The key difference between carbamazepine and oxcarbazepine is that carbamazepine converts into an epoxide metabolite during its metabolism, whereas oxcarbazepine converts into its monohydroxy derivative.
Carbamazepine is an anticonvulsant medication useful in treating epilepsy and neuropathic pain. Oxcarbazepine is a medication useful in treating epilepsy. These medications are two important medications that are structurally analogous to each other but different in metabolic pathways.
CONTENTS
1. Overview and Key Difference
2. What is Carbamazepine
3. What is Oxcarbazepine
4. Carbamazepine vs Oxcarbazepine in Tabular Form
5. Summary – Carbamazepine vs Oxcarbazepine
What is Carbamazepine?
Carbamazepine is an anticonvulsant medication useful in treating epilepsy and neuropathic pain. This medication is sold under the name Tegretol. This medication is useful as an adjunctive treatment in schizophrenia. Moreover, it is useful as a second-line agent in bipolar disorder. Besides, this medication apparently works well with phenytoin and valproate in focal and generalized seizures. However, it is not effective for absence or myoclonic seizures.
Figure 01: The Chemical Structure of Carbamazepine
In 1953, a Swiss chemist named Walter Schindler discovered carbamazepine. This medication came to the market for the first time in 1962. Moreover, it is available in the market as a generic medication.
The administration of carbamazepine can be done orally. The bioavailability of this medication is about 100%, and its protein binding ability ranges from 70- 80%. The metabolism occurs in the liver, and as metabolites, active epoxides form. The elimination half-life is around 36 hours, and the excretion occurs through urine and feces.
Typically, we use carbamazepine for the treatment of seizure disorders and neuropathic pain. We can use this medication off-label as a second-line treatment for bipolar disorder, and we can also use it in combination with an antipsychotic when treating this condition with a conventional antipsychotic alone is not giving the desired result.
What is Oxcarbazepine?
Oxcarbazepine is a medication useful in treating epilepsy. It is sold under the trade name Trileptal. When treating epilepsy, we can use it for both focal seizures and generalized seizures. Moreover, we can use it alone or as add-on therapy for people having a bipolar disorder that does not answer to other treatments. The route of administration of this medicine is oral.
Figure 02: The Chemical Structure of Oxcarbazepine
The bioavailability of oxcarbazepine is about 95%, and its metabolism occurs in the liver in the presence of cytosolic enzymes and glucuronic acid. The elimination half-life of oxcarbazepine is 1- 5 hours, and the excretion occurs in the kidney.
There can be some side effects of oxcarbazepine, such as nausea, vomiting, dizziness, drowsiness, double vision, and trouble walking. However, there are some severe side effects as well: anaphylaxis, liver problems, pancreatitis, suicide ideation, and abnormal heartbeat. Moreover, using this medication during pregnancy can harm the baby; further, it is not recommended during breastfeeding.
The patent for oxcarbazepine was obtained in 1969, and it came into the market for the first time in 1990 for medical use. It is available in the market as a generic medication.
What is the Difference Between Carbamazepine and Oxcarbazepine?
Carbamazepine and oxcarbazepine are two important medications that are structurally analogous to each other but different in metabolic pathways. The key difference between carbamazepine and oxcarbazepine is that carbamazepine converts into an epoxide metabolite during its metabolism, whereas oxcarbazepine converts into its monohydroxy derivative.
Below is a summary of the difference between carbamazepine and oxcarbazepine in tabular form for side by side comparison.
Summary – Carbamazepine vs Oxcarbazepine
Carbamazepine is an anticonvulsant medication useful in treating epilepsy and neuropathic pain. Oxcarbazepine is a medication useful in treating epilepsy. The key difference between carbamazepine and oxcarbazepine is that carbamazepine converts into an epoxide metabolite during its metabolism, whereas oxcarbazepine converts into its monohydroxy derivative.
Reference:
1. “Carbamazepine: Medlineplus Drug Information.” MedlinePlus, U.S. National Library of Medicine.
Image Courtesy:
1. “Carbamazepine” By Harbin – Own work (Public Domain) via Commons Wikimedia
2. “Oxcarbazepine” By Harbin – Own work (Public Domain) via Commons Wikimedia