Rufinamide
Mechanism :
It is a triazole-derivative antiepileptic whose exact mechanism is unknown. It is known to prolong the inactive state of the sodium channels.
Indication :
- Lennox-Gastaut syndrome: As an adjunctive treatment
Contraindications :
Patients with familial short QT syndrome; hypersensitivity to rufinamide, triazole derivatives, or any component of the formulation.
Dosing :
Initial:
10 mg/kg/day PO in 2 equally divided doses; increase dose by ~10 mg/kg every other day to a maximum dose of 45 mg/kg/day, not to exceed 3,200 mg daily in 2 equally divided doses.
Adverse Effect :
Shortened QT interval, ataxia, aggressive behaviour, hyperactivity, headache, drowsiness, fatigue, vomiting, nausea, skin rash, decreased appetite, leukopenia, anemia, diplopia, blurred vision.
Interaction :
Alcohol (Ethyl): May enhance the adverse/toxic effect of Rufinamide. Specifically, sleepiness and dizziness may be enhanced.
Carbamazepine: Rufinamide may decrease the serum concentration of Carbamazepine and vice-versa.
CNS Depressants: Rufinamide may enhance the adverse/toxic effect of CNS Depressants.
Valproate Products: May increase the serum concentration of Rufinamide.
Hepatic Dose :
Mild to moderate hepatic impairment: Dose reduction may be needed.
Severe hepatic impairment: Use is not recommended.