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RUFINAMIDE

rufinamide
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Dr. C P Ravi Kumar

Dr. C. P. Ravi Kumar Lead & Senior Consultant – Paediatric Neurology, The Krishna Institute of Medical Sciences (KIMS), Mahadevapura, Bangalore

What is Rufinamide?

Rufinamide is an anti-Seizure medication. It belongs to a class of drugs known as triazole derivatives. It is primarily used to treat seizures associated with Lennox-Gastaut Syndrome (LGS), a severe form of epilepsy that typically begins in childhood. It is not widely available in India.

What is Rufinamide used for?

  • Lennox-Gastaut syndrome.

How is Rufinamide available?

  • Tablet
  • Oral suspension.

How does Rufinamide act (mechanism of action)?

Rufinamide helps control seizures by prolonging the inactive state of voltage-gated sodium channels in brain cells which stabilizes brain cell activity and prevents rapid, repetitive firing that triggers seizures.

How much time does Rufinamide take to act?

Rufinamide starts working within 4-6 hours after taking it, but it may take several days or weeks to see its full effect in reducing seizures.

What is the ideal time to take Rufinamide?

Take the medicine two times a day — once in the morning and once in the evening — about 10–12 hours apart. For example, if you take it around 7–8 AM, take the next dose around 7–8 PM. You can adjust the timings to suit your daily schedule, but try to take it at the same times every day so you don’t miss a dose.

When should Rufinamide be taken?

Rufinamide should be taken after food to help your body absorb it better. Your doctor will tell you how many times a day to take it, usually once or twice daily, based on your condition.

How should I give the medicine?

Tablets: You must swallow an entire tablet with a glass of milk, juice, or water. It can be given by crushing it and combining it with juice, water, or a little portion of yoghurt or curd.
Liquid or syrup: Measure the right amount with a medical spoon or an oral syringe. These are readily available at any local pharmacy. A kitchen teaspoon will not provide the precise amount of the medication, so avoid using it.

Does this medication carry any side effects on my child?

Every medicine can help you, but it can also have possible side effects. Most people don’t face any problems, but it’s good to know what to look out for. This helps us act quickly if something goes wrong, while still getting the benefits of the treatment.
In rare cases, some people may develop serious side effects. If you notice any warning signs, contact your doctor or get medical help right away.

SIDE EFFECTS:

  • Heart-related: Changes in ECG.
  • Stomach: Nausea, vomiting, Constipation, Loss of appetite.
  • Nervous system: Drowsiness (Somnolence), Fatigue, Headache, Dizziness
  • Urinary system: Frequent urination.
  • Muscle and bone: Back pain.
  • Vision: Blurred vision, double vision, rapid eye movement.
  • Respiratory: Bronchitis, Cold symptoms, Sinus infection

Rare Side Effects-

  • Blood: low white blood cell count.
  • Allergic reactions: Severe reactions involving fever, rash, swollen organs and Stevens-Johnson syndrome. SEEK IMMEDIATE MEDICAL ADVICE from your DOCTOR.

Does Rufinamide cause weight gain?

Rufinamide does not typically cause weight gain. In some cases, it may even reduce appetite, especially in children and adolescents. If you notice any changes in weight, talk to your doctor.

Can other common medicines be taken during the course of Rufinamide?

Yes, some common medicines such as ibuprofen, paracetamol, antibiotics, or other over-the-counter drugs can generally be taken alongside Rufinamide, as long as they are not contraindicated by your doctor, but it is important to be cautious about potential interactions. Rufinamide can interact with other drugs such as other anti-Seizure medicines, CYP Enzyme Inducers (e.g; Carbamazepine, Phenytoin, Phenobarbital other Sedatives or CNS Depressants, Antacids which may affect how well it works or increase the risk of side effects.

What foods to avoid while taking Rufinamide?

There are no specific foods that need to be completely avoided while taking Rufinamide. However, while taking Rufinamide, it is best to avoid:
  • High-fat meals: They may affect how the drug is processed, potentially increasing side effects.
  • Grapefruit and grapefruit juice: May interfere with drug metabolism.
  • Alcohol: Can increase side effects like drowsiness and dizziness.
Always consult your healthcare provider for personalized advice.

PREGNANCY AND LACTATION:

Pregnancy & Breastfeeding:

There are not enough studies to suggest it’s use; animal models have suggested harm to fetus. In humans, its used only if there are no other options. Hence caution is advised and act after due discussion with your clinician.

Is there any risk if I conceive while taking Rufinamide?

If you conceive while taking Rufinamide, it’s important to consult your healthcare provider. They can assess your specific situation and guide you on the best course of action.

Can I stop taking Rufinamide (withdrawal)?

You should not stop taking Rufinamide suddenly without your doctor’s guidance, as it can lead to withdrawal symptoms or worsen seizures. Consult your healthcare provider to create a safe tapering plan if you wish to discontinue the medication.

Monitoring parameters of Rufinamide:

  • Suicidal thoughts
  • Rashes
  • Seizure (frequency and durations)
  • Serum levels if concurrent anticonvulsants

Let your doctor know about any changes or problems while taking Rufinamide.

How to cope with side effects of Rufinamide?

Dizziness or Drowsiness:

  • Avoid driving or using heavy machinery until you know how the medicine affects you.
  • Lie down or sit to relax.

Nausea or Vomiting:

  • Take Rufinamide with food to reduce stomach upset.
  • Eat small, light meals and avoid spicy or greasy foods.

Fatigue:

  • Get plenty of rest and take breaks during the day if needed.
  • Talk to your doctor if it gets worse or doesn’t improve.

Headache:

  • Stay hydrated and rest in a quiet, dark room.
  • You can take a mild pain reliever if approved by your doctor.

Skin Rash or Itching:

  • Use a gentle moisturizer to soothe your skin.
  • Contact your doctor if the rash worsens or spreads.

Blurred Vision or Double Vision:

  • Avoid activities requiring clear vision until it improves.
  • Let your doctor know if it continues or gets worse.

If side effects are severe or don’t go away, tell your doctor. They may adjust your dose or recommend other treatments.

SUMMARY:

Rufinamide is an anticonvulsant medication used to treat seizures, particularly in conditions like Lennox-Gastaut syndrome. It acts by bringing the brain’s electrical activity under control. Usually, it is administered orally as a liquid or pill. Common side effects may include dizziness, tiredness, or irritability. As with any medication, it should be taken as prescribed, and any changes in dosage or discontinuation should be done under a doctor’s supervision.

Let us know if this information was useful!

REFERENCE:

1. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/201367Orig1s011lbl.pdf
2. Besag FM. Rufinamide for the treatment of Lennox-Gastaut syndrome. Expert Opin Pharmacother. 2011 Apr;12(5):801-6. doi: 10.1517/14656566.2011.560836. Epub 2011 Feb 24. PMID: 21348771.
3. Besag FM. Rufinamide for the treatment of Lennox-Gastaut syndrome. Expert Opin Pharmacother. 2011 Apr;12(5):801-6. doi: 10.1517/14656566.2011.560836. Epub 2011 Feb 24. PMID: 21348771.
Author:
  1. Dr. Likitha B S, Pharm. D, Clinical Pharmacologist, Aster Hospitals, Bengaluru
  2. Dr Praveen Kumar, B. Pharm, Pharm D(PB), Lead Clinical Pharmacologist, REGIONAL HEAD KIMS Hospitals, Bengaluru
  3. Dr. C. P. Ravi Kumar Lead & Senior Consultant – Paediatric Neurology KIMS HOSPITALS BENGALURU
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