Felbamate for epilepsy

Examples

Generic Name	Brand Name
felbamate	Felbatol

Felbamate requires several daily doses. It comes in liquid and tablet forms.

How It Works

It is not known exactly how felbamate prevents seizures.

Why It Is Used

Felbamate may be used to prevent partial seizures in adults and children, although 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.

How Well It Works

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 However, it has made some children more alert and improved their quality of life.

Side Effects

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, however.

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

What To Think About

Serious health risks

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.

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. However, 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.

Other concerns

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 you 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.

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.

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 unwanted side effects as possible. After the most effective medicine program is determined, it is important that you follow it exactly as prescribed.

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Author:	Monica Rhodes	Last Updated: October 29, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Theresa O'Young, PharmD - Clinical Pharmacist Steven C. Schachter, MD - Neurology
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