Felbamate
Commercial names and formulations:
Brand name: Felbatol
Formulation: tablets, oral suspension
Years on the market:
In the US since 1993
How to store it?
Store at room temperature
What does the body do to the medication?
Can I take it with food?
Yes
How long does it take to get to the blood after I take it?
2-6 hours
How long does it take to start having a steady effect?
Two to five days
Can this medication be started at a high dose or it has to be started gradually?
Gradually
How long does it stay in the body?
About 1 day
How is it eliminated?
Liver
What does the medication do to the body?
Type of epilepsy that helps:
Partial and generalized Epilepsy, Lennox-Gastaut Syndrome
FDA approved for:
Used alone or in combination with other anti-epileptic medications for the treatment of partial seizures in adults and children, and for the treatment of Lennox-Gastaut syndrome in children.
Common side effects:
• Skin: acne, rash
• Bones: none
• Blood: none
• Liver: none
• Kidneys: none
• Stomach and intestines: upset stomach, vomiting, constipation, diarrhea
• Heart: none
• Brain: difficulty sleeping, headache
• Mood: anxiety
• Others: blurred vision, fatigue, weight decrease, face swelling
Serious side effects:
Acute liver failure
Severe anemia which may be fatal
Risk of suicidal thoughts or behavior
What happens if I get too much of it (intoxication)?
Symptoms may include mild stomach pain and increased heart rate. Some cases of kidney failure from crystal formation in the urine have been reported.
What happens if I stop it suddenly (withdrawal)?
Patients should not suddenly discontinue felbamate abruptly, as it could cause an increase in seizure frequency or severity.
Who should not take this medication?
Felbatol should not be used in patients with liver problems or liver failure, abnormal conditions of the blood, or known hypersensitivity (allergy) to the medication.
What is the average dose and how many times a day should be given?
Children: initial 15 mg/kg/day (in divided doses), may increase up to 20-45 mg/kg/day
Adults: initial 1200 mg/day (in divided doses), may increase in 600 mg increments every 2 weeks to 3600 mg/day
Does the body get used to the medication?
Yes
Medications to be careful with:
Other AEDs that can increase the blood level of felbamate:
None anticipated
Other AEDs that can decrease the blood level of felbamate:
Phenobarbital, Phenytoin, Primidone, Carbamazepine
Other drug interactions:
Increases level of phenytoin, Phenobarbital, and valproic acid, increases a metabolite of carbazepine which can cause side effectsMay render oral contraceptives less effective resulting in unintended pregnancy.
Blood work required?
CBC and CPM?
Yes
How often?
Every 1-2 weeks for 3 to 4 months, then monthly thereafter
Are medication levels in blood useful?
Yes
Normal range
30-100 mcg/mL
Women’s health
Affects contraceptives?
Yes
Affect fertility?
No
Are safe in pregnancy?
This drug should be used during pregnancy only if clearly needed.
Category
Pregnancy Category C
Can breastfeed?
The effect on the nursing infant is unknown, therefore it is not recommended to use this medication while breast feeding.
Affect bones (osteoporosis)?
No
Men’s health
Affects sexual performance?
No
Affects fertility?
No
Use other than epilepsy:
None