Eslicarbazepine
Antiseizure medicines
Antiseizure medicines
A carbamazepine-family prodrug for focal seizures. It becomes S-licarbazepine, which blocks sodium channels, and is taken once a day.
Also called: Eslicarbazepine acetate
Quick facts
- Group
- Antiseizure medicines
- Target
- Voltage-gated sodium channel (Nav)
- Used for
- Focal
- Key effects
- Dizziness · Double or blurred vision and nystagmus
- Monitor
- Blood sodium · Skin and mucous membranes
- ATC
- N03AF04
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows carbamazepine, a close relative that occupies the same site, bound to human Nav1.7 (SCN9A); there is no structure with eslicarbazepine or its active metabolite.
Eslicarbazepine acetate is a prodrug converted to S-licarbazepine, the same active metabolite that oxcarbazepine produces, but more quickly. S-licarbazepine competitively inhibits fast voltage-gated sodium channels and stabilizes their inactivated state, which reduces sustained firing and sodium-dependent transmitter release.
- The prodrug becomes S-licarbazepine
- S-licarbazepine binds inactivated Na⁺ channels
- Sustained repetitive firing is limited
- Fewer focal seizures
Indications
- Focal (partial-onset) seizures, alone or as add-on treatment Epilepsy and seizures →
Adverse effects
Common
- Dizziness, drowsiness and poor balance
- Double or blurred vision and nystagmus
- Headache, nausea and vomiting
- Tremor, slowed thinking and memory problems
Contraindications
- Hypersensitivity to eslicarbazepine acetate or oxcarbazepine
Key interactions
- Hormonal contraceptives
- They may not work well; another method is needed
- Alcohol and other sedatives
- More drowsiness
What is monitored
- Blood sodium
- Skin and mucous membranes
- Kidney function for dosing
- Mood and suicidal thoughts
Administration and safety
- Oral tablet, once a day; it can be swallowed whole or crushed
- Raised after the first week if needed
- Tapered, not stopped suddenly
Pregnancy and breastfeeding
Its safety in pregnancy is not established, and it can make hormonal contraceptives fail; family planning is discussed with the treating team.
Nursing care
- Teach the signs of low sodium: headache, confusion, weakness, more seizures
- Check for rash and mouth sores, especially early
- Advise non-hormonal contraception
- Ask about kidney and liver disease
Pharmacokinetics
- Metabolism
- Rapidly converted to S-licarbazepine
- Elimination
- As a glucuronide in the urine; the dose is lowered in kidney disease
- Half-life
- Similar to carbamazepine
Test yourself
Think of the answer, then tap the question to see it.
What is the active metabolite of eslicarbazepine acetate?
S-licarbazepine, the same as that of oxcarbazepine.
Which electrolyte disorder is watched for with eslicarbazepine?
Hyponatraemia (low blood sodium).
On which ion channel does eslicarbazepine act?
Voltage-gated sodium channels, stabilizing their inactivated state.
Connections
← Back to the class: Antiseizure medicines
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Eslicarbazepine: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); DailyMed - ESLICARBAZEPINE ACETATE tablet (DailyMed (U.S. National Library of Medicine), 2026); RCSB PDB - 8S9C: Cryo-EM structure of Nav1.7 with CBZ (RCSB Protein Data Bank, 2026).
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Representative model, for educational purposes only.