Ezogabine

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Ezogabine, which is known as retigabine in Europe, is a unique anticonvulsant used largely as an adjunctive agent in the treatment of partial seizures. 

Liver safety of Ezogabine

Therapy with ezogabine has not been associated with serum aminotransferase elevations, and clinically apparent liver injury from ezogabine has yet to be reported and must be rare, if it occurs at all. 

Mechanism of action of Ezogabine

Ezogabine (e zog' a been) is an anticonvulsant with a unique mechanism of action, decreasing excitability and seizure activity by opening voltage-gated potassium channels in the brain.  Ezogabine has been shown to be effective both as monotherapy and in combination with other anticonvulsants for partial seizures. 

FDA approval information for Ezogabine

Ezogabine was approved for use in the United States in 2011 and current indications are as adjunctive therapy for partial seizures. 

Dosage and administration for Ezogabine

Ezogabine is available in tablets of 50, 200, 300 and 400 mg under the brand name Potiga in the United States and Trobalt in Europe and elsewhere.  The recommended initial dose in adults is 100 mg three times daily, which can be increased to 200 to 400 mg three times daily.  The dose should be increased and tapered gradually. 

Side effects of Ezogabine

The most common side effects are dose related and include dizziness, somnolence, impaired concentration, nervousness, headache, fatigue nausea, weakness and tremor.  Long term therapy has been associated with urinary retention and blue discoloration of the skin, lips, sclera and retina.  Rare, but potentially severe adverse events include psychiatric symptoms such as confusion and hallucination and decrease in visual acuity as a result of retinal pigmentation. Anticonvulsants

Generic Name / Brand Name Liver Toxicity Score Approval Year Major Indications
Brivaracetam / Briviact E 2016 Partial seizures
Carbamazepine / Tegretol A 1968 Partial, mixed and generalized seizures, trigeminal neuralgia
Clobazam / Onfi E 2011 Seizures assocated with Lennox-Gastaut syndrome
Clonazepam / Klonopin D 1975 Absence and myoclonic seizures, anxiety and panic disorders
Clorazepate / Tranxene E 1972 Partial seizures, anxiety disorders, and alcohol withdrawal
Diazepam / Valium E 1963 Convulsions, anxiety disorders, muscle spasms
Eslicarbazepine / Aptiom D 2013 Partial seizures
Ethosuximide / Zarontin E 1960 Absence seizures
Ezogabine / Potiga E 2011 Partial seizures
Felbamate / Febatol B 1993 Refractory or severe epilepsy
Fosphenytoin / Cerebyx A 1996 Tonic-clonic seizures, status epilepticus
Gabapentin / Neurontin C 1993 Partial seizures, post-herpetic neuralgia
Lacosamide / Vimpat D 2008 Partial seizures
Lamotrigine / Lamictal B 1994 Partial and generalized tonic-clonic seizures, bipolar disorder
Levetiracetam / Keppra C 1999 Partial, generalized tonic-clonic, and myoclonic seizures
Methsuximide / Celontin E 1957 Absence seizures
Oxcarbazepine / Trileptal D 2000 Partial seziures
Perampanel / Fycompa E 2012 Partial and generalized tonic-clonic seizures
Phenobarbital / Luminal A 1916 Partial and generalized seizures, anxiety, and irritable bowel syndrome
Phenytoin / Dilantin A 1938 Generalized tonic-clonic and partial onset seizures, status epilepticus
Pregabalin / Lyrica C 2004 Partial seizures, fibromyalgia, and neuropathic pain
Primidone / Mysoline E 1954 Partial and generalized tonic-clonic seizures
Rufinamide / Banzel E 2008 Seizures associated with Lennox-Gastaut syndrome
Tiagabine / Gabitril E 1997 Partial seizures
Topiramate / Topamax C 1996 Partial and generalized tonic-clonic seizures, migraine headaches
Valproate / Depakene A 1978 Absence and complex partial seizures
Vigabatrin / Sabril D 2009 Refractory, complex partial seizures, and infantile spasms
Zonisamide / Zonegran D 2000 Partial seizures

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