TABLE 3.

RECOMMENDATIONS FOR OXCARBAZEPINE THERAPY BASED ON HLA-B GENOTYPE

Genotype	Implication	Therapeutic recommendation	Classification of recommendation	Considerations for other aromatic anticonvulsants
HLA-B*15:02 negative	Normal risk of oxcarbazepine-induced SJS/TEN	Use oxcarbazepine per standard dosing guidelines.	Strong	N/A
HLA-B*15:02 positive	Greater risk of oxcarbazepine-induced SJS/TEN	If patient is oxcarbazepine-naïve, do not use oxcarbazepine.	Strong	Other aromatic anticonvulsantsa have weaker evidence linking SJS/TEN with the HLA-B*15:02 allele; however, caution should still be used in choosing an alternative agent.
		The latency period for drug-induced SJS/TEN is short with continuous dosing and adherence to therapy (~4–28 days), and cases usually occur within three months of dosing; therefore, if the patient has previously used oxcarbazepine consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of oxcarbazepine in the future.	Optional	Previous tolerance of oxcarbazepine is not indicative of tolerance to other aromatic anticonvulsants.a

N/A = not applicable; SJS = Stevens-Johnson syndrome; TEN = toxic epidermal necrolysis

^aAromatic anticonvulsants include carbamazepine, oxcarbazepine, eslicarbazepine, lamotrigine, phenytoin, fosphenytoin, and phenobarbital.