Class Name(s):

• 28:12.24 Ion Channel Inhibition Agents

Pronunciation:

• (sen" oh bam' ate)

Brand Name(s):

• Xcopri^®

WHY is this medicine prescribed?

Cenobamate is used to treat partial onset seizures (seizures that begin in one part of the brain). Cenobamate is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in the brain.

HOW should this medicine be used?

Cenobamate comes as a tablet to take by mouth. Take once daily with or without food. Take cenobamate at around the same time every day.

Take cenobamate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If unable to swallow the tablet whole, it can be crushed and mixed with water to take by mouth or give through a nasogastric tube. Place the crushed tablet in 25 mL water in a cup and then swirl the cup to combine the mixture. Then either drink the suspension or pull the mixture up into a syringe and place in the nasogastric tube. If giving by mouth, add 25 mL more water to the cup used to create the mixture then swirl around and drink again to make sure all of the crushed tablet is given. If more tablet pieces are left, repeat the last step. If giving through the nasogastric tube, add 10 mL more water to the syringe used to place in the nasogastric tube and place in the nasogastric tube again. Once the crushed tablet is mixed with water, it should be administered right away. Do not store for later use.

Your doctor will probably start you on a low dose of cenobamate and increase your dose over time, not more than once every 2 weeks.

Cenobamate may be habit forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor.

Cenobamate may help control your condition, but it does not cure it. Do not stop taking cenobamate without talking to your doctor. If you suddenly stop taking cenobamate, your seizures may become worse. Your doctor will probably decrease your dose gradually.

Are there OTHER USES for this medication?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before taking cenobamate,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking cenobamate. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• you should know that cenobamate may decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, or implants). Talk to your doctor about methods of birth control that will work for you while taking cenobamate.
• tell your doctor if you have familial short QT syndrome (an inherited condition that causes irregular heartbeat, dizziness, fainting, or sudden death). Your doctor will probably tell you not to take cenobamate.
• tell your doctor if you have or have ever had liver or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking cenobamate, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking cenobamate.
• you should know that cenobamate may cause dizziness, drowsiness, and problems with coordination and balance. Do not drive a car, operate machinery, or participate in activities requiring alertness or coordination until you know how this medication affects you.
• ask your doctor about the safe use of alcoholic beverages while you are taking cenobamate. Alcohol can make the side effects from cenobamate worse.
• you should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while you are taking cenobamate. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: panic attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling asleep or staying asleep; aggressive, angry, or violent behavior; mania (frenzied, abnormally excited mood); talking or thinking about wanting to hurt yourself or end your life; or any other unusual changes in behavior or mood. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own. Talk to your doctor about the risk of taking cenobamate.
• you should know that cenobamate has caused liver damage. Call your doctor right away if you have any of the following symptoms: nausea, vomiting, upper right-sided stomach pain, tiredness or weakness, lack of appetite, yellowing of skin or whites of eyes, dark urine, pale stools.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Cenobamate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• tiredness
• nausea, vomiting, diarrhea, constipation
• dry mouth, taste changes
• heartburn
• stomach pain, loss of appetite, weight loss
• back pain
• difficulty reading, writing, or speaking
• confusion
• hallucinations, paranoia, hostility, aggression

Some side effects can be serious. If you experience any of these symptoms or those listed in the SPECIAL PRECAUTIONS section, call your doctor immediately or get emergency medical treatment:

• double vision or blurred vision
• rash; hives; swelling of your face or legs; difficulty swallowing or breathing
• fever, sore throat, or swollen glands
• sores in mouth or around eyes
• unusual bruising or bleeding
• fatigue or weakness; muscle pain; yellowing of skin or eyes; or dark urine
• shortness of breath
• irregular heartbeat or fainting

Cenobamate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at http://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website http://goo.gl/c4Rm4p for more information.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Cenobamate is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™ Copyright, 2025. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: October 15, 2025.