CENOBAMATE
It belongs to a class of drugs known as anticonvulsants. It is a newly approved drug, belongs to third generation, anti‐seizure medication (ASM). It is currently used as an add on drug in management of resistant seizures.
What is Cenobamate used for?
Focal onset seizures
How is Cenobamate available?
Tablets
Film coated tablets
How does Cenobamate act (mechanism of action)?
Cenobamate helps stop seizures by calming down the brain. It acts on sodium channels and GABA Channels. It does this by blocking some signals that cause overactivity and boosting natural chemicals that help keep the brain relaxed.
How much time does Cenobamate take to act?
Cenobamate typically starts working within a few hours of taking it, but it may take a few weeks to feel its full effect. This is because the dosage is usually increased gradually to avoid side effects and allow the body to adjust. It’s important to follow your doctor’s instructions for the best results.
Why is Cenobamate important for you/your child’s treatment?
It is important that your child takes Cenobamate regularly so that you/your child doesn’t suffer from Seizures or have fewer seizures episodes and other diseases.
Cenobamate controls seizures but doesn’t cure epilepsy and works only while you keep taking it. So do not stop giving Cenobamate all of a sudden, as it may result in having more seizures
What is the ideal time to take Cenobamate?
Cenobamate is typically taken once a day, and it can be taken either in the morning or at night. The time of day that works best depends on how you respond to the medication.
Consistent Timing: It’s important to take it at the same time each day to help maintain steady levels in your bloodstream.
When should Cenobamate be taken?
There is no specific recommendation that it must be taken before or after meals. If you experience any gastrointestinal discomfort when taking it on an empty stomach, you might find it helpful to take it after food. Always check with your doctor if you’re uncertain about how to take your medication.
How should I give the medicine?
Tablets: Swallow a whole tablet with water, juice, or milk. You can also crush it and mix it in water, juice, yogurt, or curd. Film coated tablets: Swallow the whole tablet; do not split, chew, or crush themNEVER GIVE A DOUBLE DOSE OF CENOBAMATE
If your child vomits within 30 minutes of taking the medication, you may administer the dose again. However, if your child vomits after 30 minutes of taking the dose, do not administer it again.
Could this medication have any side effects on my child?
Every medication has both positive and potential negative effects. Fortunately, adverse effects are not common for everyone, but it’s essential to be aware of them. Understanding possible side effects allows us to act quickly and effectively if they occur, ensuring that we can address any concerns promptly while continuing to benefit from the intended effects of medications.
Even though it may be rare, few people sometimes may have serious side effects when taking a drug. Consult your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
SIDE EFFECTS:
- Heart: Abnormal ECG (heart rhythm problems)
- Body: Higher potassium levels in the blood, Weight loss
- Nervous system: Dizziness, tiredness, feeling sleepy, headaches, fatigue, lack of energy, suicidal ideations, mood changes
- Eyes: Double vision, involuntary eye movement
- Skin: Itching or rash with bumps
- Stomach: Stomach pain, constipation, loss of appetite, diarrhoea, bad taste, indigestion, hiccups, nausea, vomiting, dry mouth.
- Urinary: Painful periods, frequent urination, urinary tract infections
- Liver: Higher liver enzyme levels
If you/your child start developing skin Rash, Stop Medications right there and SEEK IMMEDIATE MEDICAL ADVICE from your DOCTOR.
Sometimes you/your child may experience other side-effects that are not listed above. If you notice any abnormalities with your child’s body or behaviour, do not hesitate and immediately contact your doctor.
Does Cenobamate cause weight gain?
No, Cenobamate is not typically associated with weight gain. In fact, weight loss has been reported in some people using it.
Can other common medicines be taken during the course of Cenobamate?
Common medications such as ibuprofen, paracetamol, antibiotics, or other over-the-counter drugs can generally be taken alongside Cenobamate, as long as they are not contraindicated by your doctor.
What food to avoid while taking Cenobamate?
There are no specific foods that need to be completely avoided while taking Cenobamate. However, it’s a good idea to be mindful of certain things:
- Alcohol: It is best to avoid alcohol while taking Cenobamate, as it can increase the risk of side effects like drowsiness, dizziness, or difficulty concentrating.
- Grapefruit: While grapefruit is not specifically listed as a concern for Cenobamate, grapefruit can interact with medication and affect how they work.
To stay on the safe side, follow your doctor’s guidance on diet and talk to them if you have concerns about any specific foods or drinks.
PREGNANCY AND LACTATION:
Pregnancy: Cenobamate should be used during pregnancy only if the benefit to the mother outweighs the potential risk to the baby. It is important to talk to your doctor if you are pregnant or planning to become pregnant. Your doctor may adjust your treatment or suggest alternative medications that are safer during pregnancy. Lactation (Breastfeeding): If you are breastfeeding, you should discuss with your doctor whether to continue taking Cenobamate or whether you might need to stop breastfeeding. Your doctor will assess the risks and benefits and advise you.Is there any risk if I conceive while taking Cenobamate?
There could be potential risks if you conceive while taking Cenobamate. It’s important to talk to your doctor if you’re planning to get pregnant or become pregnant while on this medication.
Can I stop taking Cenobamate (withdrawal)?
Medication should not be discontinued abruptly because the possibility of increasing seizure frequency; therapy should be withdrawn gradually to minimize the potential of increased seizure frequency.
Where should you store Cenobamate?
- Keep the medicine in a cupboard, secured away from heat and direct sunlight. It is not a must to keep the medicine in the refrigerator though.
- Make sure the medicine is out of your child’s reach.
- Store the medication in the same box it was packed in.
For complete information please see the manufacturer’s information leaflet.
Monitoring parameters Of Cenobamate
- Liver function Test
- Serum sodium and potassium levels
- Suicidal ideation, depression, behaviour changes
How to cope with side effects of Cenobamate?
- Dizziness: use a wall or furniture for support which can help you avoid falls. Avoid machinery works and driving.
- Fatigue: Engaging in physical activity, even a brief walk, can help increase your energy levels. Additionally, short naps during the day can be effective in combating fatigue.
- Vision changes: If you notice any changes in your vision, take extra care to move slowly and cautiously to prevent falls.
- Heart rhythm changes and severe allergic reactions: If you experience changes in your heartbeat, along with chest pain, difficulty breathing, or light-headedness, get medical attention immediately.
- Suicidal thoughts: If you experience any changes in your mood or thoughts while on lacosamide, contact your healthcare provider.
- Manage Nausea: If you’re feeling nauseous, try eating smaller meals more often and avoid greasy or spicy foods.
- Report Severe Symptoms: If you notice more serious side effects like mood changes, thoughts of self-harm, or unusual movements, seek medical help immediately.
Always follow your doctor’s advice and don’t stop taking Cenobamate without their guidance. They can help you find the best approach to managing side effects.
Summary
Cenobamate is an anticonvulsant used to treat partial-onset seizures in adults with epilepsy. There are studies that are being carried out to study its effectiveness in children. It works by stabilizing electrical activity in the brain to help prevent seizures. The medication is typically taken in tablet form, with the dosage gradually increased to minimize side effects. Common side effects include dizziness, drowsiness, headache, and fatigue. Pregnant or breastfeeding women should consult their doctor before using Cenobamate. Always inform your doctor about any other medications you’re taking to avoid interactions. Let us know if this information was useful!Author:
- Dr. Ramya. R, Pharm D, Clinical pharmacologist, Aster Hospitals, Bengaluru
- Dr Praveen Kumar, B. Pharm, Pharm D(PB), Head Clinical Pharmacologist, Aster Hospitals, Bengaluru
- Dr C P Ravi Kumar, Consultant Paediatric Neurologist, Aster CMI Hospital.