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Felbamate, a medication used for treating severe seizures that cannot be managed with other drugs, carries significant risks that demand careful consideration. Before starting felbamate, it is crucial to discuss the potential benefits and risks with your healthcare provider. Below are important safety warnings and precautions:

• Blood and Bone Marrow Issues: Felbamate may cause severe, potentially life-threatening blood disorders, including aplastic anemia, which leads to dangerously low blood cell counts. This condition can increase your risk of infections and bleeding. Regular blood tests are necessary to monitor your blood cell levels. Contact your doctor immediately if you experience symptoms such as persistent sore throat, fever, chills, unusual fatigue, easy bruising or bleeding, or red/purple spots on your skin. Those with a history of low blood cell counts should not use this medication.

• Liver Damage: There is a risk of severe liver problems, including liver failure, which may require a liver transplant. Do not use felbamate if you have a history of liver issues. Routine blood tests will be conducted to monitor liver function. Notify your healthcare provider immediately if you experience symptoms such as right-sided abdominal pain, decreased appetite, dark urine, persistent nausea or vomiting, or yellowing of the skin or eyes. If liver problems occur, discontinuation of the medication will likely be necessary.

• Suicidal Thoughts or Behavior: Antiepileptic drugs, including felbamate, may increase the risk of suicidal thoughts or behavior. Monitor for any new or worsening depression or unusual mood changes, especially during the initial months of treatment or when adjusting the dose. Report any concerning changes to your healthcare provider. Seek immediate medical attention if you have thoughts of self-harm.

• Drug Interactions: Felbamate can interact with other antiepileptic medications, potentially increasing their levels and side effects or decreasing the effectiveness of felbamate. Inform your healthcare provider of all medications you are taking to adjust doses safely and avoid harmful interactions.

In case of an overdose, seek emergency medical attention promptly. Ensure you maintain all medical and laboratory appointments to monitor your health while on felbamate. Always consult your healthcare provider for personalized advice and instructions.

Common side effects:

• headache
• nausea
• drowsiness
• dizziness
• tiredness
• low appetite
• difficulty sleeping
• vomiting
• indigestion
• constipation

Less common but important to monitor:

• diarrhea
• stomach pain
• uncontrollable shaking
• difficulty with movement and coordination
• changes in vision
• changes in taste
• feelings of nervousness
• anxiety

Serious side effects:

• low blood cell counts
• liver injury
• depression
• thoughts of harming yourself
• very serious allergic reaction

Felbamate (Felbatol) can interact with various medications and potentially affect their effectiveness or increase the risk of side effects. Always inform your doctor or pharmacist about all medications, including prescription, over-the-counter drugs, and supplements you are taking.

Notably, Felbamate may interact with Clopidogrel and Orlistat. Additionally, this medication can reduce the effectiveness of hormonal birth control methods like pills, patches, or rings, which could lead to an unintended pregnancy. It is advisable to consult your healthcare provider about using additional or alternative birth control methods. Report any unusual spotting or breakthrough bleeding to your doctor, as it might indicate that your birth control is not functioning effectively.

Also, Felbamate may enhance the sedative effects of certain substances. Be cautious if consuming alcohol, marijuana, antihistamines (such as Cetirizine, diphenhydramine), sleep or anxiety medications (such as Alprazolam, Diazepam, Zolpidem), muscle relaxants (such as Carisoprodol, Cyclobenzaprine), or opioid pain relievers (such as codeine, Hydrocodone). These interactions can increase drowsiness, so check medication labels for ingredients that may cause sleepiness and consult your pharmacist for safe usage instructions.

Certain drugs are not recommended to be used with Felbamate, including Bepridil, Cisapride, Dronedarone, Mesoridazine, Pimozide, Piperaquine, Saquinavir, Sparfloxacin, Terfenadine, Thioridazine, and Ziprasidone. In some situations, Felbamate may still be used with other medications like Amiodarone, Chloroquine, Clopidogrel, Orlistat, and many others, but this requires careful adjustment of dosages or monitoring by your doctor.

Lastly, combining Felbamate with certain medications such as Carbamazepine, Clobazam, Fosphenytoin, Phenytoin, Valproic Acid, or Warfarin might increase side effects, but may be necessary for your treatment. Your doctor will adjust your treatment plan accordingly to ensure safety and efficacy.