What is the role of rufinamide in the treatment of epilepsy?

Updated: Jan 28, 2020
  • Author: Juan G Ochoa, MD; Chief Editor: Selim R Benbadis, MD  more...
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Rufinamide is a triazole derivative that is structurally unrelated to other AEDs approved in the United States. The precise mechanism of the antiepileptic effect is unknown. In vitro studies suggest that the principal mechanism of action of rufinamide is modulation of the activity of sodium channels and, in particular, prolongation of the inactive state of the channel.

It is indicated as an adjunctive treatment for seizures associated with Lennox-Gastaut syndrome in adults and children aged 1 y or older.

The initial adult dose is 400-800 mg/day PO divided q12h. Increase the daily dose by 400-800 mg every other day until a maximum of 3200 mg/day divided q12h is reached.

The initial pediatric dose is 10 mg/kg/d PO divided q12h. The pediatric target dose is 45 mg/kg/day divided q12h. Increase the daily dose by ~10 mg/kg every other day (not to exceed 3200 mg/day) until the target dose is reached.

It is not known whether doses lower than the target doses are effective.

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