Why is this medication prescribed?

Cenobamate is prescribed primarily as an antiepileptic medication. It is used to treat focal (partial-onset) seizures in adults. Focal seizures are seizures that start in one area or side of the brain.

How should this medicine be used?

Here’s how Cenobamate is typically used:

• Dosage: The initial recommended dosage of Cenobamate is usually 12.5 mg once daily, which may be increased weekly by 12.5 mg increments. The typical maintenance dosage range is between 100 mg to 400 mg once daily, depending on individual patient response and tolerability.
• Administration: Cenobamate should be taken orally, with or without food. It is typically taken once daily at bedtime to reduce the risk of dizziness or sleepiness that may occur with the medication.
• Titration: The dosage should be gradually titrated upwards to achieve the desired therapeutic effect while minimizing potential side effects. The rate of titration should be guided by the prescribing healthcare provider.
• Monitoring: Patients should be monitored for any signs of allergic reactions, mood changes, or suicidal thoughts, which are possible side effects of Cenobamate.
• Special Considerations: It is important for patients to follow their healthcare provider’s instructions carefully regarding dosage adjustments and to report any unusual symptoms or side effects promptly.

As with any prescription medication, Cenobamate should only be used as directed by a healthcare provider and should not be stopped abruptly without medical supervision, as this can increase the risk of seizures.

Other uses for this medicine

Cenobamate is primarily indicated for epilepsy, specifically focal seizures in adults. Its use for other conditions or populations (such as children or other seizure types) may not be established or recommended without specific guidance from a healthcare professional.

What special precautions should I follow?

When taking Cenobamate, it’s essential to follow specific precautions to ensure safe and effective use:

• Liver Function: Before starting Cenobamate, healthcare providers typically assess liver function, as the medication can affect liver enzymes. Periodic monitoring of liver function tests during treatment may be recommended.
• Psychiatric Effects: Cenobamate may cause mood changes, behavioral changes, or psychiatric symptoms such as depression, aggression, or suicidal thoughts. Patients should report any unusual mood changes or thoughts to their healthcare provider promptly.
• Dizziness and Drowsiness: Cenobamate can cause dizziness and drowsiness, especially at the beginning of treatment or with dosage adjustments. Patients should avoid driving or operating heavy machinery until they know how the medication affects them.
• Drug Interactions: Cenobamate may interact with other medications, including hormonal contraceptives, which can affect their effectiveness. It’s crucial for patients to inform their healthcare provider about all medications, supplements, and herbal products they are taking.
• Pregnancy and Breastfeeding: The safety of Cenobamate during pregnancy has not been established, and it may harm an unborn baby. It is generally recommended to avoid using Cenobamate during pregnancy unless the potential benefits outweigh the risks. It is also not recommended during breastfeeding due to potential adverse effects on the infant.
• Allergic Reactions: Some individuals may experience allergic reactions to Cenobamate, which can include rash, itching, swelling, severe dizziness, or trouble breathing. Any signs of an allergic reaction should be reported to a healthcare provider immediately.
• Withdrawal: Abruptly stopping Cenobamate can increase the risk of seizures. Dosage should be tapered down under the guidance of a healthcare provider when discontinuing treatment.

Patients should always communicate openly with their healthcare provider regarding any concerns or side effects experienced while taking Cenobamate. Following these precautions can help ensure safe and effective treatment for focal seizures and other potential uses under medical supervision.

What special dietary instructions should I follow?

There are generally no specific dietary restrictions for Cenobamate. However, maintaining a healthy and balanced diet is always recommended for overall well-being. Avoid excessive alcohol consumption, as it can increase the risk of dizziness and drowsiness associated with Cenobamate.

What should I do if I forget a dose?

• Take it as soon as you remember, unless it is close to the time of your next scheduled dose.
• If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not double the dose to catch up.
• Notify your healthcare provider if you frequently forget doses or have difficulty adhering to the dosing schedule.

What side effects can this medication cause?

Cenobamate, like any medication, can cause side effects. Some of the common and potentially serious side effects of Cenobamate include:

• Dizziness: This is one of the most commonly reported side effects. It may occur especially at the beginning of treatment or with dose adjustments.
• Drowsiness: Another common side effect, which can affect daily activities and may be more pronounced when starting the medication.
• Fatigue: Feeling unusually tired or lacking energy.
• Double vision or blurred vision: Vision problems can occur, affecting clarity of sight.
• Balance problems: Difficulty maintaining balance or coordination.
• Headache: Some individuals may experience headaches as a side effect of Cenobamate.
• Nausea: Feeling queasy or experiencing an upset stomach.
• Irritability: Changes in mood or behavior, including irritability or agitation.
• Skin reactions: Rarely, Cenobamate may cause skin reactions such as rash or itching.
• Cognitive effects: Some people may experience difficulty concentrating or memory problems.
• Psychiatric effects: Cenobamate has been associated with mood changes, including depression, anxiety, aggression, or suicidal thoughts. It’s essential to report any new or worsening psychiatric symptoms to your healthcare provider.
• Allergic reactions: Although rare, some individuals may experience severe allergic reactions to Cenobamate, characterized by symptoms such as rash, itching, swelling, severe dizziness, or trouble breathing.

It’s important to note that not all people will experience these side effects, and some individuals may tolerate Cenobamate well. Your healthcare provider can help monitor for side effects and adjust your treatment plan as needed to minimize any adverse effects while maximizing the medication’s effectiveness in controlling seizures. Always communicate openly with your healthcare provider about any concerns or symptoms you may experience during treatment.

What should I know about storage and disposal of this medication?

Storage and Disposal of Cenobamate:

• Storage:
  • Store Cenobamate at room temperature, away from moisture and heat.
  • Keep the medication in its original packaging or container to protect it from light.
  • Avoid storing Cenobamate in the bathroom, where it could be exposed to moisture.
• Disposal:
  • Dispose of unused or expired Cenobamate properly according to local regulations or guidelines.
  • Do not flush medications down the toilet or pour them into a drain unless instructed to do so.
  • If you are unsure how to dispose of medications, consult your pharmacist or healthcare provider for advice.

In case of emergency/overdose

• Emergency: In case of a medical emergency, such as severe allergic reactions (difficulty breathing, swelling of the face/tongue/throat), call emergency services immediately (911 in the US) or seek urgent medical attention. Be prepared to provide information about the medication, including its name (Cenobamate) and dosage if possible.
• Overdose: Symptoms of overdose may include extreme drowsiness, confusion, slurred speech, severe dizziness, loss of coordination, or fainting. If you suspect an overdose or someone has taken more than the prescribed amount of Cenobamate, contact your local poison control center (1-800-222-1222 in the US) or seek emergency medical assistance.

What other information should I know?

• Regular Follow-up: Attend regular follow-up appointments with your healthcare provider to monitor your response to Cenobamate and adjust your treatment plan as needed. Report any new or worsening symptoms, including changes in seizure frequency or severity, to your healthcare provider promptly.
• Medication Adherence: Take Cenobamate exactly as prescribed by your healthcare provider. Do not increase or decrease your dose without consulting them first. Use a pill organizer or set reminders to help you remember to take your medication consistently.
• Interactions: Inform your healthcare provider about all other medications, supplements, and herbal products you are taking, as they may interact with Cenobamate.
• Travel: If you plan to travel, ensure you have an adequate supply of Cenobamate with you. Keep medications in their original packaging when traveling to avoid issues with customs or security checks.
• Patient Education: Educate yourself about Cenobamate, including its potential side effects, precautions, and how to manage them. Use reliable sources of information, such as your healthcare provider or pharmacist, for any questions or concerns about your medication.

By following these guidelines and staying informed, you can help ensure safe and effective use of Cenobamate for the treatment of focal seizures. Always consult your healthcare provider for personalized advice and guidance regarding your medication regimen.