title: EPICON consensus: recommendations for proper management of switching to eslicarbazepine acetate in epilepsy.
abstract: BACKGROUND
  The objective of the EPICON Project is to develop a set of recommendations on how to adequately switch from carbamazepine (CBZ) and oxcarbazepine (OXC) to eslicarbazepine acetate (ESL) in some patients with epilepsy.
  
  
  METHODS
  A steering committee drafted a questionnaire of 56 questions regarding the transition from CBZ or OXC to ESL in clinical practice (methodology and change situation). The questionnaire was then distributed to 54 epilepsy experts in 2 rounds using the Delphi method. An agreement/disagreement consensus was defined when a median ≥ 7 points or ≤ 3 was achieved, respectively, and a relative interquartile range ≤ 0.40. We analysed the results obtained to reach our conclusions.
  
  
  RESULTS
  Our main recommendations were the following: switching from CBZ to ESL must be carried out over a period of 1 to 3 weeks with a CBZ:ESL dose ratio of 1:1.3 and is recommended for patients who frequently forget to take their medication, those who work rotating shifts, polymedicated patients, subjects with cognitive problems, severe osteoporosis-osteopaenia, dyslipidaemia, or liver disease other than acute liver failure, as well as for men with erectile dysfunction caused by CBZ. The transition from OXC to ESL can take place overnight with an OXC:ESL dose ratio of 1:1 and it is recommended for patients who frequently forget to take their medication, those who work rotating shifts, polymedicated patients, or those with cognitive problems. The transition was not recommended for patients with prior rash due to CBZ or OXC use.
  
  
  CONCLUSIONS
  The EPICON Project offers a set of recommendations about the clinical management of switching from CBZ or OXC to ESL, using the Delphi method.
authors.affiliation: Hospital Universitario y Politécnico La Fe, València, España. Electronic address: vevillanuevah@yahoo.es.
authors.forename: V
authors.initials: V
authors.lastname: Villanueva
authors.affiliation: Hospital Universitario Infanta Sofía, San Sebastián de Los Reyes, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Ojeda
authors.affiliation: Hospital del Mar, Barcelona, España.
authors.forename: R A
authors.initials: RA
authors.lastname: Rocamora
authors.affiliation: Hospital Universitario Torrecárdenas, Almería, España.
authors.forename: P J
authors.initials: PJ
authors.lastname: Serrano-Castro
authors.affiliation: Hospital Universitario La Paz, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Parra
authors.affiliation: Hospital Quirón Sagrado Corazón, Sevilla, España.
authors.forename: J J
authors.initials: JJ
authors.lastname: Rodríguez-Uranga
authors.affiliation: Clínica Teknon, Barcelona, España.
authors.forename: H
authors.initials: H
authors.lastname: Bathal
authors.affiliation: Clínica Universitaria Navarra, Pamplona, Navarra, España.
authors.forename: C
authors.initials: C
authors.lastname: Viteri
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003697:Delphi Technique; D003984:Dibenzazepines / Q000627:therapeutic use*; D057915:Drug Substitution / Q000379:methods*; D004827:Epilepsy / Q000188:drug therapy*; D017408:Guidelines as Topic; D006801:Humans; D000072141:Neurologists; D000078330:Oxcarbazepine; D011795:Surveys and Questionnaires; D061567:Voltage-Gated Sodium Channel Blockers / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D003984:Dibenzazepines; D061567:Voltage-Gated Sodium Channel Blockers; D002220:Carbamazepine; C416835:eslicarbazepine acetate; D000078330:Oxcarbazepine
keywords: Acetato de eslicarbazepina; Cambio; Carbamazepina; Carbamazepine; Drug switching; Eslicarbazepine acetate; Methodology; Metodología; Oxcarbazepina; Oxcarbazepine; Situaciones; Situations