder stone
  • Other

  62. 091

  Vitamin and mineral deficiency in pregnant women. MIDDLE

  can be donated at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 10,145

  -15%

  RUB 8,620

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.092

  Vitamin and mineral deficiency in pregnant women. MAXIMUM

  can be donated at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 13,540

  -10%

  RUB 12,185

  6 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.090

  Vitamin and mineral deficiency in pregnant women. MINIMUM

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 4,975

  -20%

  RUB 3,980

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62. 096

  Vitamin and mineral deficiency in children (0-12 years old)

  can be donated at home

  * Biomaterial collection is paid separately:
  RUB 200

  RUB 13,500

  -15%

  RUB 11,475

  6 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.097

  Vitamin and mineral deficiency in adolescents (12-18 years old)

  can be taken at home

  * Taking biomaterial is paid separately:
  200 RUB

  16 730 ₽

  -15%

  14 220 ₽

  6 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.095

  Vitamins and minerals for the beauty of skin, hair and nails. MAXIMUM

  can be donated at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 17,070

  -15%

  RUB 14,505

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62. 099

  Vitamins and minerals for women’s reproductive health

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 15,900

  -15%

  RUB 13,515

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.093

  Deficiency of vitamins and minerals while taking oral contraceptives. MIDDLE

  can be donated at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 7,760

  -15%

  RUB 6,595

  6 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.094

  Deficiency of vitamins and minerals while taking oral contraceptives. MINIMUM

  can be donated at home

  * Biomaterial collection is paid separately:
  RUB 200

  RUB 3,020

  -30%

  RUB 2,110

  1 day

  ?
  *The specified period does not include the day of taking the biomaterial

  99. 022

  Vitamins and minerals for the beauty of skin, hair and nails

  can be donated at home

  200 RUB

  4 165 ₽

  -25%

  3 120 ₽

  1 day

  ?
  *The specified period does not include the day of taking the biomaterial

  62.115

  Check up of vitamins and minerals in diseases of the hematopoietic system

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 5,310

  -15%

  RUB 4,510

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.112

  Check up of vitamins and minerals in diseases of the thyroid gland

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 5,215

  -15%

  RUB 4,430

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62. 116

  Check up of vitamins and minerals for insulin resistance and diabetes mellitus

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 7,500

  -5%

  RUB 7,125

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.122

  Vitamin and mineral deficiency in vegans and vegetarians

  can be donated at home

  * Biomaterial collection is paid separately:
  200 RUB

  8 370 RUB

  -20%

  6 695 RUB

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.114

  Check up of vitamins and minerals for oncological diseases

  can be taken at home

  * Taking biomaterial is paid separately:
  200 RUB

  13 420 ₽

  -10%

  12 075 ₽

  6 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62. 124

  Vitamin and mineral deficiency with frequent acute respiratory infections

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 10,980

  -10%

  RUB 9,880

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.123

  Vitamin and mineral deficiency after antibiotic therapy

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 4,570

  -10%

  RUB 4,110

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.113

  Check up of vitamins and minerals in diseases of the musculoskeletal system

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 5,810

  -35%

  RUB 3,775

  1 day

  ?
  *The specified period does not include the day of taking the biomaterial

  62. 118

  Check up vitamins and minerals for eye diseases

  can be donated at home

  * Biomaterial collection is paid separately:
  RUB 200

  RUB 4,740

  -5%

  RUB 4,500

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.117

  Check up of vitamins and minerals for autoimmune diseases

  can be taken at home

  * Taking biomaterial is paid separately:
  200 RUB

  11 045 ₽

  -5%

  10 490 ₽

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.126

  Deficiency of vitamins and minerals due to bad habits (smoking, drinking alcohol, drugs, fast food)

  can be taken at home

  * Taking biomaterial is paid separately:
  200 RUB

  14 770 RUB

  -5%

  14 030 ₽

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62. 111

  Check up of vitamins and minerals in diseases of the pancreas

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 7,450

  -10%

  RUB 6,705

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.108

  Check up of vitamins and minerals in diseases of the stomach and intestines

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 11,900

  -20%

  RUB 9,520

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.109

  Check up of vitamins and minerals for liver diseases

  can be taken at home

  * Taking biomaterial is paid separately:
  RUB 200

  RUB 13,900

  -15%

  RUB 11,815

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62. 107

  Check up vitamins and minerals for kidney disease

  can be donated at home

  * Biomaterial collection is paid separately:
  RUB 200

  RUB 11,455

  -15%

  RUB 9,735

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.098

  Vitamins and minerals for male reproductive health

  can be taken at home

  * Taking biomaterial is paid separately:
  200 RUB

  14 095 ₽

  -15%

  11 980 ₽

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.125

  Deficiency of vitamins and minerals in diseases of the nervous system (depression, radiculopathy)

  can be taken at home

  * Taking biomaterial is paid separately:
  200 RUB

  8 320 RUB

  -15%

  7 070 ₽

  5 days

  ?
  *The specified period does not include the day of taking the biomaterial

  62.