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Anti-epileptic

Cenobamate

Brand names: Ontozry

Cenobamate is an antiseizure medication used as adjunctive therapy for focal (partial-onset) seizures in adults with epilepsy that is inadequately controlled by other treatments.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is thought to reduce neuronal excitability through inhibition of persistent sodium currents and positive allosteric modulation of GABA-A receptors at a non-benzodiazepine site.

Prescribing in practice

  • Titrate slowly from a low starting dose because rapid titration is associated with drug reaction with eosinophilia and systemic symptoms (DRESS).
  • It induces and inhibits various cytochrome P450 enzymes, so review interacting drugs including other antiseizure medicines and hormonal contraception.
  • QT shortening can occur; use caution in those with familial short QT syndrome.

Monitoring

Monitor for hypersensitivity and DRESS during titration, alongside seizure control, sedation and interaction-related effects on co-prescribed medicines.

Counselling the patient

  • Follow the slow dose increase schedule exactly and do not accelerate it.
  • Seek urgent advice if you develop rash, fever, facial swelling or swollen glands.
  • Use additional or non-hormonal contraception, as this medicine can reduce the effectiveness of the contraceptive pill.

Evidence & guidelines

Cenobamate is recommended by NICE as an adjunctive option for focal seizures, supported by randomised placebo-controlled adjunctive trials.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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