This sheet talks about exposure to oxcarbazepine in pregnancy or while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is oxcarbazepine?
Oxcarbazepine is a medication that has been approved for the treatment of partial seizures. It has also been used to treat migraine, symptoms of dementia, and bipolar disorder. Some brand names for oxcarbazepine are Trileptal® and Oxtellar XR®.
I take oxcarbazepine. Can it make it harder for me to become pregnant?
Studies have not been done in people to see if oxcarbazepine could make it harder to get pregnant. When possible, a person with a seizure disorder or a migraine disorder who could become pregnant should discuss their options for treatment in a pregnancy with their healthcare providers before becoming pregnant. They should also discuss taking a folic acid or prenatal vitamin supplement.
I just found out that I am pregnant. Should I stop taking oxcarbazepine?
Talk with your healthcare providers before making any changes to how you take your medication(s).
Having a seizure while pregnant might be harmful to the pregnancy.
Does taking oxcarbazepine increase the chance for miscarriage?
Miscarriage can occur in any pregnancy. One study did not find a higher rate of miscarriage among 262 people with epilepsy who took oxcarbazepine compared to those with epilepsy who took other medications.
Does taking oxcarbazepine increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Animal studies found oxcarbazepine might increase the chance for birth defects. Oxcarbazepine has not been well studied for use during pregnancy in humans. However, reports on close to 1,300 pregnancies have not suggested a significantly increased chance for birth defects when oxcarbazepine was used. The chance for birth defects might increase when other anticonvulsant medications are used in addition to oxcarbazepine.
Could taking oxcarbazepine cause other pregnancy complications?
Animal studies have suggested that oxcarbazepine might cause a lower birth weight. One human report also found low birth weight in 7 out of 8 newborns exposed to oxcarbazepine in pregnancy. However, this report also found that low birth weight was more common among newborns born to women with epilepsy. It is not clear if it is the medication or the underlying medical condition that might lead to a low birth weight.
In rare cases, taking anticonvulsant medications, including oxcarbazepine, during pregnancy can cause bleeding problems in the newborn due to low vitamin K levels. Women taking oxcarbazepine in pregnancy should talk with their healthcare providers about taking vitamin K supplements near the end of their pregnancies. They can also talk to their child’s pediatrician before delivery about giving the newborn a vitamin K supplement at birth.
I need to take oxcarbazepine throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?
There are 2 case reports of newborns who might have had withdrawal (neonatal abstinence syndrome) from oxcarbazepine exposure in pregnancy. Some of the symptoms included poor feeding, tremor, irritability, sneezing, and a high-pitched cry. Symptoms went away after 9 to 12 days. Two case reports are not enough to know if oxcarbazepine was the cause of these symptoms.
Does taking oxcarbazepine in pregnancy cause long-term problems in behavior or learning for the baby?
One study among women taking anticonvulsant medications (only 10 took oxcarbazepine), found some delayed verbal skill in infants evaluated at age 7 months. Other studies have not been done to see if oxcarbazepine use in a pregnancy could cause long–term behavior or learning issues in a child.
Can I breastfeed while taking oxcarbazepine?
Oxcarbazepine passes into breast milk. Oxcarbazepine has not been well studied for use while breastfeeding. There are case reports that describe healthy children with no side effects after being exposed to oxcarbazepine through breast milk. If a person is breastfeeding while taking oxcarbazepine, the nursing child should be watched for signs of drowsiness (very sleepy or unable to wake for feeds) or not gaining weight. Be sure to talk to your healthcare provider about all your breastfeeding questions.
I take oxcarbazepine. Can it make it harder for me to get my partner pregnant or increase the chance of birth defects?
People who have epilepsy can have reduced fertility and poorer sperm quality than those without epilepsy. One study among people with epilepsy found a lower birth rate in partners of men treated with oxcarbazepine compared to those not being treated. The authors mentioned that other lifestyle factors from having seizures might explain these results. Another study among 18 men who were treated with oxcarbazepine showed abnormal sperm. It is unclear if this finding affected their fertility.
In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.
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