An add-on epilepsy medicine for Lennox-Gastaut syndrome
Rufinamide
An add-on epilepsy medicine used to help control seizures in Lennox-Gastaut syndrome.
What is Rufinamide?
Rufinamide is a specialist epilepsy medicine used as an add-on treatment to help control seizures in Lennox-Gastaut syndrome, a severe form of epilepsy that usually begins in childhood. It is added to other epilepsy medicines rather than used on its own, and it is taken by mouth with food. It must be taken with food because food helps the body absorb it. Important safety points include a rare but serious whole-body allergic reaction (called DRESS or a hypersensitivity reaction), and an effect on the heart's rhythm (it shortens the QT interval), so it is avoided in people with the inherited condition familial short QT syndrome. As with all epilepsy medicines, it should not be stopped suddenly.
Education and reference only. This is a plain-language guide to Rufinamide — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Rufinamide is a medicine used to help control seizures in Lennox-Gastaut syndrome, a severe epilepsy that usually starts in childhood and causes several different seizure types that are often hard to control. It is used as an add-on (adjunctive) treatment, meaning it is taken together with other epilepsy medicines rather than alone. It is taken by mouth as a tablet or liquid, with food, and is prescribed and supervised by a specialist epilepsy team. The dose is built up gradually, and it should never be stopped suddenly.
How it works
Seizures happen when nerve cells in the brain fire in an uncontrolled, excessive way. Rufinamide is thought to calm this overactivity by acting on sodium channels in nerve cells, helping to stabilise them so they are less likely to fire repeatedly. By dampening down this excessive electrical activity, it helps reduce how often and how severely seizures happen in Lennox-Gastaut syndrome. It is taken with food because food helps the body absorb it properly, and it is added to other treatments to build on the seizure control they provide.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist epilepsy medicine used in the UK as an add-on treatment for seizures in Lennox-Gastaut syndrome, a severe childhood epilepsy.
What it treats
Conditions Rufinamide is used for
Practical use
How to take Rufinamide
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth with food, as food helps the body absorb it; do not take it on an empty stomach.
- Take it twice a day as prescribed, building the dose up slowly as your specialist team directs.
- Keep taking your other epilepsy medicines too, as rufinamide is an add-on treatment used alongside them.
- Do not stop it suddenly, as this can trigger seizures; any changes should be made gradually with specialist advice.
- Report any rash, fever or feeling generally unwell straight away, especially in the first weeks of treatment.
Weighing it up
Advantages & disadvantages of Rufinamide
Advantages
- Can help reduce seizures in Lennox-Gastaut syndrome when added to other epilepsy medicines.
- Available as a tablet or a liquid, which helps with dosing in children.
- Taken by mouth at home alongside existing treatment.
Disadvantages
- Must be taken with food and built up slowly, and it is an add-on rather than a standalone treatment.
- Commonly causes drowsiness, dizziness and tiredness, especially at first.
- Can rarely cause a serious whole-body allergic reaction and affects the heart's rhythm (shortening the QT interval).
Practical use
Good to know
A practical but important point is that rufinamide must be taken with food, because food helps the body absorb it; taking it on an empty stomach can mean it does not work as well. It is built up slowly and is an add-on treatment, so it is taken alongside other epilepsy medicines, and like all epilepsy medicines it should never be stopped suddenly, as that can trigger seizures. A rare but serious risk, usually in the first weeks, is a whole-body allergic reaction sometimes called DRESS, with a rash, fever and feeling generally unwell; any rash or fever after starting should be reported urgently. It can also affect the heart's electrical rhythm by shortening what is called the QT interval, so it is avoided in people with the inherited condition familial short QT syndrome. Drowsiness, dizziness and tiredness are common, especially at first.
Who should not take it / use with caution
- People who have had a serious allergic reaction to rufinamide should not take it.
- It is avoided in people with the inherited condition familial short QT syndrome, because it shortens the heart's QT interval.
- It is used with caution in people with significant liver problems, under specialist guidance.
- It is used in pregnancy only when clearly needed and under specialist epilepsy supervision.
Monitoring
- Reviewing how well seizures are controlled and how the dose is tolerated as it is built up.
- Watching for any rash, fever or signs of a serious allergic reaction, especially early on.
- Reviewing other epilepsy medicines and overall treatment with the specialist team.
Side effects
- Drowsiness, dizziness, tiredness and headache, especially when first starting.
- Nausea, vomiting or loss of appetite.
- Changes in the heart's rhythm (a shortened QT interval) and, sometimes, changes in mood or behaviour.
- Rarely but seriously, a whole-body allergic reaction (DRESS) with rash, fever and feeling unwell, which needs urgent medical attention.
Key interactions
- Some other epilepsy medicines can change rufinamide levels, and rufinamide can change theirs, so doses are reviewed by your team.
- It can reduce how well hormonal contraception works, so additional contraception may be advised.
- Medicines that affect the heart's QT interval, or that cause drowsiness, need careful review by your team.
Available as: Tablets and an oral liquid taken by mouth.
Answers
Rufinamide: frequently asked questions
What is rufinamide used for?
It is used as an add-on treatment to help control seizures in Lennox-Gastaut syndrome, a severe form of epilepsy that usually begins in childhood.
Why must I take it with food?
Food helps the body absorb rufinamide properly, so taking it on an empty stomach can mean it does not work as well; it should always be taken with food.
Can it be used on its own?
No. Rufinamide is an add-on treatment, taken alongside other epilepsy medicines rather than by itself.
What serious reaction should I watch for?
Report any rash, fever or feeling generally unwell straight away, especially in the first weeks, as these can be signs of a serious whole-body allergic reaction (DRESS).
Can I stop it if seizures improve?
No. Like all epilepsy medicines, it should not be stopped suddenly, as that can trigger seizures; any changes are made gradually with specialist advice.
Authoritative sources
- BNF
- NICE CKS
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