Two medicines, side by side
Carbamazepine vs oxcarbazepine
Carbamazepine and oxcarbazepine are both labeled for seizures and epilepsy. Drugs@FDA records approvals of carbamazepine since 1968 and of oxcarbazepine since 2000. Pharmacies paid $0.119 per carbamazepine 200 mg tablet and $0.167 per oxcarbazepine 300 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, carbamazepine is a mood stabilizer and oxcarbazepine an anti-epileptic agent.
Check it at the source: the carbamazepine FDA label on DailyMed (effective August 20, 2026); the oxcarbazepine FDA label on DailyMed (effective December 16, 2025).
Highlights of the carbamazepine record
Carbamazepine (Tegretol) · label of August 20, 2026
SERIOUS DERMATOLOGIC REACTIONS AND HLA-B*1502 ALLELE SERIOUS AND SOMETIMES FATAL DERMATOLOGIC REACTIONS, INCLUDING TOXIC EPIDERMAL NECROLYSIS (TEN) AND STEVENS-JOHNSON SYNDROME (SJS), HAVE BEEN REPORTED DURING TREATMENT WITH TEGRETOL. THESE REACTIONS ARE ESTIMATED TO OCCUR IN 1 TO 6 PER 10,000 NEW USERS IN COUNTRIES WITH MAINLY CAUCASIAN POPULATIONS, BUT THE RISK IN SOME ASIAN COUNTRIES IS ESTIMATED TO BE ABOUT 10 TIMES HIGHER.
Used for
From the label: indicationsEpilepsy Tegretol is indicated for use as an anticonvulsant drug. Evidence supporting efficacy of Tegretol as an anticonvulsant was derived from active drug-controlled studies that enrolled patients with the following seizure types: Partial seizures with complex symptomatology (psychomotor, temporal lobe). Patients with these seizures appear to show greater improvement than those with other types. […]
On the market
- Earliest approval on file
- March 11, 1968
- Generic labelers
- 42 labelers
- Pharmacy cost
- $0.119 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 11
Highlights of the oxcarbazepine record
Oxcarbazepine (Trileptal) · label of December 16, 2025
Used for
From the label: indicationsTRILEPTAL is indicated for use as monotherapy or adjunctive therapy in the treatment of partial-onset seizures in adults and as monotherapy in the treatment of partial-onset seizures in pediatric patients aged 4 years and above, and as adjunctive therapy in pediatric patients aged 2 years and above with partial-onset seizures. […]
On the market
- Earliest approval on file
- January 14, 2000
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.167 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 6
Source: FDA drug labels via openFDA (Carbamazepine label of August 20, 2026, Oxcarbazepine label of December 16, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do carbamazepine and oxcarbazepine differ on the record?
In FDA's classes, carbamazepine is a mood stabilizer and oxcarbazepine an anti-epileptic agent.
How each works, in its label's words: Carbamazepine, “It appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation.”; Oxcarbazepine, “The pharmacological activity of TRILEPTAL is primarily exerted through the 10-monohydroxy metabolite (MHD) of oxcarbazepine [ see Clinical Pharmacology (12.3) ].”
Half-life, in each label's words: Carbamazepine, “Initial half-life values range from 25 to 65 hours, decreasing to 12 to 17 hours on repeated doses.”; Oxcarbazepine, “The half-life of the parent is about 2 hours, while the half-life of MHD is about 9 hours, so that MHD is responsible …”
Only the carbamazepine label carries a boxed warning.
Generics: carbamazepine since 1986; oxcarbazepine since 2007 (Drugs@FDA).
| Carbamazepine | Oxcarbazepine | |
|---|---|---|
| Labeled for | Bipolar disorder, Seizures and epilepsy | Seizures and epilepsy |
| Pharmacologic class | Mood Stabilizer | Anti-epileptic Agent |
| How it works (label) | Mechanism of Action Tegretol has demonstrated anticonvulsant properties in rats and mice with electrically and chemically induced seizures. It appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation. | The pharmacological activity of TRILEPTAL is primarily exerted through the 10-monohydroxy metabolite (MHD) of oxcarbazepine [ see Clinical Pharmacology (12.3) ]. |
| Half-life (label) | Initial half-life values range from 25 to 65 hours, decreasing to 12 to 17 hours on repeated doses. | The half-life of the parent is about 2 hours, while the half-life of MHD is about 9 hours, so that MHD is responsible for most antiepileptic activity. |
| Earliest approval on file (Drugs@FDA) | March 11, 1968 | January 14, 2000 |
| First generic approved | August 14, 1986 | October 9, 2007 |
| Generic labelers (NDC) | 42 labelers | 43 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.119 per tablet (Carbamazepine 200 mg tablet) | $0.167 per tablet (Oxcarbazepine 300 mg tablet) |
| 12-month price change | +0.6% | -4% |
| Boxed warning | Yes | No |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 11 | 6 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 66,615 | 31,342 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Carbamazepine label, drug interactions… itraconazole, lamotrigine, levothyroxine, methadone, methsuximide, mianserin, midazolam, olanzapine, oral and other hormonal contraceptives, oxcarbazepine, paliperidone, phensuximide, phenytoin, praziquantel, protease inhibitors, risperidone, sertraline, sirolimus, tadalafil, theophylline, tiagabine, topiramate, tramadol, trazodone, tricyclic antidepressants (e.g., imipramine, amitriptyline, nortriptyline) …
Carbamazepine label, warningsPatients should be informed that about a third of patients who have had hypersensitivity reactions to carbamazepine also experience hypersensitivity reactions with oxcarbazepine (Trileptal ® ).
Oxcarbazepine label, drug interactionsReduced dose of phenytoin may be required ( 7.1 ) Carbamazepine, Phenytoin, and Phenobarbital:
Oxcarbazepine label, warnings and precautionsWARNINGS AND PRECAUTIONS Hyponatremia: Monitor serum sodium levels ( 5.1 ) Cross Hypersensitivity Reaction to Carbamazepine:
Source: FDA drug labels via openFDA
What next?
- Alternatives to carbamazepine
- every medicine labeled for the same conditions