cenobamate at a glance
Medicine class
Antiseizure treatment affecting GABA-A receptors and neuronal sodium channels.
Licensed role
Add-on treatment for inadequately controlled focal-onset seizures in adults.
Food
May be taken with or without food.
Tablets
May be swallowed whole or crushed and mixed with water, but not split to obtain equal portions.
What is cenobamate used for?
Licensed only as an add-on treatment in adults.
Focal-onset seizures, with or without progression to bilateral convulsive seizures, when at least two antiseizure medicines have not provided adequate control.
How does cenobamate work?
Cenobamate strengthens inhibitory signalling through GABA-A receptors and alters sodium-channel activity to reduce repeated neuronal firing. Its precise therapeutic mechanism is not fully established.
cenobamate preparations and strengths
Tablet
Route: Oral
Strengths: 12.5 mg, 25 mg, 50 mg, 100 mg, 150 mg, 200 mg
How to take cenobamate
Follow the product instructions for tablet administration.
May be taken with or without food.
Swallow with water, or crush and mix with water.
Do not split tablets to obtain equal portions.
Crushed tablets may be administered through a nasogastric tube by appropriately trained people.
cenobamate side effects
Common or expected effects
- Sleepiness, sedation or fatigue
- Dizziness, vertigo, or balance and coordination problems
- Headache
- Confusion, irritability, memory or speech difficulties
- Blurred or double vision and involuntary eye movements
- Nausea, vomiting, constipation, diarrhoea or dry mouth
- Rash or itching
- Raised liver enzymes
Get urgent medical advice
- DRESS, with fever, rash, swollen glands, facial involvement or signs of internal-organ injury
- Liver injury, including jaundice, dark urine, pale stools, repeated vomiting, severe tiredness, abdominal pain or unusual bruising
- Thoughts of self-harm or suicide
- Serious hypersensitivity or rapidly worsening rash
cenobamate in pregnancy
Human pregnancy information is inadequate, and animal studies identified reproductive toxicity. Cenobamate should not be used during pregnancy unless the woman’s clinical condition requires it. Pregnancy planning or suspected pregnancy needs prompt specialist review. Effective contraception is required, and oral contraceptives may be less effective.
cenobamate while breastfeeding
It is unknown whether cenobamate enters human milk, and risk to a breastfed child cannot be excluded. The product information advises stopping breastfeeding during treatment; discuss feeding options with the specialist team.
cenobamate interactions
Cenobamate affects several metabolic enzymes and may add to sedative effects. Medicines and contraception should be reviewed when treatment is started, changed or stopped.
Phenytoin
Exposure can increase substantially, requiring monitoring of concentrations and adverse effects.
Phenobarbital
Exposure may increase, requiring monitoring for toxicity and sedation.
Clobazam
Exposure to its active metabolite may rise, increasing sedation and other adverse effects.
Lamotrigine
Concentrations may fall, so seizure control should be reviewed.
Common questions about cenobamate
Answers are fully visible for fast scanning and source review.
Can cenobamate be taken with food?
Yes. Food does not meaningfully affect absorption.
Can the tablets be crushed?
Yes. They may be crushed and mixed with water for oral or nasogastric administration.
Can the tablets be split?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.