Xcopri (Cenobamate): Uses, Dosage, Side Effects, and Safety Guide

Epilepsy significantly impacts multiple facets of life — safety, employment, sleep, independence, and both mental and emotional health. For adult patients who have uncontrolled epilepsy, specialists may suggest Xcopri as an option. This antiepileptic must be prescribed in a careful manner, as serious adverse reactions, dangerous drug-drug interactions, and required slow titration to therapeutic doses, are of concern.

What Is Xcopri?

Xcopri is a cenobamate-containing oral seizure medication. Anti-seizure medication is a drug class that Xcopri is a member of. This drug class alleviates unstable, erroneous electricity in the brain. When this class is prescribed, it is to decrease the probability of a seizure. Xcopri is specifically approved for the management of adult partial-onset seizures. It is unknown whether Xcopri can be approved for pediatric patients. A physician will assess the patient's seizure disorder as well as the patient's medical and psychiatric history in order to determine if Xcopri is an appropriate therapy.

How Xcopri Works?

Xcopri aids in the management of seizure control via the influence of imbalanced neuronal signaling. Xcopri also aids in the suppression of errant neuronal signaling, which also serves to decrease the probability of seizure occurrence and thus, the frequency of seizures. Because Xcopri does not cure epilepsy, the only way to fully manage your condition is to take this medication as prescribed. Neglecting to take your medication can cause your seizures to worsen. If you are considering changing your dosage for any reason, you need to consult your physician.

Common Uses of Xcopri

Xcopri is prescribed to adults who experience partial-onset seizures. If other medications have not completely controlled a patient’s seizures, then the physician may prescribe Xcopri.

Common Uses of Xcopri Seizure Control Prescriptions

• Adult Partial-onset Seizures
• Other anti-seizure medications are not controlling seizures
• Increased anti-seizure medication control is
• Long term control of epilepsy
• Other management plans that are neurology based
• Xcopri can be used as monotherapy or as a part of a polytherapy seizure control management plan.

How Xcopri is Taken?

Xcopri is administered orally once a day. Patients can take the medication either with or without food. The medication can be taken in its entirety or for some patients may be prescribed that the medication is to be crushed. Xcopri has a unique treatment plan in that the dosage increase is done very slowly. Physicians are to start on a very small dosage that is increased in several week intervals. This is done to decrease the risk of serious side effects, adverse and severe allergic reactions.

Patients are to follow the plan as designed and adjust no deviations. Faster increases run the risk of negative side effects. The side effects that can be experienced include dizziness, severe fatigue/sleepiness, and impaired coordination.

Benefits of Xcopri

For adults with partial-onset seizures, Xcopri could provide useful benefits. Better seizure control means an improved quality of life and confidence for many patients.

Potential benefits of Xcopri:

• Reduces partial-onset seizures
• Can be combined with other anti-seizure medications
• Taken once a day
• Supports long-term management of epilepsy
• Used for patients who have breakthrough seizures and are on other therapies
• Dosing flexibility (taken with or without food)

Seizures can significantly disrupt daily life and managing them can help, though this can be very individual. Some patients may respond well to the medication and others may need dose adjustments or supplemental therapies.

Potential Side Effects of Xcopri

Xcopri, as with any other medication, has some adverse effects. These effects can be mild or serious and potentially life-threatening.

Some of the common side effects of Xcopri are:

• Drowsiness
• Dizziness
• Tiredness
• Double vision
• Headaches
• Nausea
• Problems with balance
• Difficulty walking
• Issues with coordination

Xcopri causes drowsiness and dizziness, so patients should use caution and avoid driving or performing activities that require full alertness and concentration until they have an understanding of how Xcopri affects them.

In addition to the listed side effects, Xcopri can cause life-threatening effects in some patients. The most important of these effects is the risk of severe and multiple organ system (anaphylactic) hypersensitivity reactions. These will present with fever and rash, and may be associated with weakness, facial swelling, lymphadenopathy, jaundice, or unusual bleeding.

Seek immediate medical treatment if you experience any of the following.

• Skin rash
• Fever
• Swollen glands
• Loss of strength
• Swelling of the face
• Difficulty breathing
• Skin or eyes turning yellow
• Bruising or bleeding easily
• Dizziness
• Significant mood changes
• Suicidal thoughts
• Irregular heartbeat
• Fainting

Elderly patients taking anti-seizure medications may experience increased risks for developing suicidal thoughts or actions. Mood changes, including depression, anxiety, or irritability, or any other unusual behavior should be monitored by the caregiver.

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Who Needs to be More Cautious When Using Xcopri?

Xcopri is not for everyone. It is the patient's responsibility to provide their doctor with an accurate and complete medical history in order to be prescribed Xcopri.

Greater caution should be taken when the patient is likely to fall into any of the following classifications:

• Mood disorders
• Kidney problems
• Liver problems
• Heart rhythm problems
• Depression
• Suicidal thoughts
• Drug or alcohol dependence
• Medication allergies
• Pregnancy/breastfeeding

Xcopri is a controlled substance. This means it is likely to have abuse potential, and dependence can develop. It should be kept secure and not shared with other people.

Drug Interactions

Xcopri can interact with other anti-seizure medications and most other medications. These drug interactions may limit how some drugs can be prescribed or increase side effects. Other seizure medications may need to be prescribed in lower dosages.

Patients are required to disclose all of the following to their doctor:

• All prescribed medications
• Over-the-counter medications
• Supplements including vitamins and herbal remedies
• Contraceptives
• Alcohol
• Other anti-seizure medications

Xcopri may make some hormonal contraceptives less effective. Patients should make their prescribing doctor aware of any changes to their contraception to ensure they have an effective form of contraception.

Safety Tips While Taking Xcopri

Xcopri should be taken as prescribed. The risk of seizures may increase if medications are missed or stopped suddenly.

Here are some Xcopri safety tips:

• Use Xcopri once a day as instructed.
• Do not stop taking it suddenly.
• Adhere to the titration schedule.
• Use of alcohol is discouraged and should only be considered if your doctor gives you the go-ahead.
• Do not drive until you know how Xcopri affects you.
• Report changes to your moods or behavior to your doctor.
• Keep the medication away from children and other people.
• Do not give Xcopri to others.
• Keep your scheduled doctor appointments.
• Specialized symptoms should be reported as needed.

Conclusion

Xcopri is used to help adult patients with partial-onset seizures. Adult patients with epilepsy who have not achieved adequate control should consider Xcopri. It has the potential to help improve control of seizures and of the condition itself. The convenience of Xcopri's once a day dosing is undermined by the need for slow, careful, and frequent monitoring of the patient. Xcopri should be used under the careful monitoring of a medical professional. The serious side effects, drug interactions, mood changes and allergic-type reactions are all Xcopri concerns. The protection and efficacy of Xcopri for adult patients with epilepsy will depend on regular follow-up.

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