Oxcarbazepine

A derivative of carbamazepine with a very similar chemical structure and therapeutic action. It is used in the treatment of certain epilepsies, bipolar disorder and neuropathic pain. It is rapidly and extensively metabolised to licarbazepine (MHD), its active metabolite.

It is excreted in breast milk in clinically insignificant amount ^{(Chen 2017, Lutz 2007, Bülau 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 15% of maternal plasma levels. ^{(Birnbaum 2020, Chen 2017, Öhman 2009, Lutz 2007)}

A mother told us in 2016 that she took Trileptal during pregnancy and 9 months of breastfeeding and her son had no problems.

A 12-hour neonate who developed neonatal abstinence syndrome (irritability, muscle hypertonia) after intrauterine exposure to oxcarbazepine improved after being breastfed. ^{(Chen 2017)}

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 possible to take during breastfeeding. ^{(Hale, LactMed, Uguz 2021 & 2016, Briggs 2015, 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:

• Carbamazepine (Safe product and/or breastfeeding is the best option.)
• Maternal Epilepsy (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)