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Xcopri (350 MG Daily Dose)
Xcopri (cenobamate) is an anticonvulsant medication used to treat partial-onset seizures in adults with epilepsy. Cenobamate works by stabilizing abnormal electrical activity in the brain, helping to reduce the frequency of seizures. Xcopri is known for its effectiveness in treating drug-resistant epilepsy, offering a new option for patients who may not respond to other seizure medications.
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Frequently Asked Questions
How long does it take for Xcopri to start controlling seizures?
Seizure control may begin once a therapeutic dose is reached, which typically occurs after several weeks of titration. The full effect may take several weeks to months depending on the dose and individual response.
Can I drive while taking Xcopri?
Due to the potential for drowsiness, dizziness, and coordination problems, it is advised to avoid driving or operating heavy machinery until you know how Xcopri affects you.
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’s almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not double up doses.
Is Xcopri safe during pregnancy?
There is limited information on the safety of Xcopri during pregnancy. It should only be used if the potential benefit justifies the potential risk to the fetus. Always consult your healthcare provider if you are pregnant or planning to become pregnant while on Xcopri.
Can I take Xcopri with other anticonvulsants?
Yes, Xcopri can be used in combination with other anticonvulsants. However, interactions with other antiepileptic drugs should be monitored by your healthcare provider, and dose adjustments may be necessary.
Comprehensive Drug Guide
How Does Xcopri (350 MG Daily Dose) Work?
Xcopri works by blocking voltage-gated sodium channels in the brain, which helps stabilize neuronal membranes and reduces excessive brain activity that leads to seizures. Additionally, Xcopri has been shown to enhance GABAergic inhibition, which further helps to calm overactive neurons and prevent seizure episodes.
Common Dosages
- Week 1-2: 12.5 mg once daily
- Week 3-4: 25 mg once daily
- Week 5-6: 50 mg once daily
- Week 7-8: 100 mg once daily
- Week 9-10: 150 mg once daily
- Week 11 and beyond: Increase by 50 mg increments every 2 weeks until the target dose of 350 mg daily is reached.
Typical Dosing
- The typical maintenance dose for treating partial-onset seizures is between 200 mg and 400 mg daily, with the 350 mg daily dose being a common target dose for those needing higher seizure control. Dose adjustments are made based on the patient's response and tolerability.
Typical Dosing
FDA Approved Indications
- Partial-onset seizures in adults with epilepsy.
Who Shouldn't Take Xcopri (350 MG Daily Dose)?
- Hypersensitivity to cenobamate or any of its components.
- A history of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) or serious hypersensitivity reactions to anticonvulsants.
Advice From The Pharmacist
- Titration is critical: Xcopri should be started at a low dose and slowly titrated up to the 350 mg daily dose to minimize the risk of side effects, particularly somnolence and dizziness.
- Do not stop taking Xcopri suddenly, as this may cause seizure rebound or status epilepticus. If discontinuation is necessary, it must be done gradually under medical supervision.
- Avoid alcohol while taking Xcopri, as it can increase the sedative effects of the medication.
- Inform your healthcare provider about all medications you are taking, as Xcopri can interact with other drugs, including CYP450 enzymes.
Side Effects of Xcopri (350 MG Daily Dose)
Common Side Effects
- Drowsiness
- Dizziness
- Fatigue
- Headache
- Nausea
- Diplopia (double vision)
Uncommon/Severe Side Effects
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), a severe allergic reaction that can involve the liver, kidneys, and other organs.
- Suicidal thoughts or behaviors, which can occur with anticonvulsant use.
- Coordination problems, which may increase the risk of falls.
- QT shortening, a heart rhythm abnormality that should be monitored in patients at risk.
Risks and Warnings of Xcopri (350 MG Daily Dose)
- DRESS Syndrome: Patients should be monitored for symptoms of DRESS syndrome, such as rash, fever, swollen lymph nodes, and organ dysfunction, particularly in the first 8 weeks of treatment. If DRESS is suspected, Xcopri should be discontinued immediately.
- Suicidal Thoughts and Behaviors: Like other antiepileptic drugs, Xcopri may increase the risk of suicidal ideation. Patients should be monitored for any changes in mood or behavior, and any concerning symptoms should be reported to a healthcare provider immediately.
- QT Interval Changes: Xcopri has been associated with QT interval shortening, which could lead to cardiac arrhythmias. Monitoring is recommended in patients with a history of heart problems or those on medications that also affect the QT interval.
Interactions with Xcopri (350 MG Daily Dose)
Common Drug Interactions
- Carbamazepine: Concomitant use may increase the risk of CNS side effects.
- Phenytoin: Xcopri can increase phenytoin levels, leading to toxicity, so dose adjustments may be necessary.
- Phenobarbital: Co-administration can increase sedative effects.
- Alcohol: Alcohol should be avoided due to the increased risk of excessive sedation and CNS depression.
Alternatives to Xcopri (350 MG Daily Dose)
- Lamotrigine (Lamictal): Another anticonvulsant used for partial-onset seizures and bipolar disorder.
- Levetiracetam (Keppra): An anticonvulsant used to treat partial-onset and generalized seizures.
- Topiramate (Topamax): An anticonvulsant used for seizure control and migraine prevention.
- Lacosamide (Vimpat): An anticonvulsant specifically indicated for partial-onset seizures.
