Class
- Antiepileptic drug (AED)
Rufinamide
Commonly Prescribed for
(FDA approved in bold)
- Lennox-Gastaut syndrome (LGS) (adjunctive for age 4 and older)
- Partial-onset seizures with and without generalization in adults and adolescents
Rufinamide
How the Drug Works
- The exact mechanism is unknown but likely related to modulation of sodium channel activity and membrane stabilization. Rufinamide prolongs the inactive state of the sodium channel
Rufinamide
How Long Until It Works
- Seizures – should decrease by 2 weeks
Rufinamide
If It Works
- Seizures – goal is the remission of seizures. Continue as long as effective and well-tolerated
Rufinamide
If It Doesn’t Work
- Increase to highest tolerated dose
- Epilepsy: consider changing to another agent, adding a second agent or referral for epilepsy surgery evaluation
Rufinamide
Best Augmenting Combos for Partial Response or Treatment-Resistance
- Generally used adjunctively in combination with other AEDs for refractory epilepsy
Rufinamide
Tests
- No regular blood tests are recommended
Adverse Effects (AEs)
Rufinamide
How Drug Causes AEs
- CNS AEs are probably caused by effects on sodium channels
Rufinamide
Notable AEs
- Sedation, anorexia, nausea/vomiting, headache, dizziness, tremor, nasopharyngitis, influenza
Rufinamide
Life-Threatening or Dangerous AEs
- Suicidal ideation
- Blood dyscrasias including leukopenia
- Bundle branch and first-degree AV block infrequently occurred in clinical trials but the relationship of this to rufinamide is unclear
Rufinamide
Weight Gain
- Unusual
Rufinamide
Sedation
- Not unusual
Rufinamide
What to Do About AEs
- Decrease dose
- Taking drug in fasting state will lower absorption and may reduce both AEs and effectiveness
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