What Is Trileptal?

Trileptal is the brand name for Oxcarbazepine, a prescription anticonvulsant (antiepileptic drug) used to treat partial (focal) seizures in adults and children. It was developed by Novartis Pharmaceuticals and first approved by the FDA in 2000.

Trileptal works by blocking voltage-sensitive sodium channels in the brain, which reduces abnormal electrical activity that causes seizures. It belongs to the same chemical family as Carbamazepine (Tegretol) but is generally better tolerated with fewer drug interactions.

What Is Trileptal Used For?

Trileptal is FDA-approved for:

• Partial (focal) seizures in adults — Can be used as the only seizure medication (monotherapy) or alongside other antiepileptic drugs (adjunctive therapy).
• Partial (focal) seizures in children aged 4–16 — Also approved for both monotherapy and adjunctive therapy.

Doctors also prescribe Trileptal off-label for several other conditions:

• Bipolar disorder — Used as a mood stabilizer, especially for people who don't respond well to or can't tolerate other options.
• Trigeminal neuralgia — A type of severe facial nerve pain. Trileptal is often used when Carbamazepine causes too many side effects.
• Neuropathic pain — Nerve pain from various causes.

If you'd like to understand the science behind how it works, read our article on how Trileptal works.

How Is Trileptal Taken?

Trileptal comes in several forms:

• Immediate-release tablets: 150 mg, 300 mg, and 600 mg
• Oral suspension: 300 mg per 5 mL (for those who have difficulty swallowing tablets)
• Extended-release tablets (Oxtellar XR): 150 mg, 300 mg, and 600 mg — taken once daily

Typical Dosing for Adults

Most adults start at 300 mg twice daily (600 mg/day total). Your doctor will increase the dose gradually — usually by 300 mg per day every 3 days — until you reach an effective dose. The typical maintenance dose ranges from 600 mg to 2,400 mg per day, taken in two divided doses.

Dosing for Children (Ages 4–16)

Children's doses are based on body weight. Children tend to clear the drug faster than adults, so they may need higher doses per kilogram. Your child's neurologist will determine the right dose.

Important Dosing Notes

• Immediate-release tablets can be taken with or without food.
• The oral suspension should be shaken well before each dose.
• Extended-release tablets should be swallowed whole — do not crush or chew.
• Never skip doses or stop taking Trileptal suddenly, as this can trigger breakthrough seizures.

Who Should Not Take Trileptal?

Trileptal is not right for everyone. You should not take Trileptal if you:

• Have a known allergy to Oxcarbazepine or any of its inactive ingredients.
• Have a known allergy to Eslicarbazepine acetate (Aptiom), which is chemically related.

You should use Trileptal with caution and talk to your doctor if you:

• Are of Asian descent — You may need genetic testing for the HLA-B*1502 allele, which is linked to serious skin reactions like Stevens-Johnson syndrome.
• Have kidney problems — If your creatinine clearance is below 30 mL/min, you'll likely need a lower starting dose (half the usual amount).
• Are elderly — Older adults are more sensitive to side effects, especially hyponatremia (low sodium) and dizziness.
• Are pregnant or breastfeeding — Trileptal is Pregnancy Category C and is excreted in breast milk. Discuss the risks and benefits with your doctor.
• Take oral contraceptives — Trileptal can make birth control pills less effective. You may need a backup method. See our guide on Trileptal drug interactions for details.

For a complete list of potential side effects, read our article on Trileptal side effects.

How Much Does Trileptal Cost?

The cost of Trileptal depends on whether you take the brand name or the generic, your dose, and your insurance coverage.

• Brand-name Trileptal: $160 to $815 per month depending on dose.
• Generic Oxcarbazepine: As low as $11 per month with discount coupons like GoodRx Gold. Retail price for 60 tablets of 300 mg is around $164.
• With insurance: Generic Oxcarbazepine is covered by about 76% of Medicare and commercial plans. Typical copays range from $60 to $80.

There are also savings programs available:

• Novartis co-pay savings card for brand-name Trileptal (commercially insured patients).
• Supernus co-pay card for Oxtellar XR.
• Novartis Patient Assistance Foundation for uninsured patients who qualify.

For a complete breakdown, see our guide on how to save money on Trileptal.

Final Thoughts

Trileptal is a well-established medication that has helped millions of people manage seizures and other neurological conditions. If your doctor has prescribed it — or if you're exploring treatment options — understanding the basics can help you feel more confident and prepared.

Need help finding Trileptal at a pharmacy? Check out our guide on how to find Trileptal in stock near you. Looking for a prescribing doctor? We have a guide for finding a doctor who can prescribe Trileptal too.