There are few reports of overdose. The maximum dose described in the reports was approximately g. After the symptomatic treatment of all cases achieved recovery. Symptoms: drowsiness, dizziness, nausea, vomiting, hyperkinesia, hyponatraemia, ataxia, nystagmus.
Treatment. There is no specific antidote. Symptomatic and supportive treatment. It should be borne in mind that in order to reduce absorption of oxcarbazepine may be conducted gastric lavage and an appointment activated carbon.
Interaction with other medicinal products and other forms of interaction . The inhibition of enzymes oxcarbazepine and its pharmacologically active metabolite are inhibitors of cytochrome . Thus, the simultaneous use Trileptal in high doses and drugs are metabolized with nandrolone (eg, phenobarbital, phenytoin), can lead to their interaction. Some patients may require a dose reduction substrates. It has been demonstrated that oxcarbazepine s weak or does not interact with the following microsomal enzymes. The induction of enzymes As inducers of cytochrome , oxcarbazepine reduce plasma concentrations of drugs metabolized by these enzymes: digidropiridinovgh calcium antagonists, oral contraceptives, and antiepileptic drugs (eg, carbamazepine). In an application with Trileptalom also may reduce plasma concentrations of other drugs that are substrates for enzymes , (eg, drugs of immunosuppressants – cyclosporine). Since in vitro is a weak inducer transferase, it is unlikely that in vivo it is able to affect the metabolism of drugs that are excreted as conjugates with glyukurokovoy acid (eg, valproic acid and lamotrigine). However, even taking into account the weak inducing ability of oxcarbazepine , may require increased doses of both of the drugs that are metabolized transferase. In case of cancellation may require dose reduction of these drugs. With In vitro, studies have confirmed the ability of inducing a weak oxcarbazepine and nandrolone with regard to isozymes of subsystems nzymes. Inducing influence of oxcarbazepine to other enzymes known.
- The concentration of phenytoin in blood plasma increases to 40% while applying Trileptal a dose of 1200 mg daily or higher. Therefore, when using Trileptal in the above doses may need to reduce the dose of phenytoin.
Increasing the concentration of phenobarbital in serum while the use slightly (15%) With the simultaneous use of strong inducers (ie carbamazepine, phenytoin and phenobarbital) decreases the concentration.
have Trileptal showed no auto-induction phenomena. Hormonal contraceptives proved interaction with the components of oral contraceptives: ethinyl estradiol and levonorgestrel. Mean values for them is reduced by 48-52% and 32-52%, respectively. Interaction studies with other oral or implanted contraceptives have been conducted. Thus, the simultaneous use nandrolone and hormonal contraceptives can lead to reduced efficiency of the latter. Calcium channel blockers simultaneous use and felodipine may reduce the value of felodipine at 28%, although the plasma concentration remains within the therapeutic range. On the other hand, while the use of verapamil may decrease in serum concentration of 20%. This reduction in the concentration in the serum has clinical importance. Interaction with other drugs cimetidine, erythromycin, dextropropoxyphene not affect the pharmacokinetic parameters ; viloksazin little effect on the plasma concentration . There was no any interaction with warfarin as coadministration with single and repeated.
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