How does Aptiom work?

This medication has an effect on the sodium channels of the nerve cells in the brain, and this may be related to its anti-seizure effect.

What drugs should not be taken with Aptiom?

Aptiom has many drug interactions. It decreases the effectiveness of certain oral contraceptives and cholesterol-lowering medications . When used with other anticonvulsants, the level of Aptiom, as well as the level of other anticonvulsants, can be altered.

How do I safely stop taking Aptiom?

You should not suddenly stop taking Aptiom. Instead, follow your healthcare provider's instructions when you discontinue it. Suddenly stopping can cause you to have a seizure. Instead, your healthcare provider may give you a schedule to gradually reduce your dose until you can safely discontinue it and/or replace it with another anti-epilepsy drug.

Aptiom (Eslicarbazepine) - Oral: Uses, Side Effects

What Is Aptiom?

Aptiom (eslicarbazepine) is an anti-seizure medication (also described as an anticonvulsant or an anti-epilepsy drug, AED) often prescribed to prevent partial-onset seizures (also called focal seizures) for adults and children ages 4 and older who have epilepsy. It is available in tablet form for oral use.

This medication converts to eslicarbazepine, which is thought to have anti-seizure effects by inhibiting voltage-gated sodium channels in the brain. These channels mediate nerve activity in the brain, and their inhibition may reduce seizures.

Drug Facts

Generic Name: Eslicarbazepine

Brand Name(s): Aptiom

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Anticonvulsant

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Eslicarbazepine acetate

Dosage Form(s): Tablet

What Is Aptiom Used For?

The Food and Drug Administration (FDA) approved Aptiom to prevent partial-onset seizures in people 4 years and older. Partial-onset seizures begin in one area of the brain. Symptoms can include involuntary movements or sensory changes in one part of the body. These seizures typically last between a few seconds to a few minutes, but they can sometimes have a longer duration.

Usually, partial-onset seizures have the same pattern of symptoms whenever they recur—typically affecting the same side of the body each time.

Apitiom (Esclicarbazepine) Drug Information: A person with their brain — Verywell / Zoe Hansen

How to Take Aptiom

This medication is meant to be taken once per day. You can take it with or without food, as a whole tablet, or crushed.

Follow your healthcare provider's instructions on how to take your medication. Be careful not to stop taking Aptiom abruptly, as this can cause seizures to worsen.

Storage

Keep Aptiom in its original container and out of the reach of children and pets. Store the tablets at room temperature (68 F to 77 F).

Off-Label Uses

Healthcare providers sometimes prescribe Aptiom off-label for other conditions besides its approved uses. Research has examined the potential for off-label uses as well.

Off-label uses of Aptiom include:

Headaches
Neuropathic pain
Trigeminal neuralgia
Alzheimer’s disease

When prescribed for these indications, Aptiom is used every day to prevent symptoms. It is not used to treat symptoms that are already occurring.

How Long Does Aptiom Take to Work?

Aptiom begins to have effects on the body within one day, and it can take five days before it has a therapeutic effect for preventing seizures.

What Are the Side Effects of Aptiom?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects of Aptiom are:

Dizziness
Extreme sleepiness, fatigue
Nausea, vomiting
Headaches
Double vision, blurred vision
A sense that the room is spinning
Diminished balance
Tremors

Talk to your healthcare provider about any side effects you have while taking Aptiom. While the symptoms may be tolerable, you might need to make certain adjustments in your life, such as being careful to avoid falls if you have dizziness or problems with your balance. Depending on the severity of the side effects, your healthcare provider might prescribe a different dose of Aptiom, stop the medication, or give you treatment for your side effects.

Severe Side Effects

Sometimes harmful or life-threatening side effects can occur due to Aptiom.

Potentially serious side effects of this medication:

Thinking about suicide or having suicidal behavior
Serious skin reactions
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), which can cause fevers, a severe rash, swelling, and organ failure
Liver damage, which can cause a yellow appearance of the eyes and skin (jaundice) and a general feeling of illness
Low blood cell counts
Low blood sodium levels, which can cause changes in consciousness, seizures, and brain damage
Severe dizziness, balance problems, and difficulty walking
Confusion and trouble thinking

Be sure to familiarize yourself with the signs of these complications and get medical attention right away if you start to experience them.

Long-Term Side Effects

If you have liver damage or blood cell problems, you may have long-term effects of these problems after you stop taking this drug. DRESS and severe skin reactions can also cause prolonged health issues if left untreated.

Report Side Effects

Aptiom may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

(800) 332-1088

Dosage: How Much Aptiom Should I Take?

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- For seizures:
  - Adults—At first, 400 milligrams (mg) once per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 1600 mg once per day.
  - Children 4 to 17 years of age—Dose is based in body weight and must be determined by your doctor.
    - Weighs more than 38 kilograms (kg)—At first, 400 mg once per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 1200 mg once per day.
    - Weighs 32 to 38 kg—At first, 300 mg once per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 900 mg once per day.
    - Weighs 22 to 31 kg—At first, 300 mg once per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 800 mg once per day.
    - Weighs 11 to 21 kg—At first, 200 mg once per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 600 mg once per day.
  - Children younger than 4 years of age—Use and dose must be determined by your doctor.

Modifications

The following instances may require your healthcare provider to change your dosage of this medication:

Taking certain other anti-epileptic drugs, such as Tegretol (carbamazepine)
Moderate or severe kidney impairment
Discontinuation of Aptiom, which may require a gradual reduction in dosage to prevent the risk of increased seizures that can occur when stopping treatment too abruptly

Missed Dose

Ask your healthcare provider what you should do if you miss a dose of Aptiom. You should not stop taking this medication without talking to your healthcare provider first.

Overdose: What Happens If I Take Too Much Aptiom?

Dangerous consequences can occur from taking too much Aptiom.

Effects of an overdose include:

Low sodium levels
Severe dizziness and trouble walking
Nausea and vomiting
Extreme fatigue
Tingling of the mouth
Trouble walking
Mood changes
Double vision
Coordination problems

You would need to be observed and treated for any symptoms you experience from taking too much Aptiom. Sometimes the drug can be removed from the body with gastric lavage (a tube is placed through the mouth to remove the medication), activated charcoal, or hemodialysis.

What Happens If I Overdose on Aptiom?

If you think you or someone else may have overdosed on Aptiom, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Aptiom, call 911 immediately.

911

Precautions

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Eslicarbazepine may cause some people to be agitated, irritable, or display other abnormal behaviors, such as feeling sad or hopeless, getting upset easily, or feeling nervous, restless, or hostile. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you notice any of these side effects, tell your doctor right away.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine.

This medicine may cause serious allergic reactions affecting multiple body organs (eg, liver, kidneys). Check with your doctor right away if you have the following symptoms: a fever, dark urine, headache, rash, stomach pain, swollen, painful, or tender lymph glands in neck, armpit, or groin, unusual tiredness, or yellow eyes or skin.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema. These can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

This medicine may cause hyponatremia (low sodium in the blood). Check with your doctor right away if you have confusion, decreased urine output, dizziness, fast or irregular heartbeat, headache, muscle pain or cramps, nausea, vomiting, swelling of the face, ankles, or hands, or unusual tiredness or weakness while you are using this medicine.

Eslicarbazepine may make you dizzy, drowsy, clumsy, tired, or have vision changes. Do not drive or do anything else that could be dangerous until you or your child know how this medicine affects you. If these reactions are especially bothersome, check with your doctor.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help decrease your chance of having more seizures.

This medicine may increase your risk of having blood problems (eg, pancytopenia, agranulocytosis, leukopenia). Talk to your doctor about this risk.

Some birth control pills may not work as well while you are using this medicine. You might need additional forms of birth control with your pills to avoid getting pregnant. Talk to your doctor if you have concerns.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Aptiom?

Aptiom may not be the best medication if you:

Are allergic to eslicarbazepine acetate or oxcarbazepine
Are pregnant or plan to become pregnant: You and your healthcare provider should weigh the risks vs. benefits of taking Aptiom during your pregnancy.
Are breastfeeding: Aptiom can pass into human breast milk. Talk to your healthcare provider about whether you should continue this medication.
Have liver problems

What Other Medications Interact With Aptiom?

Sometimes, Aptiom is prescribed with other AEDs. This can cause interactions that may alter drug levels, which may require dose changes.

When taken together, these drugs can decrease levels of Aptiom in the body:

Carbamazepine
Phenobarbital
Dilantin (phenytoin)
Mysoline (primidone)

On the other hand, when taken together, Aptiom can increase the levels of:

Aptiom can decrease levels and reduce the action of:

Hormonal contraceptives
Zocor (simvastatin)
Lovastatin

Your healthcare provider may recommend close monitoring while taking medications that interact with each other. They may adjust the dosage of Aptiom or any other medications.

What Medications Are Similar?

Zebinix is another brand of eslicarbazepine acetate approved for use outside of the United States in Europe.

Some other commonly prescribed AEDs include:

Carbamazepine
Trileptal (oxcarbazepine)
Dilantin (phenytoin)
Lamcital (lamotrigine)
Phenobarbital
Mysoline (primidone)

Aptiom can be used to prevent more than one seizure type and may be prescribed with other AEDs when add-on therapy is needed.

Frequently Asked Questions

What is Aptiom used for?

Aptiom is prescribed to prevent partial-onset seizures (also called focal seizures) for adults and children aged 4 and older who have epilepsy.
How does Aptiom work?

This medication has an effect on the sodium channels of the nerve cells in the brain, and this may be related to its anti-seizure effect.
What drugs should not be taken with Aptiom?

Aptiom has many drug interactions. It decreases the effectiveness of certain oral contraceptives and cholesterol-lowering medications. When used with other anticonvulsants, the level of Aptiom, as well as the level of other anticonvulsants, can be altered.
What are the side effects of Aptiom?

This medication can cause a variety of side effects, including drowsiness, nausea, dizziness, and balance problems. These common side effects can range from mild to severe. Aptiom can also cause serious side effects, such as suicidal thoughts or actions, serious skin reactions, and organ failure.
How do I safely stop taking Aptiom?

You should not suddenly stop taking Aptiom. Instead, follow your healthcare provider's instructions when you discontinue it. Suddenly stopping can cause you to have a seizure. Instead, your healthcare provider may give you a schedule to gradually reduce your dose until you can safely discontinue it and/or replace it with another anti-epilepsy drug.

How Can I Stay Healthy While Taking Aptiom?

There are several things you can do to stay healthy while taking Aptiom. Make sure to take Aptiom and your other medications as directed by your healthcare provider.

Having epilepsy can impact your day-to-day activities and functioning. This condition not only affects the physical aspects of your life but can also take an emotional toll. Learning more about epilepsy, its triggers, and available therapies can help you feel empowered to take control of your health. There are many different coping strategies that can help you better manage your epilepsy.

Staying adherent to your medication regimen is especially important with epilepsy. In some cases, you might be prescribed multiple drugs. Consider using a pill organizer, a medication-related app, or reminders on your smartphone to keep tabs on your medication schedule.

Always tell your healthcare team about any new medications you are taking and if you experience any side effects. Never abruptly stop taking Aptiom without talking to your healthcare provider. If you need to stop taking it, they can help you safely discontinue your medication to minimize the risk of severe withdrawal effects.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Food and Drug Administration. Aptiom label.
Shaikh S, Rizvi SM, Hameed N, et al. Aptiom (eslicarbazepine acetate) as a dual inhibitor of β-secretase and voltage-gated sodium channel: advancement in Alzheimer's disease-epilepsy linkage via an enzoinformatics study. CNS Neurol Disord Drug Targets. 2014;13(7):1258-1262. doi:10.2174/1871527313666140917121600
Alcántara Montero A, Sánchez Carnerero CI. Eslicarbazepine acetate for neuropathic pain, headache, and cranial neuralgia: evidence and experience. Neurologia (Engl Ed). 2019;34(6):386-395. doi:10.1016/j.nrl.2016.11.009
Gambeta E, Chichorro JG, Zamponi GW. Trigeminal neuralgia: an overview from pathophysiology to pharmacological treatments. Mol Pain. 2020;16:1744806920901890. doi:10.1177/1744806920901890
Fowler T, Bansal AS, Lozsádi D. Risks and management of antiepileptic drug induced skin reactions in the adult out-patient setting. Seizure. 2019;72:61-70. doi:10.1016/j.seizure.2019.07.003

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.

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