Xcopri vs. Cerebyx for Epilepsy: Important Differences and Potential Risks.

Key takeaways

Cenobamate (Xcopri) and fosphenytoin (Cerebyx) are both antiepileptic medications used to treat seizures, but they differ in several ways. Cenobamate is specifically approved for treating partial-onset seizures in adults and is taken orally once a day. In contrast, fosphenytoin is an injectable medication used to treat and prevent seizures in both children and adults, including during neurosurgery and for tonic-clonic status epilepticus. Cenobamate is a Schedule V controlled substance, meaning it has some potential for misuse, while fosphenytoin is not a controlled medication. Cenobamate can cause side effects like sleepiness, dizziness, and fatigue, and it may interact with birth control pills. Fosphenytoin can cause side effects such as itching, dizziness, and muscle control problems. It also carries a risk of serious heart problems and allergic reactions. Cenobamate is only available as a brand-name medication, whereas fosphenytoin also comes in a generic form.

Xcopri

(cenobamate)

Get free coupons

Fosphenytoin

(Cerebyx)

Get free coupons

Summary for Xcopri

Prescription only

Xcopri (cenobamate) is an antiepileptic (antiseizure) medication that treats partial-onset seizures in adults. The tablets are taken by mouth once daily. This medication can cause side effects, like sleepiness, dizziness, and fatigue. You'll start at a low dose and then your dose will be raised slowly over several weeks to the recommended dosage to help with side effects. Xcopri (cenobamate) is a controlled substance, so there can be restrictions on how many refills your prescription can have.

Indications for Xcopri

Partial-onset (focal) seizures in adults

Pros and Cons for Xcopri

Pros

Many tablet strengths available, so your prescriber can adjust your dose based on your individual needs
Only taken once a day
Can cut the number of seizures you have per month by half (when taking the maintenance dose)
Can take by itself or together with other seizure medications

Cons

Can take several weeks to reach the maintenance dose and see the full effects of the medication
Can make you sleepy, tired, and dizzy
Not approved for use in children
No lower-cost generic available; only as a brand-name medication

Common Side Effects for Xcopri

Sleepiness (22%)
Dizziness (22%)
Feeling low energy (14%)
Headache (12%)

Warnings for Xcopri

Serious skin reaction
Heart rhythm problems
Suicidal thoughts or behavior
Side effects related to the nervous system (e.g., drowsiness, fatigue, difficulty controlling movements)
Worsening of seizures if you stop the medication suddenly

Summary for Cerebyx

Prescription only

Fosphenytoin (Cerebyx) is an injectable medication used to treat and prevent seizures in both children and adults. This medication has many risks and possible side effects, including uncontrolled eye movements, dizziness, and trouble moving your muscles. Fosphenytoin (Cerebyx) is typically given by a healthcare provider.