felbamate

Generic Name: felbamate (fel BAM ate)
Brand Name: Felbatol

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 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 nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

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You may have thoughts about suicide when you first start taking this medicine. Your doctor will need to check you at regular visits.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

Do not stop using felbamate without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using felbamate suddenly. You may 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.

Wear a medical alert tag or carry an ID card stating that you take felbamate. Any medical care provider who treats you should know that you take 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.

To make sure felbamate is safe for you, tell your doctor if you have kidney disease.

You may have thoughts about suicide while taking this medicine. Tell your doctor if you have depression or suicidal thoughts during the first several weeks 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.

FDA pregnancy category C. It is not known whether felbamate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

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 exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. 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 oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for 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.

You may need regular medical tests to be sure this medication is not causing harmful effects. Visit your doctor regularly.

Do not stop using felbamate without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using felbamate suddenly. You may 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.

Wear a medical alert tag or carry an ID card stating that you take felbamate. Any medical care provider who treats you should know that you take seizure medication.

Use felbamate regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include fast heart rate, upset stomach, or unusual thoughts or behaviors.

What should I avoid while taking felbamate?

This medication may cause blurred vision and may impair your thinking 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.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, 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, upper stomach pain, itching, 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.

See also: Side effects (in more detail)

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?

Tell your doctor about all other medicines you use, especially other seizure medications, such as:

  • carbamazepine (Carbatrol, Equetro, Tegretol);

  • clopidogrel (Plavix);

  • divalproex (Depakote);

  • oxcarbazepine (Trileptal);

  • phenobarbital (Solfoton);

  • phenytoin (Dilantin); or

  • valproic acid (Depakene, Stavzor).

This list is not complete and other drugs may interact with felbamate. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start 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.
  • Disclaimer: 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.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.01. Revision Date: 2012-09-28, 4:12:49 PM.

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