Comparative Pharmacology
Head-to-head clinical analysis: DILANTIN versus ESLICARBAZEPINE ACETATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILANTIN versus ESLICARBAZEPINE ACETATE.
DILANTIN vs ESLICARBAZEPINE ACETATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Phenytoin stabilizes neuronal membranes and decreases seizure activity by increasing efflux or decreasing influx of sodium ions across cell membranes in the motor cortex during generation of nerve impulses. It acts by blocking voltage-dependent sodium channels, thereby inhibiting the spread of seizure activity.
Eslicarbazepine acetate is a voltage-gated sodium channel blocker that stabilizes the inactive state of sodium channels, reducing high-frequency repetitive firing of neurons. It also modulates T-type calcium channels and enhances slow inactivation of sodium channels.
300–400 mg/day orally in 2–3 divided doses; IV loading dose 15–20 mg/kg at max 50 mg/min, then 300 mg/day IV divided 2–3 times daily.
400 mg orally once daily, titrated to a maintenance dose of 800-1200 mg once daily.
None Documented
None Documented
Clinical Note
moderateEslicarbazepine acetate + Estrone sulfate
"The serum concentration of Estrone sulfate can be decreased when it is combined with Eslicarbazepine acetate."
Clinical Note
moderateEslicarbazepine acetate + Aripiprazole
"The serum concentration of Aripiprazole can be decreased when it is combined with Eslicarbazepine acetate."
Clinical Note
moderateCyclophosphamide + Eslicarbazepine acetate
"The metabolism of Eslicarbazepine acetate can be decreased when combined with Cyclophosphamide."
Clinical Note
moderateAverage 22 hours (range 7-42 hours) in adults. Dose-dependent; increases with higher concentrations due to saturable metabolism. In neonates: 10-15 hours. In chronic use, half-life may increase.
Terminal half-life of eslicarbazepine is 13-20 hours (mean ~14 hours), supporting once-daily dosing.
Primarily hepatic metabolism to inactive metabolites (p-hydroxyphenyltoin and glucuronide conjugate). Less than 5% excreted unchanged in urine. Fecal excretion minimal (<2%).
Renal: ~90% (as glucuronide conjugates and unchanged drug; ~30% as eslicarbazepine acetate, ~60% as eslicarbazepine). Fecal: <1%. Biliary: negligible.
Category C
Category C
Anticonvulsant
Anticonvulsant
Phenytoin + Eslicarbazepine acetate
"The serum concentration of Eslicarbazepine acetate can be decreased when it is combined with Phenytoin."