• See Also
  1. Seizure Disorder
  • Mechanism
  1. Anticonvulsant
  2. Sodium channel inhibitor
  • Indications
  1. Lennox-Gestaut Syndrome (adjunct)
  • Contraindications
  1. Severely impaired hepatic function
  2. Short QTc
  • Dosing
  1. General
    1. Take with food
  2. Adult
    1. Start 400 mg to 800 mg/day divided twice daily
      1. Start 400 mg/day if also taking Valproic Acid
    2. Titrate by increasing dose by 400 to 800 mg/day every 2 days as needed
    3. Maximum target dose: 3200 mg/day divided twice daily
  3. Child (age >1 year old)
    1. Start 10 mg/kg/day divided twice daily taken orally
    2. Titrate by increasing dose by 10 mg/kg/day every 2 days as needed
    3. Maximum target dose: 45 mg/kg/day (up to 3200 mg/day) divided twice daily
  • Safety
  1. Pregnancy Category C
    1. Fetal toxicity has been found in animal studies
  2. Unknown Safety in Lactation
  • Metabolism
  1. Hepatic Metabolism
  2. Hemodialysis reduces available drug level by 30%
  • Adverse Effects
  1. Common
    1. Headache
    2. Dizziness
    3. Fatigue
    4. Sedation
    5. Nausea
  2. Serious
    1. DRESS Syndrome
    2. Status Epilepticus
  3. Other
    1. QTc Shortening
    2. Leukopenia
  • Drug Interactions
  1. Valproic Acid
    1. Start Rufinamide at lower dose
  2. Oral Contraceptives
    1. Decreases contraceptive efficacy
  • Resources
  1. Rufinamide (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=da9ee326-a383-4d46-9d4e-fcc2be3d2680
  • References
  1. (2022) Presc Lett, Resource #361206, Antiseizure Medications
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 56-7
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia