Rufinamide: a new anti-epileptic medication

Abstract

Rufinamide (1-[2,6-difluorobenzyl]-1H-1,2,3-triazole-4-carboxamide) is a new anti-epileptic drug with a novel triazole derivative structure. The suspected mechanism of action is limitation of sodium-dependent action potentials, thought to result in a membrane stabilizing effect. Rufinamide is extensively metabolized in the liver by non-CYP450 enzymes with an elimination half-life of 8 – 12 h. Three randomized, placebo-controlled trials have shown that rufinamide is effective against partial seizures in adults. Efficacy in the Lennox-Gastaut syndrome, a severe, disabling childhood onset epilepsy syndrome, was shown in a single, randomized, placebo-controlled trial. It has recently been approved for treatment of Lennox-Gastaut syndrome in Europe. In the US it is under regulatory review. Most common adverse effects are somnolence, fatigue, dizziness, dipolopia, nausea and ataxia. Rufinamide has shown promise as adjunctive treatment for Lennox-Gastaut syndrome and may have some role in localization related epilepsies as well.

Keywords::

• anti-epileptic drugs
• epilepsy
• Lennox-Gastaut syndrome
• localization related epilepsy
• rufinamide
• seizures

Disclosures

S Hakimian, A Cheng-Hakimian and JW Miller are participating in rufinamide clinical trials sponsored by Eisai Pharmaceuticals. GD Anderson has no conflict of interest to disclose. This article was independently commissioned and no fee was received for preparation of the manuscript.