title: Usefulness of oral loading of oxcarbazepine suspension in selected patients with epilepsy.
abstract: OBJECTIVE
  Oral loading of oxcarbazepine tablet is effective and well tolerated to adequately achieve the therapeutic levels of its active metabolite, 10,11-dihydro-10-hydroxy-carbazepine (monohydroxy derivative, MHD) in epilepsy patients. The present study was performed to investigate the safety, tolerability, and pharmacokinetic profiles of oral loading of oxcarbazepine suspension in epilepsy patients with a high risk of recurrent seizures.
  
  
  METHODS
  Oxcarbazepine suspension was administered orally at a single loading dose of 30 mg/kg to 38 adult patients with recurrent seizures, who required rapid seizure control or temporarily discontinued antiepileptic drugs for diagnostic or pre-surgical evaluation. Plasma concentrations of oxcarbazepine and MHD were determined, and adverse events were assessed at 2, 4, 6, 8, 10, 12, 14, 16, and 24 hours after oral loading of oxcarbazepine suspension.
  
  
  RESULTS
  30 patients experienced ≥ 1 adverse event during the first 24 hours after oral loading of oxcarbazepine (e.g., dizziness, transient diplopia, nausea or vomiting), most of which occurred within 4 hours after loading, suggesting no temporal association with MHD plasma levels. 35 (92.1%) patients were still compliant with a maintenance dose of oxcarbazepine after discharge from hospital. 34 (89.4%) patients reached the lower therapeutic level of MHD (12 mg/l) at 4 hours after oral loading of oxcarbazepine suspension, which lasted up to 24 hours in most patients. No patient reached the supratherapeutic levels of MHD (> 35 mg/l) during the study. The mean plasma concentration-time curves and pharmacokinetic profiles of oral loading of oxcarbazepine suspension were similar to those of oral loading of oxcarbazepine tablet.
  
  
  CONCLUSIONS
  Oral loading of oxcarbazepine suspension followed by maintenance dosing is well tolerated and effective in steadily achieving the therapeutic level of MHD in selected patients with epilepsy.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Kim
authors.forename: Namyi
authors.initials: N
authors.lastname: Gu
authors.forename: Howard
authors.initials: H
authors.lastname: Lee
authors.forename: In-Jin
authors.initials: IJ
authors.lastname: Jang
authors.forename: Kon
authors.initials: K
authors.lastname: Chu
authors.forename: Kyung-Sang
authors.initials: KS
authors.lastname: Yu
authors.forename: Joo-Youn
authors.initials: JY
authors.lastname: Cho
authors.forename: Seo Hyun
authors.initials: SH
authors.lastname: Yoon
authors.forename: Hyun Jeong
authors.initials: HJ
authors.lastname: Na
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D019540:Area Under Curve; D002220:Carbamazepine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000078330:Oxcarbazepine; D018579:Patient Selection; D013535:Suspensions / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D013535:Suspensions; D002220:Carbamazepine; D000078330:Oxcarbazepine