Table 3.

Rufinamide clinical use summary.

FDA indication:

Adjunctive treatment of seizures associated with Lennox–Gastaut syndrome in patients 4 years old and older

Clinical effectiveness:

Broad-spectrum, but especially efficacious for tonic–atonic seizures associated with Lennox–Gastaut syndrome

Contraindications:

Familial Short QT syndrome

Most common side effects*:

Fatigue

Nausea and vomiting

Decreased appetite

Availability within the United States:

200 mg tabs

400 mg tabs

40 mg/ml liquid suspension

Recommended dosing:

Package insert:

Initial: 10 mg/kg/day in two divided doses, with meals

Increase by 10 mg/kg increments every other day

Maintenance: 45 mg/kg/day up to 3600 mg/day in two divided doses, with meals

Clinical practice recommendation:

Initial: 5–10 mg/kg/day in two divided doses, with meals

Increase by 5–10 mg/kg increments every 5–7 days

Maintenance: 45–50 mg/kg/day, with meals, adjusted as tolerated

^*Somnolence and vomiting were the only adverse effects more commonly reported with rufinamide treatment with a significant treatment difference versus placebo [Glauser et al. 2008].