苯巴那酯有哪些注意事项？

Precautions for Phenobarnate (XCOPRI) mainly include drug reactions with eosinophilia and systemic symptoms (DRESS)/multiple organ hypersensitivity reactions, QT shortening, suicidal tendencies and ideation, neurological adverse reactions, and risk of discontinuation.

(XCOPRI, Cenobamate) is a sodium channel blocker developed by South Korea's SK Biopharm aceuticals. It was approved by the US FDA on November 21, 2019 for the treatment of partial-onset epilepsy in adults. Its trade name is Xcopri. The following are the precautions for phenobamate:

Drug reaction with eosinophilia and systemic symptoms (DRESS)/multiorgan hypersensitivity

Drug reactions associated with eosinophilia and systemic symptoms (DRESS), also known as multi-organ hypersensitivity reactions, have been reported in patients taking XCOPRI. It is worth noting that even if the rash is not obvious, early signs of allergy may occur, such as fever or lymphadenopathy.

Management: If these signs or symptoms occur, the patient should be evaluated immediately. If an alternative cause of the signs or symptoms cannot be determined, XCOPRI should be discontinued immediately and should not be restarted.

QT shortening

Familial short QT syndrome is associated with an increased risk of sudden death and ventricular arrhythmias, particularly ventricular fibrillation. Such events in this syndrome are thought to occur primarily when the corrected QT interval is less than 300 msec. Nonclinical data also suggest that QT shortening is associated with ventricular fibrillation.

Management: Patients with familial short QT syndrome should not receive XCOPRI. Caution should be used when taking XCOPRI with other drugs that shorten the QT interval as there may be synergistic effects on the QT interval that could increase the risk of QT shortening.

suicidal behavior and ideation

Antiepileptic drugs (AEDs), including XCOPRI, can increase the risk of suicidal thoughts or behaviors in patients taking these drugs for any indication. Patients receiving any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behaviors, and/or any unusual changes in mood or behavior.

Management: Anyone considering prescribing XCOPRI or any other AED must weigh this risk against the risk of untreated disease. Epilepsy and many other conditions treated with AEDs are themselves associated with an increased risk of morbidity and mortality and suicidal thoughts and behaviors. If suicidal thoughts and behaviors occur during treatment, the prescriber needs to consider whether the symptoms experienced by any particular patient are related to the condition being treated.

Nervous system adverse reactions

1. Drowsiness and fatigue

XCOPRI caused a dose-dependent increase in somnolence- and fatigue-related adverse reactions (drowsiness, fatigue, asthenia, malaise, somnolence, sedation, and somnolence).

2. Dizziness, gait and coordination disorders

XCOPRI causes dose-dependent adverse reactions related to dizziness, gait and coordination disorders (dizziness, vertigo, balance disorders, ataxia, nystagmus, gait disorders and abnormal coordination).

3. Cognitive dysfunction

XCOPRI causes adverse reactions related to events related to cognitive dysfunction (i.e., memory impairment, attention impairment, amnesia, confusional state, aphasia, speech impairment, slowed thinking, disorientation, and psychomotor retardation).

4. Visual changes

XCOPRI causes adverse reactions related to visual changes, including double vision, blurred vision, and impaired vision.

5. Risk improvement

Prescribers should advise patients not to engage in hazardous activities that require mental alertness, such as operating motor vehicles or hazardous machinery, until the effects of XCOPRI are known. Due to the potential for additive effects, patients should be carefully observed for signs of central nervous system (CNS) depression, such as drowsiness and sedation, when XCOPRI is used with other drugs that have sedative effects.

Discontinuation of antiepileptic drugs

As with most antiepileptic drugs, XCOPRI should generally be discontinued gradually due to the risk of increased seizure frequency and status epilepticus. However, if treatment needs to be discontinued due to serious adverse events, rapid discontinuation may be considered.

Summary

The above are the treatment methods of Phenobarnate (XCOPRI). It is recommended that patients should be cautious when using this drug and strictly follow the doctor's instructions for treatment. If adverse reactions occur, they should contact the doctor in time, and the attending doctor will give corresponding treatment measures.

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