Epitomax, indications for treatment

Antiepileptic drug of the group of sulfate-substituted monosaccharides. Epitomax reduces the frequency of action potentials characteristic of the neuron in the state of persistent depolarization, indicating that the blocking action of Epitomax on sodium channels depends on the state of the neuron. Epitomax potentiates GABA activity against several GABA receptor subtypes (including GABA receptors) and modulates the activity of GABA receptors themselves, prevents kainate activation of kainate/AMPK receptor sensitivity to glutamate and does not affect N-methyl-D-aspartate activity against NMDA receptors.

Indications for use of Epitomax

Epitomax, indications for treatment

Partial or generalized tonic-clonic seizures in adults and children (as monotherapy or in combination with other anticonvulsants); seizures associated with Lennox-Gasto syndrome in adults and children (as adjunctive therapy).

Side effects

Ataxia, concentration disorder, confusion, dizziness, fatigue, paresthesia, somnolence, thought disorder, rarely – agitation, amnesia, anorexia, aphasia, depression, emotional lability, speech disorders, diplopia, nystagmus, visual impairment, perversion of taste; in isolated cases – increased liver function tests, hepatitis, liver failure (when concomitantly used with other drugs), rarely – nausea, nephrolithiasis, weight loss.


Epitomax, indications for treatment

Increased manifestation of side effects is possible.
Treatment: gastric lavage; symptomatic therapy if necessary. The use of activated charcoal is not shown, since it has been experimentally established that activated charcoal does not adsorb Epitomax. An effective way of eliminating Epitomax from the body is hemodialysis.

Withdrawal of the drug

Antiepileptic drugs, including Epitomax, should be withdrawn gradually to minimize the possibility of increased seizure frequency, reducing the dose by 50-100 mg at 1 week intervals when treating epilepsy and by 25-50 mg when using Epitomax to prevent migraine. In children, withdrawal within 2 to 8 weeks. If rapid withdrawal of Epitomax is medically necessary, appropriate monitoring of the patient’s condition is recommended. The main route of excretion of Epitomax and its metabolites in unchanged form is excretion by the kidneys. The rate of renal excretion depends on renal function and is independent of age. In patients with moderate or severe renal impairment, it may take 10-15 days to reach equilibrium plasma concentrations compared to 4-8 days in patients with normal renal function.

As with other antiepileptic drugs, the dosage regimen of Epitomax should be guided by therapeutic efficacy (i.e. the degree of seizure frequency reduction, absence of side effects) and should take into account that in patients with impaired renal function a longer time may be required for each dose to establish equilibrium concentrations of Epitomax in blood plasma.