Felbamate for epilepsy

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	Why It Is Used
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	Side Effects
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Felbamate comes in liquid and tablet forms.

It is not known exactly how felbamate prevents seizures.

Felbamate may be used to prevent partial seizures in adults and children, but it has some very serious side effects. It is used with caution in younger children since they may not be able to communicate symptoms of potentially serious side effects, such as chills or stomach pain.

Felbamate controls partial seizures in adults very well. In children with Lennox-Gastaut syndrome, felbamate may reduce seizure frequency but not make the child seizure-free.¹ But it has made some children more alert and improved their quality of life.

Common side effects of felbamate include:

• Nausea, vomiting, and indigestion.
• Headache.
• Loss of appetite.
• Insomnia (sleep problems).

Most of these problems tend to go away once the body adjusts to the drug. Weight loss and insomnia are common long-term problems, though.

The U.S. Food and Drug Administration (FDA) has issued a warning on antiepileptic medicines and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take antiepileptic medicine should be watched closely for warning signs of suicide. People who take antiepileptic medicine and who are worried about this side effect should talk to a doctor.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

It may take time and careful, controlled adjustments by you and your doctor to find the combination, schedule, and dosing of medicine to best manage your epilepsy. The goal is to prevent seizures while causing as few side effects as possible. After you and your doctor figure out the medicine program that works best for you, make sure to follow your program exactly as prescribed.

• Adverse effects. Felbamate should be used with extreme caution, because it carries a significant risk of liver and bone marrow failure, which can be fatal. You or your child may need to be monitored frequently for signs of liver disease while taking the drug. A serious blood problem called aplastic anemia can also result from the use of felbamate. Watch for early signs of liver, bone marrow, or blood problems, such as easy bruising, a change in skin color, prolonged bleeding, fatigue, fever, change in stool color, or a change in the color of the whites of the eyes.
• Drug interactions. Many medicines for epilepsy can interact with other medicines you may be taking. This means that your epilepsy medicine may not work as well, or it may affect the way another medicine you are taking works. Some of these interactions can be dangerous. It is important to tell your doctor about all the medicines, herbal pills, and dietary supplements you are taking. Felbamate may make birth control pills less effective. If you are taking felbamate and birth control pills, you may be more likely to become pregnant.
• Risk of birth defects. All medicines for epilepsy have some risk of birth defects. But the risk of birth defects needs to be carefully compared to other risks to the baby if the mother stops taking her epilepsy medicine. If you are thinking about becoming pregnant, it is important to plan ahead and talk with your doctor about the benefits and risks of taking epilepsy medicine during your pregnancy. It you are already pregnant, it is not too late. The best thing to do is talk to your doctor about your pregnancy before you make any changes to the medicines you are taking.
• Other concerns. Despite these risks, felbamate may be used in some people because the drug has been successful in treating seizures that do not respond to other drugs (refractory seizures). This is especially true of children with Lennox-Gastaut syndrome, which does not usually respond well to other drugs. But because of its potentially life-threatening side effects, felbamate should be used only in those people for whom the risks of having seizures are greater than the risks caused by taking felbamate.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

1. Jarrar RG, Buchhalter JR (2003). Therapeutics in pediatric epilepsy, part 1: The new antiepileptic drugs and the ketogenic diet. Mayo Clinical Procedures, 78(3): 359–370.