Felbamate

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Felbamate is a dicarbamate derivative anticonvulsant that is typically used in combination with other antiepileptic medications for refractory partial onset or generalized seizures. 


Liver safety of Felbamate[edit source]

Felbamate has been associated with multiple cases of aplastic anemia and acute liver failure and its use is now restricted.

Mechanism of action of Felbamate[edit source]

Felbamate (fel bam' ate) is a dicarbamate that has unique anticonvulsant activity.  Its exact mechanism of action has not been established. 

FDA approval information for Felbamate[edit source]

Felbamate was approved for use the United States in 1993, the first new anticonvulsant medication in more than a decade.  Within a year of release, however, reports of aplastic anemia and severe hepatotoxicity were received and severe warnings were placed on its use.  Although still available, felbamate is rarely used because of the availability of other anticonvulsants with better safety record. 


Felbamate is recommended only for refractory and severe epilepsy unresponsive to other agents. 

Dosage and administration for Felbamate[edit source]

Felbamate is available as tablets of 400 and 600 mg and as an oral solution fo pediatric use generically and under the brand name Febatol, but only on a limited named-patient basis.  The recommended initial dose in adults is 400 to 600 mg twice daily, with dose escalation based upon tolerance. 

Side effects of Felbamate[edit source]

Common side effects include dizziness, nausea, somnolence and fatigue.  Rare but potentially severe adverse events include suicidal thoughts and behaviors, aplastic anemia and acute hepatic failure. 

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