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Stiripentol: Drug information

Stiripentol: Drug information
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For additional information see "Stiripentol: Patient drug information" and "Stiripentol: Pediatric drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Diacomit
Brand Names: Canada
  • Diacomit
Pharmacologic Category
  • Antiseizure Agent, Miscellaneous
Dosing: Adult

Note: FDA approved in combination with clobazam; international labeling (European Medicines Agency, Health Canada) recommends combination with clobazam and valproic acid (Ref). Not appropriate for monotherapy. Clinical trial data are limited to patients taking stiripentol with both clobazam and valproic acid (Ref). The dosage of concomitant clobazam and valproate may need to be adjusted. Systemic exposure is slightly higher with the powder for suspension than that observed with capsules; patient monitoring is recommended when switching between dosage forms (Ref).

Dravet syndrome–associated seizures

Dravet syndrome–associated seizures (adjunctive therapy): Oral: Usual: 50 mg/kg/day given in 2 or 3 divided doses; some experts initiate with 10 to 15 mg/kg/day and increase to a target dose of 50 mg/kg/day over 2 to 4 weeks (Ref). Maximum dose: 3 g/day.

Discontinuation of therapy: In chronic therapy, withdraw gradually to minimize the potential of increased seizure frequency and status epilepticus, unless safety concerns require a more rapid withdrawal.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Use with caution with mild impairment and titrate dose per seizure control and tolerability; metabolites primarily undergo renal elimination. Avoid use in patients with moderate to severe renal impairment.

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Use with caution with mild impairment and titrate dose per seizure control and tolerability; metabolism is primarily hepatic. Avoid use in patients with moderate to severe hepatic impairment.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Stiripentol: Pediatric drug information")

Note: Systemic exposure is slightly higher with the powder for suspension than that observed with capsules; patient monitoring is recommended when switching between dosage forms (Ref). Two strengths of powder packets are available (250 mg and 500 mg); may combine the two strengths to achieve the appropriate dosage; ensure appropriate product selection.

Dravet syndrome; adjunctive therapy

Dravet syndrome; adjunctive therapy:

Note: In the United States, FDA approved for adjunct treatment of Dravet syndrome in combination with clobazam; international labeling (European Medicines Agency, Health Canada) recommends combination with clobazam and valproic acid. Other concomitant antiseizure agents have also been studied (eg, topiramate) and efficacy data are evolving, although experts suggest avoiding sodium channel blockers (eg, carbamazepine) which may exacerbate seizures (Ref). The concomitant dosage of clobazam and/or valproate may need to be adjusted with initiation of stiripentol.

Infants ≥6 months weighing ≥7 kg: Oral: 50 mg/kg/day in 2 divided doses; round dose to the nearest available dosage form; to prevent stiripentol overexposure and limit free water consumption due to volume required to administer each dose, do not administer more frequently than twice daily in infants.

Children and Adolescents weighing ≥7 kg:

≥7 to <10 kg: Oral: 50 mg/kg/day in 2 divided doses; round dose to nearest available dosage form; to prevent stiripentol overexposure and limit free water consumption due to volume required to administer each dose, do not administer more frequently than twice daily.

≥10 kg: Oral: 50 mg/kg/day in 2 or 3 divided doses; round dose to nearest available dosage form; maximum daily dose: 3,000 mg/day.

Some experts recommend initiating at a lower dosage of 10 to 15 mg/kg/day in divided doses and titrating to initial target dose of 50 mg/kg/day over a 2- to 4-week period (Ref). Higher doses were reported in one open-label, multicenter trial of patients with Dravet syndrome (n=23; ages: 1 to 22 years); the initial dose was 50 mg/kg/day in divided doses in patients <20 kg and a fixed dose of 1,000 mg/day in divided doses in patients ≥20 kg; after 4 weeks, dosage was adjusted based on clinical response up to a maximum of 100 mg/kg/day (or 4,000 mg/day) in divided doses. In patients 1 to 8 years (n=15), mean daily dose was 59 mg/kg/day (range: 30 to 100 mg/kg/day) and in patients 13 to 22 years (n=8), mean daily dose was 1,469 mg/day (range: 500 to 3,000 mg/day) (Ref). Pharmacokinetic modeling studies indicate adolescents may require lower doses of 20 to 30 mg/kg/day (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Metabolites primarily undergo renal elimination; use with caution in patients with mild impairment; use not recommended in patients with moderate to severe renal impairment.

Dosing: Liver Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Metabolism is primarily hepatic; use with caution in patients with mild impairment; use not recommended in patients with moderate to severe hepatic impairment.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Adverse reactions reported with combination (clobazam) therapy.

>10%:

Central nervous system: Drowsiness (67%), agitation (27%), ataxia (27%), hypotonia (18% to 24%), dysarthria (12%), insomnia (12%)

Endocrine & metabolic: Weight loss (27%)

Gastrointestinal: Decreased appetite (45% to 46%), nausea (15%)

Hematologic & oncologic: Decreased platelet count (13%), neutropenia (13%)

Neuromuscular & skeletal: Tremor (15%)

1% to 10%:

Central nervous system: Aggressive behavior (9%), fatigue (9%)

Endocrine & metabolic: Weight gain (6%)

Gastrointestinal: Vomiting (9%), sialorrhea (6%)

Respiratory: Bronchitis (6%), nasopharyngitis (6%)

Miscellaneous: Fever (6%)

Contraindications

There are no contraindications listed in the US manufacturer's labeling.

Canadian labeling: Additional contraindications (not in US labeling): Hypersensitivity to stiripentol or any component of the formulation.

Warnings/Precautions

Concerns related to adverse effects:

• Appetite/weight loss: Loss of appetite and weight loss have been observed in 46% and 27% of patients (mean age: 9.2 years), respectively, during clinical trials; monitor the growth rate of pediatric patients closely. Valproate dose reduction by 30% may help minimize appetite and weight loss.

• Blood dyscrasias: Neutropenia and thrombocytopenia have been observed in clinical trials; monitor CBC during therapy.

• CNS depression: May cause CNS depression (eg, drowsiness, sleepiness) and impair physical or mental abilities; patients must be cautioned about performing tasks that require mental alertness (eg, operating machinery or driving). If CNS depression occurs during co-administration with clobazam, consider dosage adjustment of clobazam and/or other concomitant antiseizure drugs.

• Suicidal ideation: Pooled analysis of trials involving various antiseizure medications (regardless of indication) showed an increased risk of suicidal thoughts/behavior (incidence rate: 0.43% treated patients compared to 0.24% of patients receiving placebo); risk observed as early as 1 week after initiation and continued through duration of trials (most trials ≤24 weeks). Monitor all patients for notable changes in behavior that might indicate suicidal thoughts or depression; notify health care provider immediately if symptoms occur.

Disease-related concerns:

• Hepatic impairment: Use with caution in patients with mild impairment; primarily undergoes hepatic metabolism. Avoid use in patients with moderate to severe hepatic impairment.

• Renal impairment: Use with caution in patients with mild impairment; elimination of metabolites is primarily renal. Avoid use in patients with moderate to severe renal impairment.

Dosage form specific issues:

• Powder for suspension: Systemic exposure is slightly higher with the powder for suspension than that observed with capsules; may consider patient monitoring when switching between dosage forms. Powder for suspension contains phenylalanine; use caution in patients with phenylketonuria.

Other warnings:

• Appropriate use: Use in conjunction with clobazam and valproate (Chiron 2000; Wirrell 2016); not approved for use as monotherapy.

• Withdrawal: Antiseizure medications should not be discontinued abruptly because of the possibility of increasing seizure frequency; therapy should be withdrawn gradually (over at least 1 month) to minimize the potential of increased seizure frequency, unless safety concerns require a more rapid withdrawal.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule, Oral:

Diacomit: 250 mg [contains fd&c blue #2 (indigotine,indigo carmine)]

Diacomit: 500 mg

Packet, Oral:

Diacomit: 250 mg (60 ea); 500 mg (60 ea) [contains aspartame]

Generic Equivalent Available: US

No

Pricing: US

Capsules (Diacomit Oral)

250 mg (per each): $42.16

500 mg (per each): $84.32

Pack (Diacomit Oral)

250 mg (per each): $42.16

500 mg (per each): $84.32

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule, Oral:

Diacomit: 250 mg [contains fd&c blue #2 (indigotine,indigo carmine)]

Diacomit: 500 mg

Packet, Oral:

Diacomit: 250 mg (1 ea) [contains aspartame]

Administration: Adult

Oral: Administer with meals.

Capsule: Swallow whole with a glass of water. Do not crush, chew, or open capsule.

Powder for suspension: Two strengths of powder packets are available (250 mg and 500 mg); may combine the 2 strengths to achieve the appropriate dosage; ensure appropriate product selection. Mix powder packet(s) required for the dose with a glass of water (~100 mL), stir, and consume immediately. More than 1 packet may be required for appropriate dose. After administering the dose, add a small amount of water (25 mL) to glass to suspend any remaining drug and consume remaining liquid immediately.

Administration: Pediatric

Oral: Administer with food.

Capsule: Swallow whole with a glass of water; do not crush, chew, or open capsule.

Powder for suspension: Note: Two strengths of powder packets are available (250 mg and 500 mg); may combine the two strengths to achieve the appropriate dosage; ensure appropriate product selection. Mix powder packet(s) required for the dose with a 100 mL of water, stir, and consume immediately. More than one packet may be required for appropriate dose. After administering the dose, add a small amount of water (25 mL) to glass to suspend any remaining drug and consume remaining liquid immediately.

Hazardous Drugs Handling Considerations

This medication is not on the NIOSH (2024) list; however, it may meet the criteria for a hazardous drug. Stiripentol may cause teratogenicity.

Use appropriate precautions for receiving, handling, storage, preparation, dispensing, transporting, administration, and disposal. Follow NIOSH and USP 800 recommendations and institution-specific policies/procedures for appropriate containment strategy (NIOSH 2023; NIOSH 2024; USP-NF 2020).

Note: Facilities may perform risk assessment of some hazardous drugs to determine if appropriate for alternative handling and containment strategies (USP-NF 2020). Refer to institution-specific handling policies/procedures.

Medication Guide and/or Vaccine Information Statement (VIS)

An FDA-approved patient medication guide, which is available with the product information and at https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/206709s000,207223s000lbl.pdf#page=17, must be dispensed with this medication.

Use: Labeled Indications

Dravet syndrome-associated seizures: Adjunctive treatment of seizures associated with Dravet syndrome in conjunction with clobazam in patients ≥6 months of age and weighing ≥7 kg; not indicated for monotherapy.

Note: FDA approved in combination with clobazam; international labeling (European Medicines Agency, Health Canada) recommends combination with clobazam and valproic acid (Diacomit European Medicines Agency 2021; Diacomit Canadian product monograph). Clinical trial data are limited to patients taking stiripentol with both clobazam and valproic acid (Brigo 2017; Chiron 2000).

Metabolism/Transport Effects

Substrate of CYP1A2 (Minor), CYP2C19 (Minor), CYP3A4 (Minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential; Inhibits CYP1A2 (Moderate), CYP2C19 (Moderate), CYP3A4 (Weak);

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Abrocitinib: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Abrocitinib. Risk C: Monitor

Acrivastine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Agomelatine: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Agomelatine. Risk C: Monitor

Alcohol (Ethyl): Stiripentol may increase sedative effects of Alcohol (Ethyl). Risk X: Avoid

Alizapride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Alosetron: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Alosetron. Management: Avoid concomitant use of alosetron and moderate CYP1A2 inhibitors whenever possible. If combined use is necessary, monitor for increased alosetron effects/toxicities. Risk D: Consider Therapy Modification

ALPRAZolam: CYP3A4 Inhibitors (Weak) may increase serum concentration of ALPRAZolam. Risk C: Monitor

Amisulpride (Oral): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Anagrelide: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Anagrelide. CYP1A2 Inhibitors (Moderate) may increase active metabolite exposure of Anagrelide. Risk C: Monitor

Articaine: May increase CNS depressant effects of CNS Depressants. Management: Consider reducing the dose of articaine if possible when used in patients who are also receiving CNS depressants. Monitor for excessive CNS depressant effects with any combined use. Risk D: Consider Therapy Modification

Azelastine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Belzutifan: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Belzutifan. Risk C: Monitor

Bendamustine: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Bendamustine. Management: Consider alternatives to moderate CYP1A2 inhibitors during therapy with bendamustine due to the potential for increased bendamustine plasma concentrations and increased bendamustine toxicity. Risk D: Consider Therapy Modification

Benperidol: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Blonanserin: CNS Depressants may increase CNS depressant effects of Blonanserin. Management: Use caution if coadministering blonanserin and CNS depressants; dose reduction of the other CNS depressant may be required. Strong CNS depressants should not be coadministered with blonanserin. Risk D: Consider Therapy Modification

Brexanolone: CNS Depressants may increase CNS depressant effects of Brexanolone. Risk C: Monitor

Brimonidine (Topical): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Brivaracetam: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Brivaracetam. Risk C: Monitor

Bromopride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Bromperidol: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Buclizine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Buprenorphine: CNS Depressants may increase CNS depressant effects of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine at lower doses in patients already receiving CNS depressants. Risk D: Consider Therapy Modification

BusPIRone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Caffeine and Caffeine Containing Products: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Caffeine and Caffeine Containing Products. Risk C: Monitor

Cannabidiol: Stiripentol may increase serum concentration of Cannabidiol. Cannabidiol may increase serum concentration of Stiripentol. Risk C: Monitor

Cannabinoid-Containing Products: CNS Depressants may increase CNS depressant effects of Cannabinoid-Containing Products. Risk C: Monitor

CarBAMazepine: May decrease serum concentration of Stiripentol. Stiripentol may increase serum concentration of CarBAMazepine. Management: Avoid the use of stiripentol and carbamazepine when possible. If combined, monitor for both reduced stiripentol efficacy and increased carbamazepine concentrations and toxicities. Dose adjustments of both drugs may be needed. Risk D: Consider Therapy Modification

Carisoprodol: CYP2C19 Inhibitors (Moderate) may decrease active metabolite exposure of Carisoprodol. CYP2C19 Inhibitors (Moderate) may increase serum concentration of Carisoprodol. Risk C: Monitor

Cetirizine (Systemic): May increase CNS depressant effects of CNS Depressants. Management: Consider avoiding this combination if possible. If required, monitor for excessive sedation or CNS depression, limit the dose and duration of combination therapy, and consider CNS depressant dose reductions. Risk D: Consider Therapy Modification

Chloral Hydrate/Chloral Betaine: CNS Depressants may increase CNS depressant effects of Chloral Hydrate/Chloral Betaine. Management: Consider alternatives to the use of chloral hydrate or chloral betaine and additional CNS depressants. If combined, consider a dose reduction of either agent and monitor closely for enhanced CNS depressive effects. Risk D: Consider Therapy Modification

Chlormethiazole: May increase CNS depressant effects of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used. Risk D: Consider Therapy Modification

Chlorphenesin Carbamate: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor

Cilostazol: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Cilostazol. CYP2C19 Inhibitors (Moderate) may increase active metabolite exposure of Cilostazol. Management: Reduce the cilostazol dose to 50 mg twice daily in patients who are also receiving moderate inhibitors of CYP2C19. Monitor clinical response to cilostazol closely. Risk D: Consider Therapy Modification

Citalopram: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Citalopram. Management: Limit citalopram dose to a maximum of 20 mg/day if used with a moderate CYP2C19 inhibitor. Patients using this combination should be monitored closely for evidence of citalopram toxicity (eg, serotonin syndrome, QT prolongation). Risk D: Consider Therapy Modification

CloBAZam: CYP2C19 Inhibitors (Moderate) may increase active metabolite exposure of CloBAZam. CYP2C19 Inhibitors (Moderate) may increase serum concentration of CloBAZam. Risk C: Monitor

ClomiPRAMINE: CYP1A2 Inhibitors (Moderate) may increase serum concentration of ClomiPRAMINE. Risk C: Monitor

Clopidogrel: CYP2C19 Inhibitors (Moderate) may decrease active metabolite exposure of Clopidogrel. Risk C: Monitor

CloZAPine: CYP1A2 Inhibitors (Moderate) may increase serum concentration of CloZAPine. Risk C: Monitor

CNS Depressants: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor

CycloSPORINE (Systemic): CYP3A4 Inhibitors (Weak) may increase serum concentration of CycloSPORINE (Systemic). Risk C: Monitor

CYP3A4 Inducers (Strong): May decrease serum concentration of Stiripentol. Management: Avoid concomitant use of stiripentol and strong CYP3A4 inducers when possible. If combined, monitor for reduced stiripentol efficacy and increase the stiripentol dose as needed. Risk D: Consider Therapy Modification

Dantrolene: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Daridorexant: May increase CNS depressant effects of CNS Depressants. Management: Dose reduction of daridorexant and/or any other CNS depressant may be necessary. Use of daridorexant with alcohol is not recommended, and the use of daridorexant with any other drug to treat insomnia is not recommended. Risk D: Consider Therapy Modification

Desmopressin: Hyponatremia-Associated Agents may increase hyponatremic effects of Desmopressin. Risk C: Monitor

Dexlansoprazole: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Dexlansoprazole. Risk C: Monitor

DexmedeTOMIDine: CNS Depressants may increase CNS depressant effects of DexmedeTOMIDine. Management: Monitor for increased CNS depression during coadministration of dexmedetomidine and CNS depressants, and consider dose reductions of either agent to avoid excessive CNS depression. Risk D: Consider Therapy Modification

DiazePAM: CYP2C19 Inhibitors (Moderate) may increase serum concentration of DiazePAM. Risk C: Monitor

Diazoxide Choline: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Diazoxide Choline. Risk C: Monitor

Difelikefalin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Difenoxin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Dihydralazine: CNS Depressants may increase hypotensive effects of Dihydralazine. Risk C: Monitor

Dimethindene (Topical): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Dofetilide: CYP3A4 Inhibitors (Weak) may increase serum concentration of Dofetilide. Risk C: Monitor

Dothiepin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Doxylamine: CNS Depressants may increase CNS depressant effects of Doxylamine. Risk C: Monitor

DroPERidol: May increase CNS depressant effects of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Risk D: Consider Therapy Modification

DULoxetine: CYP1A2 Inhibitors (Moderate) may increase serum concentration of DULoxetine. Risk C: Monitor

Emedastine (Systemic): May increase CNS depressant effects of CNS Depressants. Management: Consider avoiding this combination if possible. If required, monitor for excessive sedation or CNS depression, limit the dose and duration of combination therapy, and consider CNS depressant dose reductions. Risk C: Monitor

Entacapone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Escitalopram: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Escitalopram. Risk C: Monitor

Esketamine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Etravirine: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Etravirine. Risk C: Monitor

Fenfluramine: Stiripentol may increase serum concentration of Fenfluramine. Management: If coadministered with stiripentol and clobazam, initate fenfluramine at 0.1 mg/kg twice daily, then on day 7 increase fenfluramine to 0.15 mg/kg twice daily, and on day 14 increase fenfluramine to 0.2 mg/kg twice daily. Max dose 17 mg/day. Risk D: Consider Therapy Modification

Fezolinetant: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Fezolinetant. Risk X: Avoid

Finerenone: CYP3A4 Inhibitors (Weak) may increase serum concentration of Finerenone. Risk C: Monitor

Flibanserin: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Flibanserin. Risk C: Monitor

Flunarizine: CNS Depressants may increase CNS depressant effects of Flunarizine. Risk X: Avoid

Flunitrazepam: CNS Depressants may increase CNS depressant effects of Flunitrazepam. Management: Reduce the dose of CNS depressants when combined with flunitrazepam and monitor patients for evidence of CNS depression (eg, sedation, respiratory depression). Use non-CNS depressant alternatives when available. Risk D: Consider Therapy Modification

Fosphenytoin-Phenytoin: May decrease serum concentration of Stiripentol. Stiripentol may increase serum concentration of Fosphenytoin-Phenytoin. Management: Avoid this combination when possible. If combined, monitor for decreased stiripentol concentrations and effects and monitor for increased phenytoin concentrations and effects. Dose adjustments of either medication may be needed. Risk D: Consider Therapy Modification

HydrOXYzine: May increase CNS depressant effects of CNS Depressants. Management: Consider a decrease in the CNS depressant dose, as appropriate, when used together with hydroxyzine. Increase monitoring of signs/symptoms of CNS depression in any patient receiving hydroxyzine together with another CNS depressant. Risk D: Consider Therapy Modification

Ixabepilone: CYP3A4 Inhibitors (Weak) may increase serum concentration of Ixabepilone. Risk C: Monitor

Kava Kava: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Ketotifen (Systemic): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Kratom: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Lansoprazole: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Lansoprazole. Risk C: Monitor

Lemborexant: CYP3A4 Inhibitors (Weak) may increase serum concentration of Lemborexant. Management: The maximum recommended dosage of lemborexant is 5 mg, no more than once per night, when coadministered with weak CYP3A4 inhibitors. Risk D: Consider Therapy Modification

Lemborexant: May increase CNS depressant effects of CNS Depressants. Management: Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive CNS depressant effects. Close monitoring for CNS depressant effects is necessary. Risk D: Consider Therapy Modification

Levocetirizine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Lisuride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Lofepramine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Lofexidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Lomitapide: CYP3A4 Inhibitors (Weak) may increase serum concentration of Lomitapide. Management: Patients on lomitapide 5 mg/day may continue that dose. Patients taking lomitapide 10 mg/day or more should decrease the lomitapide dose by half. The lomitapide dose may then be titrated up to a max adult dose of 30 mg/day. Risk D: Consider Therapy Modification

Loxapine: CNS Depressants may increase CNS depressant effects of Loxapine. Management: Consider reducing the dose of CNS depressants administered concomitantly with loxapine due to an increased risk of respiratory depression, sedation, hypotension, and syncope. Risk D: Consider Therapy Modification

Magnesium Sulfate: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Mavacamten: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Mavacamten. Management: For patients on stable therapy with a moderate CYP2C19 inhibitor initiate mavacamten at 2.5 mg daily. For patients initiating a moderate CYP2C19 inhibitor during mavacamten therapy, dose reductions are recommended. See full mono for details. Risk D: Consider Therapy Modification

Mefloquine: May decrease therapeutic effects of Antiseizure Agents. Mefloquine may decrease serum concentration of Antiseizure Agents. Management: Mefloquine is contraindicated for malaria prophylaxis in persons with a history of seizures. If antiseizure drugs are being used for another indication, monitor antiseizure drug concentrations and treatment response closely with concurrent use. Risk D: Consider Therapy Modification

Melatonin: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Melatonin. Risk C: Monitor

Melitracen [INT]: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Mequitazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Metergoline: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Methotrimeprazine: CNS Depressants may increase CNS depressant effects of Methotrimeprazine. Methotrimeprazine may increase CNS depressant effects of CNS Depressants. Management: Reduce the usual dose of CNS depressants by 50% if starting methotrimeprazine until the dose of methotrimeprazine is stable. Monitor patient closely for evidence of CNS depression. Risk D: Consider Therapy Modification

Methoxyflurane: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Metoclopramide: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

MetyraPONE: Coadministration of Antiseizure Agents and MetyraPONE may alter diagnostic results. Management: Consider alternatives to the use of the metyrapone test in patients taking antiseizure agents. Risk D: Consider Therapy Modification

MetyroSINE: CNS Depressants may increase sedative effects of MetyroSINE. Risk C: Monitor

Mianserin: May decrease therapeutic effects of Antiseizure Agents. Risk C: Monitor

Midazolam: CYP3A4 Inhibitors (Weak) may increase serum concentration of Midazolam. Risk C: Monitor

Minocycline (Systemic): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Moclobemide: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Moclobemide. Risk C: Monitor

Moxonidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Nabilone: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Nalfurafine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

NiMODipine: CYP3A4 Inhibitors (Weak) may increase serum concentration of NiMODipine. Risk C: Monitor

Noscapine: CNS Depressants may increase adverse/toxic effects of Noscapine. Risk X: Avoid

OLANZapine: CYP1A2 Inhibitors (Moderate) may increase serum concentration of OLANZapine. Risk C: Monitor

Olopatadine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Omeprazole: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Omeprazole. Risk C: Monitor

Opicapone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Opioid Agonists: CNS Depressants may increase CNS depressant effects of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider Therapy Modification

Opipramol: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Orlistat: May decrease serum concentration of Antiseizure Agents. Risk C: Monitor

Orphenadrine: CNS Depressants may increase CNS depressant effects of Orphenadrine. Risk X: Avoid

Oxomemazine: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Oxybate Salt Products: CNS Depressants may increase CNS depressant effects of Oxybate Salt Products. Management: Consider alternatives to this combination when possible. If combined, dose reduction or discontinuation of one or more CNS depressants (including the oxybate salt product) should be considered. Interrupt oxybate salt treatment during short-term opioid use Risk D: Consider Therapy Modification

OxyCODONE: CNS Depressants may increase CNS depressant effects of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider Therapy Modification

Paliperidone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Paraldehyde: CNS Depressants may increase CNS depressant effects of Paraldehyde. Risk X: Avoid

Pentoxifylline: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Pentoxifylline. Risk C: Monitor

Perampanel: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Periciazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Phenobarbital-Primidone: May decrease serum concentration of Stiripentol. Stiripentol may increase serum concentration of Phenobarbital-Primidone. Risk C: Monitor

PHENobarbital: CYP2C19 Inhibitors (Moderate) may increase serum concentration of PHENobarbital. Risk C: Monitor

Pimozide: CYP3A4 Inhibitors (Weak) may increase serum concentration of Pimozide. Risk X: Avoid

Pipamperone: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor

Pirfenidone: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Pirfenidone. Management: Avoid concomitant use of pirfenidone and moderate CYP1A2 inhibitors whenever possible. If combined, decrease the pirfenidone dose to 1,602 mg per day (534 mg three times daily) and monitor for increased pirfenidone toxicities. Risk D: Consider Therapy Modification

Piribedil: CNS Depressants may increase CNS depressant effects of Piribedil. Risk C: Monitor

Pizotifen: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Pomalidomide: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Pomalidomide. Risk C: Monitor

Pramipexole: CNS Depressants may increase sedative effects of Pramipexole. Risk C: Monitor

Procarbazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Proguanil: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Proguanil. CYP2C19 Inhibitors (Moderate) may decrease active metabolite exposure of Proguanil. Risk C: Monitor

Propranolol: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Propranolol. Risk C: Monitor

Ramelteon: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Ramelteon. Risk C: Monitor

Ramosetron: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Ramosetron. Risk C: Monitor

Rasagiline: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Rasagiline. Management: Limit rasagiline dose to 0.5 mg once daily in patients taking moderate CYP1A2 inhibitors. Risk D: Consider Therapy Modification

Rilmenidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Ropeginterferon Alfa-2b: CNS Depressants may increase adverse/toxic effects of Ropeginterferon Alfa-2b. Specifically, the risk of neuropsychiatric adverse effects may be increased. Management: Avoid coadministration of ropeginterferon alfa-2b and other CNS depressants. If this combination cannot be avoided, monitor patients for neuropsychiatric adverse effects (eg, depression, suicidal ideation, aggression, mania). Risk D: Consider Therapy Modification

ROPINIRole: CNS Depressants may increase sedative effects of ROPINIRole. Risk C: Monitor

ROPINIRole: CYP1A2 Inhibitors (Moderate) may increase serum concentration of ROPINIRole. Risk C: Monitor

ROPivacaine: CYP1A2 Inhibitors (Moderate) may increase serum concentration of ROPivacaine. Risk C: Monitor

Rotigotine: CNS Depressants may increase sedative effects of Rotigotine. Risk C: Monitor

Simvastatin: CYP3A4 Inhibitors (Weak) may increase serum concentration of Simvastatin. CYP3A4 Inhibitors (Weak) may increase active metabolite exposure of Simvastatin. Risk C: Monitor

Sirolimus (Conventional): CYP3A4 Inhibitors (Weak) may increase serum concentration of Sirolimus (Conventional). Risk C: Monitor

Sirolimus (Protein Bound): CYP3A4 Inhibitors (Weak) may increase serum concentration of Sirolimus (Protein Bound). Management: Reduce the dose of protein bound sirolimus to 56 mg/m2 when used concomitantly with a weak CYP3A4 inhibitor. Risk D: Consider Therapy Modification

Suvorexant: CNS Depressants may increase CNS depressant effects of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended. Risk D: Consider Therapy Modification

Tacrolimus (Systemic): CYP3A4 Inhibitors (Weak) may increase serum concentration of Tacrolimus (Systemic). Risk C: Monitor

Tasimelteon: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Tasimelteon. Risk C: Monitor

Thalidomide: CNS Depressants may increase CNS depressant effects of Thalidomide. Risk X: Avoid

Theophylline Derivatives: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Theophylline Derivatives. Management: Consider avoidance of this combination. If coadministration is necessary, monitor for increased theophylline serum concentrations and toxicities when combined. Theophylline dose reductions will likely be required. Risk D: Consider Therapy Modification

TiZANidine: CYP1A2 Inhibitors (Moderate) may increase serum concentration of TiZANidine. Management: Avoid the use of tizanidine with moderate CYP1A2 inhibitors when possible. If combined, monitor closely for increased tizanidine toxicities (eg, hypotension, bradycardia, drowsiness). Tizanidine dose reduction or discontinuation may be necessary. Risk D: Consider Therapy Modification

Triazolam: CYP3A4 Inhibitors (Weak) may increase serum concentration of Triazolam. Risk C: Monitor

Trimeprazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Ubrogepant: CYP3A4 Inhibitors (Weak) may increase serum concentration of Ubrogepant. Management: In patients taking weak CYP3A4 inhibitors, the initial and second dose (given at least 2 hours later if needed) of ubrogepant should be limited to 50 mg. Risk D: Consider Therapy Modification

Valerian: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Vorasidenib: CYP1A2 Inhibitors (Moderate) may increase serum concentration of Vorasidenib. Management: Avoid concurrent use with moderate CYP1A2 inhibitors when possible. If combined use cannot be avoided, monitor for evidence of adverse effects and adjust vorasidenib dose accordingly if necessary. Risk D: Consider Therapy Modification

Voriconazole: CYP2C19 Inhibitors (Moderate) may increase serum concentration of Voriconazole. Risk C: Monitor

Zolpidem: CNS Depressants may increase CNS depressant effects of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Risk D: Consider Therapy Modification

Zuranolone: May increase CNS depressant effects of CNS Depressants. Management: Consider alternatives to the use of zuranolone with other CNS depressants or alcohol. If combined, consider a zuranolone dose reduction and monitor patients closely for increased CNS depressant effects. Risk D: Consider Therapy Modification

Reproductive Considerations

Manage epilepsy in patients who could become pregnant based on a shared decision-making process that optimizes seizure control and considers the possibility of pregnancy during treatment (Pack 2024). Regularly discuss age-specific and developmental needs, including pregnancy planning and contraceptive options during the patient’s reproductive lifespan (ACOG 2020; NICE 2022).

Stiripentol is used in combination with clobazam and valproic acid; refer to individual monographs for additional information.

Pregnancy Considerations

Outcome data following maternal use of stiripentol during pregnancy are limited. Data are insufficient to evaluate the risk of specific major congenital malformations or neurodevelopmental outcomes in children following in utero exposure to stiripentol. Screen for major congenital malformations and monitor fetal growth when antiseizure medications are used during pregnancy. Conduct age-appropriate developmental screening in children who had in utero exposure to antiseizure medications (Pack 2024).

Stiripentol is used in combination with clobazam and valproic acid; refer to individual monographs for additional information.

Data collection to monitor pregnancy and infant outcomes following exposure to stiripentol is ongoing. Encourage patients to enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry (1-888-233-2334 or www.aedpregnancyregistry.org). www.aedpregnancyregistry.org).

Breastfeeding Considerations

It is not known if stiripentol is present in breast milk.

Stiripentol is used in combination with clobazam and valproic acid; refer to individual monographs for additional information.

According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother. Monitor infants exposed to antiseizure medications via breast milk for sedation, signs of poor sucking, proper weight gain, abnormal platelet counts, abnormal liver function, and achievement of developmental milestones (Shawahna 2022; Tomson 2022).

Dietary Considerations

Some products may contain phenylalanine; use with caution in patient with phenylketonuria.

Monitoring Parameters

CBC (prior to initiation and every 6 months or as clinically indicated thereafter); weight; growth rate in children.

Mechanism of Action

Precise mechanism behind antiseizure effects is unknown. May enhance GABAergic inhibitory neurotransmission by weak partial agonism and/or positive allosteric modulation of gamma-aminobutyric acid (GABA)-A receptors (Fisher 2009). Also inhibits multiple cytochrome P450 isoenzymes involved in the metabolism of other antiseizure medications; concurrent use may increase their systemic exposure and efficacy.

Pharmacokinetics (Adult Data Unless Noted)

Absorption: Well absorbed; extensive first-pass metabolism (Walker 1995). Maximum concentration obtained with powder for suspension is slightly higher than that observed with capsules (Diacomit Canadian product monograph).

Protein binding: ~99% to plasma proteins

Metabolism: Hepatic through demethylenation, primarily by CYP1A2, 2C19, 3A4, and glucuronidation (Moreland 1986)

Bioavailability: 30% (Walker 1995)

Half-life elimination: Adults: 4.5 to 13 hours (dose-dependent)

Time to peak: Median: 2 to 3 hours

Excretion: Urine (73%, primarily metabolites); feces (18% as unchanged drug) (Moreland 1986)

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Pediatric: In a pharmacokinetic study of children (n=35; median age: 7.3 years) with Dravet syndrome, clearance and volume of distribution were related to body weight and elimination half-life increased from 8.5 hours (10 kg) to 23.5 hours (60 kg). Adolescents may require lower dosing than younger children (May 2012).

Molecular weight: 234.3.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AR) Argentina: Diacomit;
  • (AU) Australia: Diacomit;
  • (BE) Belgium: Diacomit;
  • (BG) Bulgaria: Diacomit;
  • (CH) Switzerland: Diacomit;
  • (CZ) Czech Republic: Diacomit;
  • (DE) Germany: Diacomit;
  • (EE) Estonia: Diacomit;
  • (ES) Spain: Diacomit;
  • (FI) Finland: Diacomit;
  • (FR) France: Diacomit;
  • (HU) Hungary: Diacomit;
  • (IE) Ireland: Diacomit;
  • (IT) Italy: Diacomit;
  • (JP) Japan: Diacomit;
  • (KR) Korea, Republic of: Diacomit;
  • (LT) Lithuania: Diacomit;
  • (LV) Latvia: Diacomit;
  • (MY) Malaysia: Diacomit;
  • (NL) Netherlands: Diacomit;
  • (NO) Norway: Diacomit;
  • (NZ) New Zealand: Diacomit;
  • (PL) Poland: Diacomit;
  • (PR) Puerto Rico: Diacomit;
  • (PT) Portugal: Diacomit;
  • (QA) Qatar: Diacomit (Biocodex);
  • (RO) Romania: Diacomit;
  • (RU) Russian Federation: Diacomit;
  • (SE) Sweden: Diacomit;
  • (SI) Slovenia: Diacomit;
  • (SK) Slovakia: Diacomit;
  • (TW) Taiwan: Diacomit;
  • (ZA) South Africa: Diacomit
  1. American College of Obstetricians and Gynecologists (ACOG). Gynecologic management of adolescents and young women with seizure disorders: ACOG committee opinion, number 806. Obstet Gynecol. 2020;135(5):e213-e220. doi:10.1097/AOG.0000000000003827 [PubMed 32332416]
  2. Brigo F, Igwe SC, Bragazzi NL. Antiepileptic drugs for the treatment of infants with severe myoclonic epilepsy. Cochrane Database Syst Rev. 2017;5(5):CD010483. doi:10.1002/14651858.CD010483.pub4 [PubMed 28521067]
  3. Chiron C, Marchand MC, Tran A, et al. Stiripentol in severe myoclonic epilepsy in infancy: a randomised placebo-controlled syndrome-dedicated trial. STICLO study group. Lancet. 2000;356(9242):1638-1642. doi: 10.1016/s0140-6736(00)03157-3 [PubMed 11089822]
  4. De Liso P, Chemaly N, Laschet J, et al. Patients with dravet syndrome in the era of stiripentol: A French cohort cross-sectional study. Epilepsy Res. 2016;125:42-46. [PubMed 27389706]
  5. Diacomit (Stiripentol) [European Medicines Agency summary of product characteristics]. Beauvais, France: Biocondex; July 2022. https://www.ema.europa.eu/en/documents/product-information/diacomit-epar-product-information_en.pdf. Accessed July 19, 2022
  6. Diacomit (stiripentol) [prescribing information]. Beauvais, France; Biocodex; June 2024.
  7. Diacomit (stiripentol) [prescribing information]. Beauvais, France; European Medicines Agency Biocodex; July 2022.
  8. Diacomit (stiripentol) [product monograph]. Dundas, Ontario, Canada; C.R.I.; December 2012.
  9. Diacomit (stiripentol) [product monograph]. Newmarket, Ontario, Canada; Biocodex Canada Inc; July 2021.
  10. Fisher JL. The anti-convulsant stiripentol acts directly on the GABA(A) receptor as a positive allosteric modulator [published online ahead of print June 10, 2008]. Neuropharmacology. 2009;56(1):190-197. [PubMed 18585399]
  11. Hodson L, Ovesen J, Couch J, et al; US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Managing hazardous drug exposures: information for healthcare settings, 2023. https://doi.org/10.26616/NIOSHPUB2023130. Updated April 2023. Accessed December 27, 2024.
  12. Inoue Y, Ohtsuka Y, Oguni H, et al. Stiripentol open study in Japanese patients with Dravet syndrome. Epilepsia. 2009;50(11):2362-2368. [PubMed 19552653]
  13. May TW, Boor R, Mayer T, et al. Concentrations of stiripentol in children and adults with epilepsy: the influence of dose, age, and comedication. Ther Drug Monit. 2012;34(4):390-397. [PubMed 22743350]
  14. Moreland TA, Astoin J, Lepage F, Tombret F, Levy RH, Baillie TA. The metabolic fate of stiripentol in man. Drug Metab Dispos. 1986;14(6):654-662. [PubMed 2877822]
  15. National Institute for Health and Care Excellence (NICE). Epilepsies in children, young people and adults. https://www.nice.org.uk/guidance/ng217. Published April 27, 2022. Accessed June 19, 2024.
  16. Ovesen JL, Sammons D, Connor TH, et al; US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. NIOSH list of hazardous drugs in healthcare settings, 2024. https://doi.org/10.26616/NIOSHPUB2025103. Updated December 18, 2024. Accessed December 20, 2024.
  17. Pack AM, Oskoui M, Williams Roberson S, et al. Teratogenesis, perinatal, and neurodevelopmental outcomes after in utero exposure to antiseizure medication: practice guideline from the AAN, AES, and SMFM. Neurology. 2024;102(11):e209279. doi:10.1212/WNL.0000000000209279 [PubMed 38748979]
  18. Refer to maufacturer's labeling.
  19. Shawahna R, Zaid L. Concentrations of antiseizure medications in breast milk of lactating women with epilepsy: a systematic review with qualitative synthesis. Seizure. 2022;98:57-70. doi:10.1016/j.seizure.2022.03.017 [PubMed 35427849]
  20. Tomson T, Battino D, Bromley R, et al. Breastfeeding while on treatment with antiseizure medications: a systematic review from the ILAE Women Task Force. Breastfeeding while on treatment with antiseizure medications: a systematic review from the ILAE Women Task Force. Epileptic Disord. 2022;24(6):1020-1032. doi:10.1684/epd.2022.1492 [PubMed 36193017]
  21. United States Pharmacopeia. <800> Hazardous Drugs—Handling in Healthcare Settings. In: USP-NF. United States Pharmacopeia; July 1, 2020. Accessed January 16, 2025. doi:10.31003/USPNF_M7808_07_01
  22. Walker MC, Patsalos PN. Clinical pharmacokinetics of new antiepileptic drugs. Pharmacol Ther. 1995;67(3):351-384. [PubMed 8577822]
  23. Wirrell EC. Treatment of Dravet Syndrome. Canadian Journal of Neurological Sciences. 2016;43(Suppl 3):S13-S18. doi:10.1017/cjn.2016.249 [PubMed 27264138]
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