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Uses
Oxtellar XR™ is indicated as adjunctive therapy of partial seizures in adults and in children 6 years to 17 years of age.
History
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Other Information
Oxtellar XR™ is an antiepileptic drug (AED). Oxtellar XR™ extended-release tablets contain oxcarbazepine for once-a-day oral administration.
Oxcarbazepine is 10,11-Dihydro-10-oxo-5H-dibenz[b,f]-azepine-5-carboxamide, and its structural formula is
Oxcarbazepine is off-white to yellow crystalline powder.
Oxcarbazepine is sparingly soluble in chloroform (30-100 g/L). In aqueous media over pH range 1 to 8, oxcarbazepine is practically insoluble and its solubility is 40 mg/L (0.04 g/L) at pH 7.0, 25°C. The molecular formula is C15H12N2O2 and its molecular weight is 252.27.
Oxtellar XR™ tablets contain the following inactive ingredients: colloidal silicon dioxide, hypromellose, yellow iron oxide (150 mg, 300 mg tablets only), red iron oxide (300 mg, 600 mg tablets only), black iron oxide (300 mg tablet only), magnesium stearate, methacrylic acid copolymer, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, povidone, sodium lauryl sulfate, talc, and titanium dioxide. Each tablet is printed on one side with edible black ink.
Sources
Oxtellar Xr Manufacturers
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Supernus
Oxtellar Xr | Supernus
2.1 Important Administration InstructionsAdminister Oxtellar XR™ as a single daily dose taken on an empty stomach (at least 1 hour before or at least 2 hours after meals) [see Clinical Pharmacology (12.3)]. If Oxtellar XR™ is taken with food, adverse reactions are more likely to occur because of increased peak levels [see Clinical Pharmacology (12.3)].
Swallow Oxtellar XR™ tablets whole. Do not cut, crush, or chew the tablets. For ease of swallowing in pediatric patients or patients with difficulty swallowing, achieve daily dosages with multiples of appropriate lower strength tablets (e.g., 150 mg tablets).
2.2 Dosing for Adults in Adjunctive TherapyThe recommended daily dose of Oxtellar XR™ is 1,200 mg to 2,400 mg per day, given once daily. The dose of 2,400 mg per day showed slightly greater efficacy than 1,200 mg per day, but was associated with an increase in adverse reactions.
Initiate treatment at a dose of 600 mg per day given once daily for one week. Subsequent dose increases can be made at weekly intervals in 600 mg per day increments to achieve the recommended daily dose.
2.3 Dosing for Children (6 to 17 years of age) in Adjunctive TherapyIn pediatric patients 6 years to 17 years of age, initiate treatment at a daily dose of 8 mg/kg to 10 mg/kg once daily, not to exceed 600 mg per day in the first week.
Subsequent dose increases can be made at weekly intervals in 8 mg/kg to 10 mg/kg increments once daily, not to exceed 600 mg, to achieve the target daily dose. The target maintenance dose, achieved over two to three weeks, is displayed in Table 1.
Table 1: Target Daily Dose in Pediatric Patients Aged 6 to 17 Years Old Weight Target Daily Dose 20 kg to 29 kg 900 mg per day 29.1 kg to 39 kg 1200 mg per day Greater than 39 kg 1800 mg per day 2.4 Dosage Modifications in Patients with Renal ImpairmentIn patients with severe renal impairment (creatinine clearance less than 30 mL/minute), initiate Oxtellar XR™ at one-half the usual starting dose (300 mg per day). Subsequent dose increases can be made at weekly intervals in increments of 300 mg to 450 mg per day to achieve the desired clinical response. [see Use in Specific Populations (8.5)].
2.5 Dosage Modifications in Geriatric PatientsIn geriatric patients, consider starting at a lower dose (300 mg or 450 mg per day). Subsequent dose increases can be made at weekly intervals in increments of 300 mg to 450 mg per day to achieve the desired clinical effect [see Use in Specific Populations (8.4)].
2.6 Dosage Modification for use with Concomitant Antiepileptic DrugsEnzyme inducing antiepileptic drugs such as carbamazepine, phenobarbital, and phenytoin decrease exposure to 10-monohydroxy derivative (MHD), the active metabolite. Dosage increases may be necessary. Consider initiating dose at 900 mg once per day [see Drug Interactions (7.1)].
2.7 Withdrawal of AEDsAs with all antiepileptic drugs, Oxtellar XR™ should be withdrawn gradually to minimize the potential of increased seizure frequency [see Warnings and Precautions (5.6)].
2.8 Conversion from Immediate-Release Oxcarbazepine to Oxtellar XR™In conversion of oxcarbazepine immediate-release to Oxtellar XR™, higher doses of Oxtellar XR™ may be necessary [see Clinical Pharmacology (12.3)].
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