Felbamate

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Toxicological Effects
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Induces
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Taloxa; Belgium: Taloxa; France: Taloxa; Germany: Taloxa; Greece: Taloxa, Taloxan; Hungary: Taloxa; Italy: Taloxa; Luxembourg: Taloxa; Netherlands: Taloxa; Poland: Taloxa; Portugal: Taloxa; Sweden: Taloxa.

North America

USA: Felbatol.

Latin America

Argentina: Felbamyl.

Drug combinations

Chemistry

Felbamate: C~11~H~14~N~2~O~4~. Mw: 238.24. 2-Phenyl-1,3-propanediol dicarbamate. CAS-25451-15-4. (1992).

Pharmacologic Category

Anticonvulsants, Miscellaneous. (ATC-Code: N03AX10).

Mechanism of action

Felbamate, a dicarbamate, is an anticonvulsant agent. Exact mechanism of action unknown, but it is suggested that it increases seizure threshold and reduces seizure spread. In vitro studies indicate that felbamate has weak inhibitory effects on binding at GABA receptors and benzodiazepine receptors. The monocarbamate, p-hydroxy, and 2-hydroxy metabolites of felbamate appear to contribute little, if any, to the anticonvulsant action of the drug.

Therapeutic use

Not indicated as first-line antiepileptic therapy. Management (alone or in combination with other anticonvulsants) of partial seizures with or without secondary generalization in adults and adolescents ≥14 years of age. Management (in combination with other anticonvulsants) of partial and generalized seizures associated with Lennox-Gastaut syndrome in children 2-14 years of age (designated an orphan drug by FDA for this use).

Pregnancy and lactiation implications

Postmarketing case reports in humans include fetal death, genital malformation, anencephaly, encephalocele, and placental disorder. Not recommended during lactation.

Unlabeled use

Contraindications

Hypersensitivity to felbamate or any component of the formulation. Use with caution in patients who have demonstrated hypersensitivity reactions to other carbamates.

Warnings and precautions

Increased risk of potentially fatal aplastic anemia, or of acute hepatic failure resulting in death or hepatic transplantation. Use with caution in renal impairment. Avoid abrupt withdrawal (may result in increased seizure frequency). Severe dermatologic reactions (e.g. toxic epidermal necrolysis, Stevens-Johnson syndrome) and photosensitivity reported rarely. Use with caution in renal impairment (decreased clearance).

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