cenobamate长期治疗癫痫的副作用和处理措施？

The side effects of long-term treatment of epilepsy with cenobamate mainly include drowsiness, dizziness, fatigue, diplopia and headache, etc. Different side effects can be treated accordingly.

cenobamate

Its Chinese names are Phenobanate and Sembacote, which are mainly used to treat partial-onset epilepsy in adults.

Cenobamate exerts anticonvulsant effects through a dual mechanism of action. Cenobamate inhibits the continuous influx of sodium ions into cells through voltage-gated sodium channels and is an allosteric modulator of non-benzodiazepine GABAA channels.

cenobamate for long-term treatment of epilepsy

1. Heart disease: palpitations.

2. Ear and labyrinth diseases: dizziness.

3. Eye diseases: double vision, vision, blur.

4. Gastrointestinal diseases: nausea, constipation, diarrhea, vomiting, dry mouth, abdominal pain, and indigestion.

5. Infectious diseases: nasopharyngitis, pharyngitis, urinary tract infection.

6. Metabolic and nutritional disorders: decreased appetite.

7. Musculoskeletal and connective tissue diseases: back pain, musculoskeletal pain, chest pain.

8. Nervous system diseases: drowsiness, dizziness, fatigue, headache, flatness, loss of taste, migraine, sedation, tremor.

9. Skin and subcutaneous tissue diseases: itching, rash, papules.

Measures to deal with side effects

1. Heart palpitations: Pay attention to the occurrence time, duration and relationship between palpitations and drugs. You can consult a doctor to adjust the drug dosage or replace other drugs. At the same time, maintain a good daily routine and avoid mental stress and anxiety.

2. Dizziness: When dizzy, try to avoid sudden changes in body position, keep the environment quiet, and avoid strenuous exercise.

3. Double vision and blurred vision: Avoid excessive use of your eyes. If these problems occur, you should stop taking the medicine immediately and seek medical treatment.

4. Nausea, constipation, diarrhea, and vomiting: Pay attention to diet, maintain adequate water intake, and avoid greasy food.

5. Back pain and musculoskeletal pain: Pain can be relieved through hot compress, massage and other methods.

6. Drowsiness, dizziness, and fatigue: Maintain a good schedule, try to avoid staying up late, go to bed early and get up early, and avoid sleeping too long during the day.

cenobamate for the treatment of epilepsy

In two randomized, double-blind, placebo-controlled studies and a large, multicenter, open-label safety study in adults with uncontrolled focal epilepsy who were concurrently taking 1 to 3 other antiepileptic drugs and treated with cenobamate, cenobamate significantly reduced the frequency of convulsions compared with placebo in the randomized studies, with up to 1/5 of the patients achieving zero convulsive seizures during maintenance treatment.

cenobamate showed high potential for efficacy in reducing epileptic seizures, with an unprecedented seizure-free rate of 28%.

In two randomized, double-blind, multicenter clinical trials involving 659 patients, cenobamate produced a significant reduction in seizure frequency compared with placebo, and more cenobamate participants demonstrated a ≥50% reduction in seizure frequency, adverse reactions, and discontinuations compared with placebo. Multiple drug interactions with other antiepileptic drugs were also observed.

Usage and dosage

The recommended starting dose is 12.5 mg/day, titrate to a target daily dose of 200 mg, and may be increased to a maximum of 400 mg/day based on clinical response.

References:

Singh A. Cenobamate for treatment-resistant focal seizures: current evidence and place in therapy. J Cent Nerv Syst Dis. 2022 Mar 7;14:11795735211070209. doi: 10.1177/11795735211070209. PMID: 35282314; PMCID: PMC8905054.

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