Oxcarbazepine for facial pain

If you have chronic pain in the face, we might prescribe you a medicine called  oxcarbazepine. Chronic pain (also called persistent pain) is long-term pain that lasts for more than 3 months.

Oxcarbazepine is a medicine used to treat epilepsy. It can also be taken for nerve pain caused by diabetes (peripheral neuropathy) or if you have a painful condition of the face called trigeminal neuralgia.

This medicine is only available on prescription. Always take the amount (dose) prescribed by your doctor, and read the leaflet that comes with your medicine.

Taking an unlicensed medicine

The use of oxcarbazepine for treating chronic facial pain is unlicensed. This means that the manufacturer of the medicine has not specified it can be used in this way, but there is evidence that it works to treat this particular condition.

Read more about unlicensed medicines, or you can contact the pharmacy medicines helpline if you have any questions or concerns.

Taking oxcarbazepine

Most people take oxcarbazepine 1 to 4 times each day.

Try to space your oxcarbazepine doses evenly through the day. For example, first thing in the morning, lunchtime, afternoon and in the evening.

You can take this medicine with or without food.

To prevent the chance of side effects, your doctor will start you on a low dose of oxcarbazepine. They will increase it gradually over a few days or weeks.

When you find a dose that suits you, it will usually stay the same (unless your condition changes, or your doctor starts you on a new medicine that might affect oxcarbazepine).

It usually takes 2 weeks for oxcarbazepine to start working.

How much to take (dose)

Day Morning Lunchtime Afternoon Night time
1 to 3 150mg -- -- 150mg
4 to 14 150mg 150mg -- 150mg
15 to 21 150mg 150mg 150mg 150mg
22 to 28 300mg 150mg 150mg 300mg
29 to 34 300mg 300mg 150mg 300mg
35 to 40 300mg 300mg 300mg 300mg
41 to 45 300mg 300mg 300mg 450mg
46 onwards 300mg 300mg 300mg 600mg

If you forget to take the medicine

If it's less than 8 hours before the next dose is due, it's better to leave out the missed dose and take your next dose as normal.

Do not take 2 doses at the same time to make up for a forgotten dose.

If you forget doses often, it might help to set an alarm to remind you. You can ask your pharmacist for advice on other ways to help you to remember to take your medicine.

Side effects of oxcarbazepine

Like all medicines, oxcarbazepine can cause side effects, although not everyone gets them.

Skin rashes

It's common to get a skin rash with oxcarbazepine. Most skin rashes are not serious.

Tell your GP or go to the nearest A&E immediately if:

  • you notice flu-like symptoms, followed by a red or purple rash that spreads and forms blisters which peel off

This can develop into a life-threatening skin condition called severe cutaneous adverse reactions.

This is a rare side effect of oxcarbazepine. It's more likely to happen in the first 8 weeks of using oxcarbazepine, or when the dose is increased too quickly. It can also happen if oxcarbazepine is stopped suddenly for a few days and then restarted at the same dose as before. If you need to stop taking oxcarbazepine for a few days, your doctor will tell you how to reduce the dose and increase it slowly again.

Try not to not start any new medicines, foods or products during the first 3 months of treatment with oxcarbazepine. This will help prevent you getting a rash that could be confused with severe cutaneous adverse reactions.

You should try not to start using oxcarbazepine within 2 weeks of having a viral infection, vaccination, or rash caused by something else.

Common side effects

  • feeling dizzy, sleepy or tired
  • feeling sick (nausea) or being sick (vomiting)
  • headaches
  • dry mouth
  • putting on weight

These side effects happen in more than 1 in 100 people. They're usually mild and go away by themselves.

If these side effects bother you or do not go away, keep taking the medicine but talk to your pharmacist or doctor.

Serious side effects

It is unusual to have serious side effects after taking oxcarbazepine.

Tell a doctor immediately if you have:

  • unusual bleeding or bruising, mouth sores, infections, a high temperature (fever) or sore throat (these can be signs of a blood disorder)
  • thoughts of harming or killing yourself (a few people taking oxcarbazepine have had suicidal thoughts)
  • a severe rash with flushing, blisters or ulcers (these can be signs of severe cutaneous adverse reactions)
  • yellowing of skin or whites of eyes (these can be signs of a liver problem)
  • pain in your joints and muscles, a rash across the bridge of your nose and cheeks, and problems breathing (these are signs of lupus)

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to oxcarbazepine.

Contact your GP or go to the nearest A&E immediately if:

  • you get a skin rash that might include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in your chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

These are not all the side effects of oxcarbazepine. For a full list see the leaflet inside your medicine packet.

Pregnancy and breastfeeding

There's no firm evidence oxcarbazepine is harmful to an unborn baby. However, for safety, your doctor will only advise you to take it in pregnancy if the benefits of the medicine outweigh the risks.

Oxcarbazepine does pass into breast milk, but the amount is probably too small to be harmful.

Taking oxcarbazepine with other medicines

There are some medicines that interfere with the effects of oxcarbazepine. Please make sure your hospital doctor is aware of other medicines you are taking.

Repeat prescriptions

Your GP will give you a repeat prescription for oxcarbazepine, which you can take to your local pharmacy.

Make sure you request your repeat prescription early so that you do not run out of medicine or miss any doses.

Resource number: 4834/VER1
Last reviewed: October 2019
Next review due: October 2022

Contact us

If you have any questions about your medicine for facial pain, please contact the oral medicine team.

Phone: 020 7188 4399, Monday to Friday, 9am to 5pm

You can also contact our pharmacy medicines helpline.

Phone: 020 7188 8748, Monday to Friday, 9am to 5pm

Email: [email protected]

Do you have any comments or concerns about your care?

Contact our Patient Advice and Liaison Service (PALS)

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