Felbamate


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What is felbamate?

Felbamate is an anti-epileptic medication, also called an anticonvulsant.
Felbamate is used alone or in combination with other medications to treat seizures in adults with epilepsy. Felbamate is also used to treat children with Lennox-Gastaut syndrome, a severe form of childhood epilepsy that also causes developmental and behavior problems.
Felbamate is usually given after other seizure medications have been tried without successful treatment of symptoms.
Felbamate may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about felbamate?

Felbamate can cause a decrease in many types of blood cells (white cells, red cells, platelets). Call your doctor at once if you have any unusual bleeding, weakness, or any signs of infection, even if these symptoms first occur after you have been using the medication for several months.
Felbamate may also cause liver damage. Call your doctor if you have symptoms such as loss of appetite, stomach pain, or jaundice (yellowing of the skin or eyes).
You may have thoughts about suicide while taking this medication. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Do not stop taking felbamate without first talking to your doctor, even if you feel better. You may have increased seizures if you stop taking felbamate suddenly. You will need to use less and less before you stop the medication completely.
Contact your doctor if your seizures get worse or you have them more often while taking felbamate.
Carry an ID card or wear a medical alert bracelet stating that you are taking felbamate, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking a seizure medication.

What should I discuss with my healthcare provider before taking felbamate?

Felbamate can cause serious side effects and is usually given only to people with severe epilepsy when the need for seizure control outweighs the risk of side effects. You may be asked to sign a consent form after you and your doctor have discussed the risks and benefits of taking felbamate.
You should not use this medication if you are allergic to felbamate, or if you have liver disease or a history of blood cell disorders such as anemia.
If you have kidney disease, you may need a dose adjustment or special tests to safely take felbamate.
You may have thoughts about suicide while taking this medication. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.
FDA pregnancy category C. It is not known whether felbamate is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. Felbamate can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. 

How should I take felbamate?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
If you are switching to felbamate from another anticonvulsant medication, carefully follow your doctor's instructions about timing and dosage when switching from one drug to another. Your doctor may occasionally change your dose over several weeks or months to make sure you get the best results from this medication.
Shake the liquid form of felbamate well before measuring a dose. To ensure that you measure a correct dose, measure the suspension with a special dose-measuring spoon or cup, not with a regular tablespoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. Felbamate can cause a decrease in many types of blood cells (white cells, red cells, platelets). This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Call your doctor at once if you have any unusual bleeding, weakness, or any signs of infection, including flu-like symptoms. These symptoms may first develop even after you have been using the medication for several months.
To be sure your blood cells do not get too low, your blood may need to be tested on a regular basis while taking felbamate. Your liver function may also need to be tested. Do not miss any scheduled appointments.
Do not stop taking felbamate without first talking to your doctor, even if you feel better. You may have increased seizures if you stop taking felbamate suddenly. You will need to use less and less before you stop the medication completely.
Contact your doctor if your seizures get worse or you have them more often while taking felbamate.
Carry an ID card or wear a medical alert bracelet stating that you are taking felbamate, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking a seizure medication.
It is important to use felbamate regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Store felbamate at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.
Overdose symptoms may include fast heart rate, upset stomach, or unusual thoughts or behaviors.

What should I avoid while taking felbamate?

Felbamate can cause side effects that may impair your vision or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Felbamate side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; fever; swollen glands; painful sores in or around your eyes or mouth; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have any of these serious side effects:
  • pale skin, weakness, easy bruising or bleeding (nosebleeds, bleeding gums);
  • fever, chills, body aches, flu symptoms;
  • fast or pounding heartbeats, feeling short of breath;
  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • pain or burning when you urinate;
  • loss of balance or coordination; or
  • worsening of seizures.
Less serious side effects may include:
  • dizziness, drowsiness, nervousness, tired feeling;
  • headache;
  • sleep problems (insomnia);
  • changes in weight or appetite;
  • acne, mild itching or skin rash;
  • diarrhea, constipation, vomiting;
  • runny or stuffy nose;
  • blurred vision; or
  • changes in your sense of taste.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Felbamate Dosing Information

Usual Adult Dose for Epilepsy:
Adjunctive therapy: 1200 mg/day in 3-4 divided doses. The daily dose can be increased in 1200 mg increments each week as tolerated to response. Maximum daily dose: 3600 mg.

Monotherapy: 1200 mg/day in 3-4 divided doses. Increase the daily dose in 600 mg increments every two weeks as tolerated to response.

Conversion to monotherapy: 1200 mg/day in 3-4 divided doses. Starting at week 2 the daily dose can be increased in 1200 mg increments weekly. Maximum daily dose: 3600 mg. The dose of concomitant anticonvulsants should be decreased by 1/3 of the original dose at the start of felbamate therapy, when felbamate is increased at week 2, and as clinically necessary.
Usual Pediatric Dose for Lennox-Gastaut Syndrome:
>2 years to 14 years with Lennox-Gastaut Syndrome:

Adjunctive therapy: 15 mg/kg/day in 3-4 divided doses. Initial therapy should include reducing the dose of concomitant anticonvulsants by 20%. Increase the dosage of felbamate by 15 mg/kg/day in weekly intervals as tolerated to desired clinical response. Maximum daily dosage: 45 mg/kg/day. Further dosage reductions of concomitant anticonvulsants may be necessary to reduce side effects due to drug interactions.

What other drugs will affect felbamate?

Before taking felbamate, tell your doctor about all other seizure medications you use, especially:
  • carbamazepine (Carbatrol, Tegretol);
  • divalproex (Depakote);
  • oxcarbazepine (Trileptal);
  • phenobarbital (Luminal, Solfoton);
  • phenytoin (Dilantin); or
  • valproic acid (Depakene).
This list is not complete and there may be other drugs that can interact with felbamate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about felbamate.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.