INTRODUCTION
ZENOXA contains Oxcarbazepine which belongs to the group of medicines called Anti-epileptics. It is used alone or in combination with other anti-epileptic medicines in children and adults to treat partial seizures with or without secondarily generalised tonic-clonic seizures. A seizure occurs due to a temporary fault in the brain’s electrical activity. Partial seizures involve a limited area of the brain, but may spread to the whole brain and may cause a generalised tonic-clonic seizure.
Before taking ZENOXA, inform your doctor if you have liver, kidney or heart disease, low levels of sodium in the blood or have intolerance to certain sugars or hereditary fructose intolerance. Prior to treatment with ZENOXA, your doctor may want you to take several blood tests to understand your existing condition.
ZENOXA should be used with caution in pregnant women only if clearly advised by the doctor and it is not recommended for use in breastfeeding women. Patients taking ZENOXA may have thoughts of harming or killing themselves. If at any time you have these thoughts, immediately consult your doctor.
ZENOXA can be used in children above 6 years of age and your child’s doctor may monitor the thyroid function of the child before and during treatment with this medicine. ZENOXA should be used with caution in elderly patients (aged 65 years and above), especially in patients with kidney impairment.
The most common side effects of taking ZENOXA are tiredness, headache, dizziness, nausea, vomiting, diarrhoea and stomach pain. Consult your doctor if any of the side effects worsen.
USES OF ZENOXA
Used alone or in combination with other anti-epileptic medicines:
To treat partial seizures with or without secondarily generalized tonic-clonic seizures
HOW ZENOXA WORKS
ZENOXA works by keeping the brain’s hyperactive nerve cells under control (by binding to sodium channels) thus reducing the chances and frequency of seizures.
DIRECTIONS FOR USE
Take ZENOXA as advised by your physician. Shake well before use. Use a measuring cup or a spoon to properly measure the dose. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition. Do not stop taking ZENOXA unless your doctor advises you to stop.
SIDE EFFECTS OF ZENOXA
COMMON
Tiredness, weakness
Headache, dizziness, drowsiness
Nausea, vomiting
Double, blurred or disturbed vision
Memory disturbances
Impaired concentration, loss of interest
Constipation, diarrhoea, stomach pain
Agitation, confusion
Acne, hair loss
Balance disturbances
Weight gain
Speech disorder
UNCOMMON
High blood pressure
Hives
RARE
Bone disorders like osteopenia and osteoporosis (thinning of the bone) and fractures
Stop taking ZENOXA and contact your doctor immediately if you experience any of the following side effects:
Increase fall
Trembling, coordination problems, involuntary movement of the eyes, anxiety and nervousness, depression, mood swing and rash
Underactive thyroid (signs include weight gain, tiredness, hair loss, muscle weakness and feeling cold)
Anaphylactic reactions and angioedema (signs include swelling of the lips, eyelids, face, throat or mouth, leading to trouble breathing, speaking or swallowing)
Drug rash with eosinophilia and systemic symptoms (skin rash or fever), acute generalized exanthematous pustulosis
Low blood sodium levels (signs include lethargy, confusion, muscle twitching or significant worsening of fits)
Decrease in the number of platelets or blood cells (signs include tiredness, shortness of breath when exercising, paleness, headache, chills, dizziness, frequent infections causing fever, sore throat, mouth ulcers, bleeding or bruising more easily than usual, nose bleeds, reddish or purplish patches or unexplained blotches on the skin)
HOW TO MANAGE SIDE EFFECTS
Nausea or vomiting:
Stick to simple meals while taking this medicine. Avoid eating oily rich, fried or spicy foods. Do not lie down or sleep immediately after eating. Consult your doctor if the symptom does not improve.
Headache:
Drink ample amount of water and avoid skipping meals. Get adequate rest. Try to be relaxed and stress-free. Apply pain relieving balm on your forehead if necessary. Consult your doctor if the symptom does not improve.
Dizziness:
Lie down until the dizziness is gone, then get up slowly. Move slowly and carefully, do not hurry. Get adequate rest. Drink plenty of water and other fluids. Avoid coffee, cigarettes, alcohol and drugs. Consult your doctor if the symptom gets worse.
Constipation:
Eat plenty of fibre-rich foods such as fresh fruits, vegetables and cereals and drink plenty of water. Exercise more regularly. Consult your doctor if the symptom does not improve.
Diarrhoea:
Drink lot of fluids, such as water to keep yourself hydrated. Avoid eating high-fat or spicy foods. Try to avoid taking any medicine on your own to treat diarrhoea and consult your doctor if the symptom gets worse.
Stomach pain:
Try to rest and relax. Eat and drink slowly or try to have smaller meals more frequently. Keep a heating pad on your stomach. If the symptom does not improve, consult your doctor.
WARNING & PRECAUTIONS
PREGNANCY
ZENOXA should be used with caution in pregnant women only if considered clearly necessary as there may be a risk to your baby. Do not stop taking this medicine during pregnancy without the advice of the doctor. Consult your doctor before taking ZENOXA.
BREASTFEEDING
ZENOXA is not recommended for use in breastfeeding women as it passes through breast milk and can affect breastfed babies. Consult your doctor before taking ZENOXA.
DRIVING AND USING MACHINES
Do not drive or operate any machines while taking ZENOXA as it may cause dizziness, sleepiness, muscle coordination problems, eye problems like double or blurred vision or depressed level of consciousness.
ALCOHOL
Avoid consumption of alcohol while taking ZENOXA as it may increase the sedative effect of this medicine.
KIDNEY
ZENOXA should be taken with caution in patients with kidney disease. Your doctor may initiate the treatment with the lowest effective dose. Consult your doctor before taking ZENOXA.
LIVER
ZENOXA should be taken with caution in patients with serious liver disease. Your doctor may adjust the dose based on liver function. Consult your doctor before taking ZENOXA.
ALLERGY
Do not take ZENOXA if you are allergic to Oxcarbazepine, eslicarbazepine or any other ingredients of this medicine.
HEART DISEASE
ZENOXA should be taken with caution in patients with heart disease (causing shortness of breath or swelling of the feet or legs due to fluid build-up). Consult your doctor before taking ZENOXA.
OTHERS
Before taking ZENOXA, inform your doctor if you:
Have low levels of sodium in the blood (hyponatremia)
Have intolerance to certain sugars or hereditary fructose intolerance
Use in pediatrics:
ZENOXA can be used in children above 6 years of age. Your child’s doctor may monitor the thyroid function of the child before and during treatment with this medicine and may adjust the dose depending on the child’s body weight. Consult your child’s doctor for advice before administering ZENOXA to your child.
Use in geriatrics:
ZENOXA should be used with caution in elderly patients (aged 65 years and above), especially in patients with kidney impairment. Consult your doctor before taking ZENOXA.
INTERACTIONS
A. Drug – Drug interactions:
Before taking ZENOXA, inform your doctor if you are taking any of the following medicines:
Other medicines used to treat fits (Ex. phenobarbital, phenytoin, carbamazepine, lamotrigine, valproic acid)
Medicines used to prevent pregnancy (Ex. ethinyl estradiol, desogestrel)
Medicines used to treat mental illness (Ex. lithium, phenelzine, moclobemide)
Medicines used to treat fluid retention (Ex. furosemide, hydrochlorothiazide)
Desmopressin (used to treat diabetes insipidus)
Medicines used to relieve pain and inflammation (Ex. indomethacin, ibuprofen)
Ciclosporin, tacrolimus (used to suppress the immune system to prevent organ rejection after transplant)
Rifampicin (used to treat tuberculosis)
Overdosage:
If you or anyone else accidentally take too much of ZENOXA, consult your doctor immediately or visit the nearby hospital. Overdosage symptoms of ZENOXA are drowsiness, dizziness, problems with coordination or involuntary movement of the eyes, muscular twitching or significant worsening of fits, headache, loss of consciousness and coma, nausea, vomiting, increased uncontrolled movements, lethargy, double or blurred vision, narrowing of the black part of the eye, tiredness, short and shallow breathing, irregular heartbeat, shaking, headache, coma, decreased consciousness, uncontrollable movements of mouth, tongue and limbs, aggression, agitation, confusion and low blood pressure.
SYNOPSIS
Drug : Oxcarbazepine
Pharmacological Category : Anti-convulsant
Therapeutic Indication : Partial seizures with or without secondarily generalised tonic-clonic seizures
Dosage Forms : Tablet, Syrup, Suspension
MORE INFORMATION
Keep ZENOXA out of reach of children
Store ZENOXA at room temperature
FAQs ABOUT ZENOXA
Can I continue taking my oral contraceptive pill with ZENOXA?
No, ZENOXA may stop hormonal contraceptives from working properly. Your doctor may advise you to use different or extra (non-hormonal) method of contraception while taking ZENOXA. Consult your doctor immediately if you experience irregular vaginal bleeding or spotting.
What if I forget to take a dose of ZENOXA?
If you forget to take a dose of ZENOXA, take it as soon as you remember. However, omit the missed dose if it is almost time for the next dose. Do not take ZENOXA twice to make up for the forgotten dose.
Can ZENOXA be used during pregnancy?
ZENOXA should be used with caution in pregnant women only if clearly advised by the doctor as there may be a risk to your baby. Do not stop taking this medicine during pregnancy without the advice of the doctor. Consult your doctor before taking ZENOXA.
Does ZENOXA affect my ability to drive or perform any activities?
Do not drive or operate any machines while taking ZENOXA as it may cause dizziness, sleepiness, muscle coordination problems, eye problems like double or blurred vision or depressed level of consciousness. You can resume your activities once if you are normal again. Consult your doctor for advice.
Can ZENOXA be used in patients with liver disease?
ZENOXA should be used with caution in patients with serious liver disease. Your doctor may adjust the dose based on liver function tests. Consult your doctor for advice before taking ZENOXA.
REFERENCES
1. Barbara G. Wells, Joseph T. DiPiro, Terry L. Shwinghammer, Cecily V. DiPiro. Epilepsy. Pharmacotherapy Handbook. Ninth edition. 2015. Page-518.
2. S M Grant, D Faulds. Oxcarbazepine. A review of its pharmacology and therapeutic potential in epilepsy, trigeminal neuralgia and affective disorders. NIH. National Center for Biotechnology Information.Pubmed.gov. June 1992. [Accessed on 4th June 2022] https://pubmed.ncbi.nlm.nih.gov/1379159/
3. Charles V. Preuss, Gagandeep Randhawa, Tom Joshua P. Wy, Abdolreza Saadabadi. Oxcarbazepine. NIH. National Library of Medicine. National Center for Biotechnology Information. May 2022. [Accessed on 4th June 2022] https://www.ncbi.nlm.nih.gov/books/NBK482313/#:~:text=Mechanism%20of%20Action,Oxcarbazepine%20binds%20to&text=Oxcarbazepine%20also%20inhibits%20the%20release,(monohydroxy%20metabolite%2C%20MHD)
4. Novartis Pharmaceuticals UK Limited. Health Products Regulatory Authority (HPRA). [Revised in April 2022] [Accessed on 4th June 2022] https://www.hpra.ie/img/uploaded/swedocuments/ecb613a4-43c2-4957-95a5-65e4e3003cdf.pdf
USEFUL DIAGNOSTIC TESTS
Electroencephalogram (EEG)
Thyroid function test
Kidney function test
Liver function test
Country Of Origin
India
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