Felbamate Clonazepam

General—myoclonic Valproic acid Clonazepam, felbamate (adjunct)... 

Drugs that may affect valproic acid include carbamazepine, charcoal, chlorpromazine, cholestyramine, cimetidine, erythromycin, ethosuximide, felbamate, lamotrigine, phenytoin, rifampin, and salicylates. Drugs that may be affected by valproic acid include carbamazepine, clonazepam, diazepam, ethosuximide, lamotrigine, phenobarbital, phenytoin, tolbutamide, tricyclic antidepressants, warfarin, and zidovudine. 

Myoclonic Valproic acid, clonazepam Lamotrigine, topiramate, felbamate... 

For simple and complex partial seizures and secondary generalized tonic-clonic seizures, the first line drugs are - carbamazepine, valproate and phenytoin. Second line drugs include - acetazolamide, clobazam, clonazepam, ethosuximide, felbamate, gabapentin, lamotrigine, levetiracetam, oxacarbamazepine, primidone, tiagabine, topiramate and vigabactin. 

For atypical absence, tonic and clonic seizures, first line treatment is with valproate and second line with acetazolamide, carbamazepine, clobazam, clonazepam, ethosuximide, felbamate, lamotrigine, oxacarbamazepine, phenobarbitone, phenytoin, primidone or topiramate. 

Phenobarbital Phenytoin Primidone Felbamate Lamotrigine Tiagabide Topiramate Valproate Zonisamide Clobazam Clonazepam Diazepam usually compensated by the effect of the added drug risk of toxicity when interfering drug is discontinued drug... 

Felbamate Clonazepam Diazepam Phenobarbital Phenytoin Valproate High risk of toxicity with phenytoin, phenobarbital, and valproate Inhibition of metabolism of the affected drug... 

Although felbamate increases the plasma concentrations of clonazepam only slightly, patients taking this... 

Colucci R, Glue P, Banfield C, Reidenberg P, Meehan J, Radwanski E, Korduba C, Lin C, Dogterom P, Ebels T, Hendriks G, Jonkman J, Affrime M. Effect of felbamate on the pharmacokinetics of clonazepam. Am J Ther 1996 3(4) 294-7. 

Myoclonic syndromes Myoclonic seizure syndromes are usually treated with valproic acid. Clonazepam can be effective, but the high doses required cause drowsiness. Lamotrigine is also reported to be effective in myoclonic syndromes in children. Felbamate has been used adjunctively with the primary drugs but has hematotoxic and hepatotoxic potential. 

Lennox-Gastaut syndrome is a mixed seizure disorder combining the atypical absence seizures with tonic, tonic-clonic, or myoclonic motor patterns. The syndrome begins in childhood and usually Includes mental retardation. Although adequate control of the seizures rarely Is achieved, valproate, phenytoin, felbamate, lamotrigine, topiramate, and clonazepam have been... 

None of the interactions between the benzodiazepines and antiepileptics described here appear to be of major clinical importance, with the possible exception of the interaction between clobazam and felbamate. If both drugs are given be aware that additive sedative or other adverse effects may occur. This may also be possible in some rare cases with chlordiazepoxide or clobazam and phenobarbital clonazepam and lamotrigine or primidone and clorazepate and primidone. 

Romanyshjm, L.A. Wichmann, J.K. Kucharczyk, N. Shumaker, R.C. Ward, D. Sofia, R.D. Simultaneous determination of felbamate, primidone, phenobarbital, carbamazepine, two carbamazepine metabolites, phenytoin, and one phenytoin metabolite in human plasma by hig -performance liquid chromatography. Ther.Drug Monit., 1994,16,90-99 [plasma extracted metabolites, felbamate, phenobarbital, primidone column temp 40-50 LOQ 195-391 ng/mL simultaneous acetaminophen, aspirin, brompheniramine, caffeine, chlorpheniramine, dextromethorphan, dimethadione, ethosuximide, ethotoin, ibuprofen, iministUbene, mephenytoin, mephobarbital, metharbital, methsuximide, para-methadione, phenacemide, phensuximide, phenylpropanolamine, theophylline, trimethadione noninterfering clonazepam valproic acid]... 

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