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Xcopri
Xcopri (generic name: cenobamate) is a prescription anticonvulsant medication used to treat partial-onset seizures in adults with epilepsy. Cenobamate works by regulating abnormal electrical activity in the brain, which helps prevent seizures. It is typically prescribed as part of a comprehensive seizure management plan, and it may be used alongside other antiepileptic drugs.
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Frequently Asked Questions
How long does it take for Xcopri to start working?
Xcopri typically begins to reduce seizure frequency within a few weeks, but the full effect may take longer as the dose is gradually increased to the maintenance level.
Can I drink alcohol while taking Xcopri?
It is best to avoid alcohol while taking Xcopri, as it can increase the risk of drowsiness, dizziness, and other side effects.
What should I do if I miss a dose of Xcopri?
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue your regular schedule. Do not double the dose to make up for a missed dose.
Is Xcopri safe for long-term use?
Yes, Xcopri can be used for long-term seizure control, but regular monitoring is necessary to ensure safety, particularly with regard to mood changes, heart function, and seizure control.
Can I stop taking Xcopri if my seizures are controlled?
No, do not stop taking Xcopri suddenly, even if your seizures are well-controlled. Abrupt discontinuation can lead to increased seizure activity. Consult your doctor before making any changes to your medication regimen.
Comprehensive Drug Guide
How Does Xcopri Work?
Xcopri works by inhibiting voltage-gated sodium channels in the brain and enhancing GABAergic transmission, both of which play critical roles in controlling excessive electrical activity that can lead to seizures. By stabilizing brain activity, Xcopri helps prevent seizures in patients with epilepsy.
Common Dosages
- 12.5 mg, 25 mg, 50 mg, 100 mg, 150 mg, and 200 mg tablets.
Typical Dosing
- For partial-onset seizures in adults: Xcopri is typically initiated at a low dose of 12.5 mg once daily and gradually increased over several weeks to a maintenance dose of 200 mg once daily, depending on the patient's response and tolerance. In some cases, the dose may be further increased to 400 mg daily, based on the doctor's recommendation.
Typical Dosing
FDA Approved Indications
- Partial-onset seizures in adults with epilepsy.
Who Shouldn't Take Xcopri?
- Known hypersensitivity to cenobamate or any component of the formulation.
- Familial Short QT Syndrome, as Xcopri may shorten the QT interval, which can increase the risk of abnormal heart rhythms.
Advice From The Pharmacist
- Take Xcopri once daily at the same time each day. It can be taken with or without food.
- Do not stop taking Xcopri abruptly, as this may increase the risk of seizures. If discontinuation is necessary, your doctor will gradually reduce the dose.
- Xcopri can interact with other medications, particularly other anticonvulsants, so it is important to inform your doctor of all medications you are currently taking.
- Avoid alcohol while taking Xcopri, as it can increase the risk of side effects such as drowsiness or dizziness.
- Monitor for mood changes or signs of depression, as Xcopri can increase the risk of suicidal thoughts or behavior in some patients.
Side Effects of Xcopri
Common Side Effects
- Drowsiness or dizziness
- Fatigue
- Headache
- Nausea
- Difficulty sleeping (insomnia)
Uncommon/Severe Side Effects
- Serious hypersensitivity reactions, such as swelling, rash, or difficulty breathing.
- Shortening of the QT interval, which may lead to abnormal heart rhythms.
- Increased risk of suicidal thoughts or behavior.
- Severe allergic skin reactions (such as Stevens-Johnson syndrome).
Risks and Warnings of Xcopri
- Suicidal Behavior and Ideation: Like other antiepileptic drugs, Xcopri may increase the risk of suicidal thoughts and behaviors. Patients should be closely monitored for any changes in mood, behavior, or mental health.
- QT Shortening: Xcopri may shorten the QT interval, which can increase the risk of serious heart rhythm problems, particularly in patients with a family history of heart conditions.
- Hypersensitivity Reactions: Rare but serious allergic reactions, such as Stevens-Johnson syndrome, can occur. Seek immediate medical attention if you experience rash, fever, or skin blistering.
Interactions with Xcopri
Common Drug Interactions
- Other antiepileptic drugs: Xcopri can interact with other anticonvulsants, such as phenytoin and carbamazepine, which may require dose adjustments.
- CNS depressants: Combining Xcopri with sedatives, opioids, or alcohol can increase the risk of CNS depression, leading to excessive drowsiness or respiratory issues.
- QT-shortening medications: Xcopri should be used cautiously with medications that also affect the QT interval, as it may increase the risk of abnormal heart rhythms.
Alternatives to Xcopri
- Lamotrigine (Lamictal): Another anticonvulsant used to treat partial-onset and generalized seizures.
- Levetiracetam (Keppra): An antiepileptic medication commonly used for various types of seizures.
- Topiramate (Topamax): An anticonvulsant used for the treatment of epilepsy and migraine prevention.
- Carbamazepine (Tegretol): Another commonly prescribed anticonvulsant for managing seizures.
