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Symptomatic Carotid Stenosis — SCE Neurology MCQ

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HardNeurologySymptomatic Carotid StenosisSCE Neurology

A patient with drug-resistant focal epilepsy is to start cenobamate. Which initiation schedule best minimises the recognised risk of drug reaction with eosinophilia and systemic symptoms?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Start 12.5 mg once daily and increase at two-week intervals

Explanation lettering: D = shown as A · E = shown as C · A = shown as D · C = shown as E

A is faster and starts above the licensed initiation dose. B is correct: cenobamate starts at 12.5 mg daily with two-week titration steps; DRESS occurred with higher, faster starts and was not seen in the large slow-titration safety cohort. C also starts too high. D waits for toxicity after unsafe exposure. E has no licensed loading strategy and would create avoidable serious risk.

Reference: Ontozry cenobamate Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/13008/smpc