Xcopri

Overview

cenobamate

carbamate

• CYP2C19 inhibitor, moderate
• CYP2B6 inducer, weak
• CYP3A4 inducer, moderate
• affected by altered fat absorption
• antiepileptic agent
• CNS depression
• shortens QT interval

Contraindicated

• amifampridine
Xcopri (cenobamate)

+

amifampridine

1 interaction

Contraindicated

cenobamate + amifampridine

contraindicated: combo may alter seizure control (antagonistic effects, amifampridine may decr. seizure threshold)

• bupropion
Xcopri (cenobamate)

+

bupropion

1 interaction

Contraindicated

cenobamate + bupropion

contraindicated: combo may decr. bupropion and metabolite levels, efficacy; may alter seizure control (hepatic metab. induced; antagonistic effects, bupropion may decr. seizure threshold)

• dalfampridine
Xcopri (cenobamate)

+

dalfampridine

1 interaction

Contraindicated

cenobamate + dalfampridine

contraindicated: combo may alter seizure control (antagonistic effects, dalfampridine may decr. seizure threshold)

• lonafarnib
Xcopri (cenobamate)

+

lonafarnib

1 interaction

Contraindicated

cenobamate + lonafarnib

contraindicated: combo may decr. lonafarnib levels, efficacy (hepatic metab. induced)

• mavacamten
Xcopri (cenobamate)

+

mavacamten

1 interaction

Contraindicated

cenobamate + mavacamten

contraindicated: combo may incr. or decr. mavacamten levels, incr. risk of heart failure, other adverse effects or decr. efficacy (hepatic metab. altered)

• ranolazine
Xcopri (cenobamate)

+

ranolazine

1 interaction

Contraindicated

cenobamate + ranolazine

contraindicated: combo may decr. ranolazine levels, efficacy (hepatic metab. induced)

Avoid/Use Alternative

• abemaciclib
Xcopri (cenobamate)

+

abemaciclib

1 interaction

Avoid/Use Alternative

cenobamate + abemaciclib

avoid combo: combo may decr. abemaciclib levels, efficacy (hepatic metab. induced)

• abrocitinib
Xcopri (cenobamate)

+

abrocitinib

1 interaction

Avoid/Use Alternative

cenobamate + abrocitinib

avoid combo if also combined w/ moderate or strong CYP2C9 inhibitor; otherwise, caution advised: combo may incr. abrocitinib and active metabolite levels, risk of serious infection, other adverse effects (hepatic metab. inhibited)

• alfentanil
Xcopri (cenobamate)

+

alfentanil

1 interaction

Avoid/Use Alternative

cenobamate + alfentanil

use alternative or monitor BP, resp. rate; decr. dose of one or both drugs: combo may decr. alfentanil levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, alfentanil may decr. seizure threshold)

• alpelisib
Xcopri (cenobamate)

+

alpelisib

1 interaction

Avoid/Use Alternative

cenobamate + alpelisib

consider alternative: combo may decr. alpelisib levels, efficacy (hepatic metab. induced)

• aprepitant
Xcopri (cenobamate)

+

aprepitant

1 interaction

Avoid/Use Alternative

cenobamate + aprepitant

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• artemether/lumefantrine
Xcopri (cenobamate)

+

artemether/ lumefantrine

1 interaction

Avoid/Use Alternative

cenobamate + artemether/ lumefantrine

avoid combo: combo may decr. artemether/lumefantrine levels, efficacy (hepatic metab. induced)

• atazanavir
Xcopri (cenobamate)

+

atazanavir

1 interaction

Avoid/Use Alternative

cenobamate + atazanavir

avoid combo: combo may decr. atazanavir levels, efficacy (hepatic metab. induced)

• atogepant
Xcopri (cenobamate)

+

atogepant

1 interaction

Avoid/Use Alternative

cenobamate + atogepant

CHRONIC MIGRAINE: avoid combo; EPISODIC MIGRAINE: incr. atogepant dose to 30 mg/day or 60 mg/day: combo may decr. atogepant levels, efficacy (hepatic metab. induced)

• atrasentan
Xcopri (cenobamate)

+

atrasentan

1 interaction

Avoid/Use Alternative

cenobamate + atrasentan

avoid combo: combo may decr. atrasentan levels, efficacy (hepatic metab. induced)

• avacopan
Xcopri (cenobamate)

+

avacopan

1 interaction

Avoid/Use Alternative

cenobamate + avacopan

avoid combo: combo may decr. avacopan levels, efficacy (hepatic metab. induced)

• avapritinib
Xcopri (cenobamate)

+

avapritinib

1 interaction

Avoid/Use Alternative

cenobamate + avapritinib

avoid combo: combo may decr. avapritinib levels, efficacy (hepatic metab. induced)

• axitinib
Xcopri (cenobamate)

+

axitinib

1 interaction

Avoid/Use Alternative

cenobamate + axitinib

avoid combo: combo may decr. axitinib levels, efficacy (hepatic metab. induced)

• bedaquiline
Xcopri (cenobamate)

+

bedaquiline

1 interaction

Avoid/Use Alternative

cenobamate + bedaquiline

avoid combo: combo may decr. bedaquiline levels, efficacy (hepatic metab. induced)

• bictegravir
Xcopri (cenobamate)

+

bictegravir

1 interaction

Avoid/Use Alternative

cenobamate + bictegravir

use alternative if also combined w/ UGT1A1 inducer: combo may decr. bictegravir levels, efficacy (hepatic metab. induced)

• bosutinib
Xcopri (cenobamate)

+

bosutinib

1 interaction

Avoid/Use Alternative

cenobamate + bosutinib

avoid combo: combo may decr. bosutinib levels, efficacy (hepatic metab. induced)

• brigatinib
Xcopri (cenobamate)

+

brigatinib

1 interaction

Avoid/Use Alternative

cenobamate + brigatinib

use alternative or incr. brigatinib daily dose after 7 days of concomitant tx; incr. by 30 mg increments q7 days as tolerated up to 2x maintenance dose: combo may decr. brigatinib levels, efficacy (hepatic metab. induced)

• buprenorphine
Xcopri (cenobamate)

+

buprenorphine

1 interaction

Avoid/Use Alternative

cenobamate + buprenorphine

use alternative or monitor withdrawal sx, resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may decr. buprenorphine levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, buprenorphine may decr. seizure threshold)

• buspirone
Xcopri (cenobamate)

+

buspirone

1 interaction

Avoid/Use Alternative

cenobamate + buspirone

consider alternative or adjust buspirone dose: combo may decr. buspirone levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• butalbital
Xcopri (cenobamate)

+

butalbital

1 interaction

Avoid/Use Alternative

cenobamate + butalbital

avoid combo: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• cabozantinib
Xcopri (cenobamate)

+

cabozantinib

1 interaction

Avoid/Use Alternative

cenobamate + cabozantinib

use alternative or incr. cabozantinib daily dose by 20 mg if renal cell CA, hepatocellular CA, differentiated thyroid CA, or NET use; consider cabozantinib dose adjustment if medullary thyroid CA use: combo may decr. cabozantinib levels, efficacy (hepatic metab. induced)

• capivasertib
Xcopri (cenobamate)

+

capivasertib

1 interaction

Avoid/Use Alternative

cenobamate + capivasertib

avoid combo: combo may decr. capivasertib levels, efficacy (hepatic metab. induced)

• capmatinib
Xcopri (cenobamate)

+

capmatinib

1 interaction

Avoid/Use Alternative

cenobamate + capmatinib

avoid combo: combo may decr. capmatinib levels, efficacy (hepatic metab. induced)

• cariprazine
Xcopri (cenobamate)

+

cariprazine

1 interaction

Avoid/Use Alternative

cenobamate + cariprazine

avoid combo: combo may decr. cariprazine and active metabolite levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, cariprazine may decr. seizure threshold)

• clarithromycin
Xcopri (cenobamate)

+

clarithromycin

1 interaction

Avoid/Use Alternative

cenobamate + clarithromycin

use alternative: combo may decr. clarithromycin levels, efficacy (hepatic metab. induced)

• clonidine
Xcopri (cenobamate)

+

clonidine

1 interaction

Avoid/Use Alternative

cenobamate + clonidine

if ADHD use, avoid combo; otherwise, caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• clopidogrel
Xcopri (cenobamate)

+

clopidogrel

1 interaction

Avoid/Use Alternative

cenobamate + clopidogrel

avoid combo: combo may decr. clopidogrel active metabolite levels, efficacy (hepatic metab. inhibited, decr. conversion of clopidogrel to active metabolite)

• cobicistat
Xcopri (cenobamate)

+

cobicistat

1 interaction

Avoid/Use Alternative

cenobamate + cobicistat

avoid combo: combo may decr. cobicistat levels, efficacy (hepatic metab. induced)

• cobimetinib
Xcopri (cenobamate)

+

cobimetinib

1 interaction

Avoid/Use Alternative

cenobamate + cobimetinib

avoid combo: combo may decr. cobimetinib levels, efficacy (hepatic metab. induced)

• codeine
Xcopri (cenobamate)

+

codeine

1 interaction

Avoid/Use Alternative

cenobamate + codeine

avoid combo if antitussive use, otherwise use alternative or monitor withdrawal sx, resp. rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. codeine and active metabolite morphine levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (hepatic metab. induced, may decr. production of active metabolite morphine; additive effects; antagonistic effects, codeine may decr. seizure threshold)

• crizotinib
Xcopri (cenobamate)

+

crizotinib

1 interaction

Avoid/Use Alternative

cenobamate + crizotinib

avoid combo: combo may decr. crizotinib levels, efficacy (hepatic metab. induced)

• daridorexant
Xcopri (cenobamate)

+

daridorexant

1 interaction

Avoid/Use Alternative

cenobamate + daridorexant

avoid combo: combo may decr. daridorexant levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• darolutamide
Xcopri (cenobamate)

+

darolutamide

1 interaction

Avoid/Use Alternative

cenobamate + darolutamide

avoid combo if also combined w/ P-gp inducer; otherwise, caution advised: combo may decr. darolutamide levels, efficacy; may alter seizure control (hepatic metab. induced; antagonistic effects, darolutamide may decr. seizure threshold)

• defactinib
Xcopri (cenobamate)

+

defactinib

1 interaction

Avoid/Use Alternative

cenobamate + defactinib

avoid combo: combo may decr. defactinib levels, efficacy (hepatic metab. induced)

• deflazacort
Xcopri (cenobamate)

+

deflazacort

1 interaction

Avoid/Use Alternative

cenobamate + deflazacort

avoid combo: combo may decr. deflazacort active metabolite levels, efficacy; may alter seizure control (hepatic metab. induced; antagonistic effects, deflazacort may decr. seizure threshold)

• desogestrel (contraceptive)
Xcopri (cenobamate)

+

desogestrel (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + desogestrel (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. desogestrel levels, contraceptive efficacy (hepatic metab. induced)

• diazoxide
Xcopri (cenobamate)

+

diazoxide

1 interaction

Avoid/Use Alternative

cenobamate + diazoxide

avoid combo if also combined w/ moderate or strong CYP1A2 inducer; otherwise, caution advised: combo may decr. diazoxide levels, efficacy (hepatic metab. induced)

• dienogest (contraceptive)
Xcopri (cenobamate)

+

dienogest (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + dienogest (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. dienogest levels, contraceptive efficacy (hepatic metab. induced)

• dihydrocodeine
Xcopri (cenobamate)

+

dihydrocodeine

1 interaction

Avoid/Use Alternative

cenobamate + dihydrocodeine

use alternative or monitor resp. rate, withdrawal sx; consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. dihydrocodeine and active metabolite dihydromorphine levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (hepatic metab. induced, may decr. production of active metabolite dihydromorphine; additive effects; antagonistic effects, dihydrocodeine may decr. seizure threshold)

• diltiazem
Xcopri (cenobamate)

+

diltiazem

1 interaction

Avoid/Use Alternative

cenobamate + diltiazem

use alternative: combo may decr. diltiazem levels, efficacy (hepatic metab. induced)

• dolutegravir
Xcopri (cenobamate)

+

dolutegravir

1 interaction

Avoid/Use Alternative

cenobamate + dolutegravir

avoid combo: combo may decr. dolutegravir levels, efficacy (hepatic metab. induced)

• doravirine
Xcopri (cenobamate)

+

doravirine

1 interaction

Avoid/Use Alternative

cenobamate + doravirine

avoid combo: combo may decr. doravirine levels, efficacy (hepatic metab. induced)

• doxorubicin
Xcopri (cenobamate)

+

doxorubicin

1 interaction

Avoid/Use Alternative

cenobamate + doxorubicin

avoid combo: combo may decr. doxorubicin levels, efficacy (hepatic metab. induced)

• doxylamine
Xcopri (cenobamate)

+

doxylamine

1 interaction

Avoid/Use Alternative

cenobamate + doxylamine

avoid combo if doxylamine use for pregnancy-related nausea/vomiting, otherwise caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dronedarone
Xcopri (cenobamate)

+

dronedarone

1 interaction

Avoid/Use Alternative

cenobamate + dronedarone

avoid combo: combo may decr. dronedarone levels, efficacy (hepatic metab. induced)

• drospirenone (contraceptive)
Xcopri (cenobamate)

+

drospirenone (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + drospirenone (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. drospirenone levels, contraceptive efficacy (hepatic metab. induced)

• duvelisib
Xcopri (cenobamate)

+

duvelisib

1 interaction

Avoid/Use Alternative

cenobamate + duvelisib

use alternative or incr. duvelisib dose on day 12 of cenobamate tx as follows: if on duvelisib 25 mg bid, incr. to 40 mg bid; if on duvelisib 15 mg bid, incr. to 25 mg bid: combo may decr. duvelisib levels, efficacy (hepatic metab. induced)

• elacestrant
Xcopri (cenobamate)

+

elacestrant

1 interaction

Avoid/Use Alternative

cenobamate + elacestrant

avoid combo: combo may decr. elacestrant levels, efficacy (hepatic metab. induced)

• elbasvir
Xcopri (cenobamate)

+

elbasvir

1 interaction

Avoid/Use Alternative

cenobamate + elbasvir

avoid combo: combo may decr. elbasvir levels, efficacy (hepatic metab. induced)

• elexacaftor/tezacaftor/ivacaftor
Xcopri (cenobamate)

+

elexacaftor/ tezacaftor/ ivacaftor

1 interaction

Avoid/Use Alternative

cenobamate + elexacaftor/ tezacaftor/ ivacaftor

avoid combo: combo may decr. elexacaftor/tezacaftor/ivacaftor levels, efficacy (hepatic metab. induced)

• elvitegravir
Xcopri (cenobamate)

+

elvitegravir

1 interaction

Avoid/Use Alternative

cenobamate + elvitegravir

avoid combo: combo may decr. elvitegravir levels, efficacy (hepatic metab. induced)

• ensartinib
Xcopri (cenobamate)

+

ensartinib

1 interaction

Avoid/Use Alternative

cenobamate + ensartinib

avoid combo: combo may decr. ensartinib levels, efficacy (hepatic metab. possibly induced)

• entrectinib
Xcopri (cenobamate)

+

entrectinib

1 interaction

Avoid/Use Alternative

cenobamate + entrectinib

avoid combo: combo may decr. entrectinib levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• erdafitinib
Xcopri (cenobamate)

+

erdafitinib

1 interaction

Avoid/Use Alternative

cenobamate + erdafitinib

use alternative or initiate erdafitinib at 9 mg qd: combo may decr. erdafitinib levels, efficacy (hepatic metab. induced)

• erlotinib
Xcopri (cenobamate)

+

erlotinib

1 interaction

Avoid/Use Alternative

cenobamate + erlotinib

use alternative or incr. erlotinib dose by 50 mg/day q2wk up to 450 mg/day: combo may decr. erlotinib levels, efficacy (hepatic metab. induced)

• estradiol (contraceptive)
Xcopri (cenobamate)

+

estradiol (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + estradiol (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. estradiol levels, contraceptive efficacy (hepatic metab. induced)

• ethanol
Xcopri (cenobamate)

+

ethanol

1 interaction

Avoid/Use Alternative

cenobamate + ethanol

avoid combo: coingestion of oral alcohol w/ cenobamate may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• ethinyl estradiol (contraceptive)
Xcopri (cenobamate)

+

ethinyl estradiol (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + ethinyl estradiol (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. ethinyl estradiol levels, contraceptive efficacy (hepatic metab. induced)

• ethynodiol (contraceptive)
Xcopri (cenobamate)

+

ethynodiol (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + ethynodiol (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. ethynodiol and active metabolite levels, contraceptive efficacy (hepatic metab. induced)

• etonogestrel (contraceptive)
Xcopri (cenobamate)

+

etonogestrel (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + etonogestrel (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. etonogestrel levels, contraceptive efficacy (hepatic metab. induced)

• everolimus
Xcopri (cenobamate)

+

everolimus

1 interaction

Avoid/Use Alternative

cenobamate + everolimus

BREAST CA, PNET, RENAL CELL CA, RENAL ANGIOMYOLIPOMA W/ TSC: if also combined w/ P-gp inducer, use alternative or double everolimus dose using increments of 5 mg or less; otherwise, caution advised; TSC-ASSOC. SEGA or TSC-ASSOC. PARTIAL-ONSET SEIZURES: if also combined w/ P-gp inducer, double everolimus dose using increments of 5 mg or less and monitor everolimus levels; otherwise, monitor everolimus levels; TRANSPLANT: use alternative or monitor everolimus levels: combo may decr. everolimus levels, efficacy (hepatic metab. induced)

• fedratinib
Xcopri (cenobamate)

+

fedratinib

1 interaction

Avoid/Use Alternative

cenobamate + fedratinib

avoid combo: combo may incr. or decr. fedratinib levels, incr. risk of myelosuppression, hepatotoxicity, other adverse effects or decr. efficacy (hepatic metab. altered)

• felodipine
Xcopri (cenobamate)

+

felodipine

1 interaction

Avoid/Use Alternative

cenobamate + felodipine

use alternative: combo may decr. felodipine levels, efficacy (hepatic metab. induced)

• fentanyl
Xcopri (cenobamate)

+

fentanyl

1 interaction

Avoid/Use Alternative

cenobamate + fentanyl

use alternative or monitor withdrawal sx, resp. rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. fentanyl levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, fentanyl may decr. seizure threshold)

• finerenone
Xcopri (cenobamate)

+

finerenone

1 interaction

Avoid/Use Alternative

cenobamate + finerenone

avoid combo: combo may decr. finerenone levels, efficacy (hepatic metab. induced)

• fosamprenavir
Xcopri (cenobamate)

+

fosamprenavir

1 interaction

Avoid/Use Alternative

cenobamate + fosamprenavir

avoid combo: combo may decr. amprenavir levels, efficacy (hepatic metab. induced)

• fosaprepitant
Xcopri (cenobamate)

+

fosaprepitant

1 interaction

Avoid/Use Alternative

cenobamate + fosaprepitant

avoid combo: combo may decr. aprepitant levels, efficacy (hepatic metab. induced)

• fostamatinib
Xcopri (cenobamate)

+

fostamatinib

1 interaction

Avoid/Use Alternative

cenobamate + fostamatinib

use alternative: combo may decr. fostamatinib active metabolite levels, efficacy (hepatic metab. induced)

• fruquintinib
Xcopri (cenobamate)

+

fruquintinib

1 interaction

Avoid/Use Alternative

cenobamate + fruquintinib

use alternative: combo may decr. fruquintinib levels, efficacy (hepatic metab. induced)

• ganaxolone
Xcopri (cenobamate)

+

ganaxolone

1 interaction

Avoid/Use Alternative

cenobamate + ganaxolone

use alternative or consider ganaxolone dose adjustment: combo may decr. ganaxolone levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• gilteritinib
Xcopri (cenobamate)

+

gilteritinib

1 interaction

Avoid/Use Alternative

cenobamate + gilteritinib

avoid combo if also combined w/ P-gp inducer; otherwise, consider alternative: combo may decr. gilteritinib levels, efficacy (hepatic metab. induced)

• ginkgo
Xcopri (cenobamate)

+

ginkgo

1 interaction

Avoid/Use Alternative

cenobamate + ginkgo

avoid consumption of ginkgo seeds; otherwise, caution advised: combo may alter seizure control (antagonistic effects, ginkgotoxin may decr. seizure threshold)

• glasdegib
Xcopri (cenobamate)

+

glasdegib

1 interaction

Avoid/Use Alternative

cenobamate + glasdegib

use alternative or incr. glasdegib dose as follows: if on glasdegib 100 mg qd, incr. to 200 mg qd; if on glasdegib 50 mg qd, incr. to 100 mg qd: combo may decr. glasdegib levels, efficacy (hepatic metab. induced)

• glecaprevir
Xcopri (cenobamate)

+

glecaprevir

1 interaction

Avoid/Use Alternative

cenobamate + glecaprevir

avoid combo: combo may decr. glecaprevir levels, efficacy (hepatic metab. induced)

• grazoprevir
Xcopri (cenobamate)

+

grazoprevir

1 interaction

Avoid/Use Alternative

cenobamate + grazoprevir

avoid combo: combo may decr. grazoprevir levels, efficacy (hepatic metab. induced)

• hydrocodone
Xcopri (cenobamate)

+

hydrocodone

1 interaction

Avoid/Use Alternative

cenobamate + hydrocodone

avoid combo if antitussive use; otherwise, use alternative or monitor resp. rate, withdrawal sx, consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. hydrocodone levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, hydrocodone may decr. seizure threshold)

• ibrexafungerp
Xcopri (cenobamate)

+

ibrexafungerp

1 interaction

Avoid/Use Alternative

cenobamate + ibrexafungerp

avoid combo: combo may decr. ibrexafungerp levels, efficacy (hepatic metab. induced)

• ibrutinib
Xcopri (cenobamate)

+

ibrutinib

1 interaction

Avoid/Use Alternative

cenobamate + ibrutinib

avoid combo: combo may decr. ibrutinib levels, efficacy (hepatic metab. induced)

• idelalisib
Xcopri (cenobamate)

+

idelalisib

1 interaction

Avoid/Use Alternative

cenobamate + idelalisib

avoid combo: combo may decr. idelalisib levels, efficacy (hepatic metab. induced)

• imatinib
Xcopri (cenobamate)

+

imatinib

1 interaction

Avoid/Use Alternative

cenobamate + imatinib

use alternative or consider imatinib dose adjustment: combo may decr. imatinib levels, efficacy (hepatic metab. induced)

• irinotecan
Xcopri (cenobamate)

+

irinotecan

1 interaction

Avoid/Use Alternative

cenobamate + irinotecan

use alternative or D/C cenobamate >2wk prior to irinotecan start: combo may decr. irinotecan and active metabolite levels, efficacy (hepatic metab. induced)

• isavuconazonium
Xcopri (cenobamate)

+

isavuconazonium

1 interaction

Avoid/Use Alternative

cenobamate + isavuconazonium

avoid combo: combo may decr. isavuconazole levels, efficacy; may incr. risk of shortened QT interval, cardiac arrhythmias (hepatic metab. induced; additive effects)

• isocarboxazid
Xcopri (cenobamate)

+

isocarboxazid

1 interaction

Avoid/Use Alternative

cenobamate + isocarboxazid

use alternative during and x10 days after isocarboxazid use: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, isocarboxazid may decr. seizure threshold)

• isradipine
Xcopri (cenobamate)

+

isradipine

1 interaction

Avoid/Use Alternative

cenobamate + isradipine

consider alternative: combo may decr. isradipine levels, efficacy (hepatic metab. induced)

• istradefylline
Xcopri (cenobamate)

+

istradefylline

1 interaction

Avoid/Use Alternative

cenobamate + istradefylline

avoid combo: combo may decr. istradefylline levels, efficacy (hepatic metab. induced)

• itraconazole
Xcopri (cenobamate)

+

itraconazole

1 interaction

Avoid/Use Alternative

cenobamate + itraconazole

avoid combo 2wk before and during itraconazole tx: combo may decr. itraconazole levels, efficacy (hepatic metab. induced)

• ivacaftor
Xcopri (cenobamate)

+

ivacaftor

1 interaction

Avoid/Use Alternative

cenobamate + ivacaftor

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metab. induced)

• ivosidenib
Xcopri (cenobamate)

+

ivosidenib

1 interaction

Avoid/Use Alternative

cenobamate + ivosidenib

avoid combo: combo may decr. ivosidenib levels, efficacy (hepatic metab. induced)

• kava
Xcopri (cenobamate)

+

kava

1 interaction

Avoid/Use Alternative

cenobamate + kava

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ketoconazole
Xcopri (cenobamate)

+

ketoconazole

1 interaction

Avoid/Use Alternative

cenobamate + ketoconazole

avoid combo 2wk before and during ketoconazole tx if possible; monitor for breakthrough fungal infection; consider incr. ketoconazole dose: combo may decr. ketoconazole levels, efficacy (hepatic metab. induced)

• kratom
Xcopri (cenobamate)

+

kratom

1 interaction

Avoid/Use Alternative

cenobamate + kratom

use alternative or monitor resp. rate: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, kratom may decr. seizure threshold)

• larotrectinib
Xcopri (cenobamate)

+

larotrectinib

1 interaction

Avoid/Use Alternative

cenobamate + larotrectinib

use alternative or double larotrectinib dose: combo may decr. larotrectinib levels, efficacy (hepatic metab. induced)

• lazertinib
Xcopri (cenobamate)

+

lazertinib

1 interaction

Avoid/Use Alternative

cenobamate + lazertinib

avoid combo: combo may decr. lazertinib levels, efficacy (hepatic metab. induced)

• lefamulin
Xcopri (cenobamate)

+

lefamulin

1 interaction

Avoid/Use Alternative

cenobamate + lefamulin

use alternative, especially w/ oral lefamulin: combo may decr. lefamulin levels, efficacy (hepatic metab. induced)

• lemborexant
Xcopri (cenobamate)

+

lemborexant

1 interaction

Avoid/Use Alternative

cenobamate + lemborexant

avoid combo: combo may decr. lemborexant levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• lenacapavir
Xcopri (cenobamate)

+

lenacapavir

1 interaction

Avoid/Use Alternative

cenobamate + lenacapavir

avoid combo: combo may decr. lenacapavir levels, efficacy (hepatic metab. induced)

• leniolisib
Xcopri (cenobamate)

+

leniolisib

1 interaction

Avoid/Use Alternative

cenobamate + leniolisib

avoid combo: combo may decr. leniolisib levels, efficacy (hepatic metab. induced)

• letermovir
Xcopri (cenobamate)

+

letermovir

1 interaction

Avoid/Use Alternative

cenobamate + letermovir

avoid combo: combo may decr. letermovir levels, efficacy (hepatic metab. induced)

• levoketoconazole
Xcopri (cenobamate)

+

levoketoconazole

1 interaction

Avoid/Use Alternative

cenobamate + levoketoconazole

consider alternative x2wk before and during levoketoconazole tx: combo may decr. levoketoconazole levels, efficacy (hepatic metab. induced)

• levonorgestrel (contraceptive)
Xcopri (cenobamate)

+

levonorgestrel (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + levonorgestrel (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. levonorgestrel levels, contraceptive efficacy (hepatic metab. induced)

• levonorgestrel (post-coital contraceptive)
Xcopri (cenobamate)

+

levonorgestrel (post-coital contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + levonorgestrel (post-coital contraceptive)

consider alternative: combo may decr. levonorgestrel levels, post-coital contraceptive efficacy (hepatic metab. induced)

• lopinavir/ritonavir
Xcopri (cenobamate)

+

lopinavir/ ritonavir

1 interaction

Avoid/Use Alternative

cenobamate + lopinavir/ ritonavir

avoid combo: combo may decr. lopinavir/ritonavir levels, efficacy (hepatic metab. induced)

• lorlatinib
Xcopri (cenobamate)

+

lorlatinib

1 interaction

Avoid/Use Alternative

cenobamate + lorlatinib

use alternative or incr. lorlatinib dose to 125 mg qd: combo may decr. lorlatinib levels, efficacy; may alter seizure control (hepatic metab. induced; antagonistic effects, lorlatinib may decr. seizure threshold)

• lumateperone
Xcopri (cenobamate)

+

lumateperone

1 interaction

Avoid/Use Alternative

cenobamate + lumateperone

avoid combo: combo may decr. lumateperone levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, lumateperone may decr. seizure threshold)

• macitentan
Xcopri (cenobamate)

+

macitentan

1 interaction

Avoid/Use Alternative

cenobamate + macitentan

avoid combo: combo may decr. macitentan levels, efficacy (hepatic metab. induced)

• maraviroc
Xcopri (cenobamate)

+

maraviroc

1 interaction

Avoid/Use Alternative

cenobamate + maraviroc

ADULTS: adjust maraviroc dose to 600 mg bid; if also combined w/ strong CYP3A4 inhibitor, adjust maraviroc dose to 150 mg bid; PEDS: avoid combo: combo may decr. maraviroc levels, efficacy (hepatic metab. induced)

• medroxyprogesterone (contraceptive)
Xcopri (cenobamate)

+

medroxyprogesterone (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + medroxyprogesterone (contraceptive)

use additional non-hormonal or alternative contraception: combo may decr. medroxyprogesterone levels, contraceptive efficacy (hepatic metab. induced)

• meperidine
Xcopri (cenobamate)

+

meperidine

1 interaction

Avoid/Use Alternative

cenobamate + meperidine

use alternative or monitor withdrawal sx, resp. rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. meperidine levels, efficacy; may incr. normeperidine levels, risk of neurotoxicity; may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (hepatic metab. induced, incr. toxic metabolite formation; additive effects; antagonistic effects, meperidine may decr. seizure threshold)

• metaxalone
Xcopri (cenobamate)

+

metaxalone

1 interaction

Avoid/Use Alternative

cenobamate + metaxalone

use alternative or monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• methadone
Xcopri (cenobamate)

+

methadone

1 interaction

Avoid/Use Alternative

cenobamate + methadone

use alternative or monitor resp. rate, ECG, withdrawal sx; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. or decr. methadone levels, incr. risk of profound CNS and resp. depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects or decr. efficacy; may alter seizure control (hepatic metab. altered, additive effects; antagonistic effects, methadone may decr. seizure threshold)

• metoclopramide
Xcopri (cenobamate)

+

metoclopramide

1 interaction

Avoid/Use Alternative

cenobamate + metoclopramide

use alternative: combo may decr. metoclopramide levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, metoclopramide may decr. seizure threshold)

• midazolam
Xcopri (cenobamate)

+

midazolam

1 interaction

Avoid/Use Alternative

cenobamate + midazolam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may decr. midazolam levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment (hepatic metab. induced; additive effects)

• midostaurin
Xcopri (cenobamate)

+

midostaurin

1 interaction

Avoid/Use Alternative

cenobamate + midostaurin

consider alternative: combo may decr. midostaurin levels, efficacy (hepatic metab. induced)

• mifepristone
Xcopri (cenobamate)

+

mifepristone

1 interaction

Avoid/Use Alternative

cenobamate + mifepristone

avoid combo if daily mifepristone use; caution advised if pregnancy termination use: combo may decr. mifepristone levels, efficacy (hepatic metab. induced)

• mitapivat
Xcopri (cenobamate)

+

mitapivat

1 interaction

Avoid/Use Alternative

cenobamate + mitapivat

consider alternative; otherwise, monitor Hgb and consider mitapivat dose adjustment up to max 100 mg bid: combo may decr. mitapivat levels, efficacy (hepatic metab. induced)

• mobocertinib
Xcopri (cenobamate)

+

mobocertinib

1 interaction

Avoid/Use Alternative

cenobamate + mobocertinib

avoid combo: combo may decr. mobocertinib levels, efficacy (hepatic metab. induced)

• naldemedine
Xcopri (cenobamate)

+

naldemedine

1 interaction

Avoid/Use Alternative

cenobamate + naldemedine

use alternative: combo may decr. naldemedine levels, efficacy (hepatic metab. induced)

• naloxegol
Xcopri (cenobamate)

+

naloxegol

1 interaction

Avoid/Use Alternative

cenobamate + naloxegol

consider alternative: combo may decr. naloxegol levels, efficacy (hepatic metab. induced)

• nefazodone
Xcopri (cenobamate)

+

nefazodone

1 interaction

Avoid/Use Alternative

cenobamate + nefazodone

avoid combo: combo may decr. nefazodone levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, nefazodone may decr. seizure threshold)

• nelfinavir
Xcopri (cenobamate)

+

nelfinavir

1 interaction

Avoid/Use Alternative

cenobamate + nelfinavir

avoid combo: combo may decr. nelfinavir levels, efficacy (hepatic metab. induced)

• neratinib
Xcopri (cenobamate)

+

neratinib

1 interaction

Avoid/Use Alternative

cenobamate + neratinib

avoid combo: combo may decr. neratinib levels, efficacy (hepatic metab. induced)

• netupitant
Xcopri (cenobamate)

+

netupitant

1 interaction

Avoid/Use Alternative

cenobamate + netupitant

consider alternative: combo may decr. netupitant levels, efficacy (hepatic metab. induced)

• nevirapine
Xcopri (cenobamate)

+

nevirapine

1 interaction

Avoid/Use Alternative

cenobamate + nevirapine

avoid combo: combo may decr. nevirapine levels, efficacy (hepatic metab. induced)

• nicardipine
Xcopri (cenobamate)

+

nicardipine

1 interaction

Avoid/Use Alternative

cenobamate + nicardipine

use alternative or monitor BP: combo may decr. nicardipine levels, efficacy (hepatic metab. induced)

• nifedipine
Xcopri (cenobamate)

+

nifedipine

1 interaction

Avoid/Use Alternative

cenobamate + nifedipine

use alternative: combo may decr. nifedipine levels, efficacy (hepatic metab. induced)

• nilotinib
Xcopri (cenobamate)

+

nilotinib

1 interaction

Avoid/Use Alternative

cenobamate + nilotinib

consider alternative: combo may decr. nilotinib levels, efficacy (hepatic metab. induced)

• nirmatrelvir
Xcopri (cenobamate)

+

nirmatrelvir

1 interaction

Avoid/Use Alternative

cenobamate + nirmatrelvir

avoid combo: combo may decr. nirmatrelvir levels, efficacy (hepatic metab. induced)

• nirogacestat
Xcopri (cenobamate)

+

nirogacestat

1 interaction

Avoid/Use Alternative

cenobamate + nirogacestat

avoid combo: combo may decr. nirogacestat levels, efficacy (hepatic metab. induced)

• nisoldipine
Xcopri (cenobamate)

+

nisoldipine

1 interaction

Avoid/Use Alternative

cenobamate + nisoldipine

use alternative or monitor BP: combo may decr. nisoldipine levels, efficacy (hepatic metab. induced)

• norelgestromin (contraceptive)
Xcopri (cenobamate)

+

norelgestromin (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + norelgestromin (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. norelgestromin levels, contraceptive efficacy (hepatic metab. induced)

• norethindrone (contraceptive)
Xcopri (cenobamate)

+

norethindrone (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + norethindrone (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. norethindrone levels, contraceptive efficacy (hepatic metab. induced)

• norgestimate (contraceptive)
Xcopri (cenobamate)

+

norgestimate (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + norgestimate (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. norgestimate and active metabolites levels, contraceptive efficacy (hepatic metab. induced)

• norgestrel (contraceptive)
Xcopri (cenobamate)

+

norgestrel (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + norgestrel (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. norgestrel levels, contraceptive efficacy (hepatic metab. induced)

• olaparib
Xcopri (cenobamate)

+

olaparib

1 interaction

Avoid/Use Alternative

cenobamate + olaparib

avoid combo: combo may decr. olaparib levels, efficacy (hepatic metab. induced)

• oliceridine
Xcopri (cenobamate)

+

oliceridine

1 interaction

Avoid/Use Alternative

cenobamate + oliceridine

use alternative or monitor withdrawal sx, BP, resp. rate; consider oliceridine dose adjustment, use lowest effective doses and shortest duration of concomitant tx: combo may decr. oliceridine levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, oliceridine may decr. seizure threshold)

• olutasidenib
Xcopri (cenobamate)

+

olutasidenib

1 interaction

Avoid/Use Alternative

cenobamate + olutasidenib

avoid combo: combo may decr. olutasidenib levels, efficacy (hepatic metab. induced)

• omaveloxolone
Xcopri (cenobamate)

+

omaveloxolone

1 interaction

Avoid/Use Alternative

cenobamate + omaveloxolone

avoid combo: combo may decr. omaveloxolone levels, efficacy (hepatic metab. induced)

• oxybate
Xcopri (cenobamate)

+

oxybate

1 interaction

Avoid/Use Alternative

cenobamate + oxybate

use alternative or monitor resp. rate; decr. dose of one or both drugs: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, syncope (additive effects)

• oxycodone
Xcopri (cenobamate)

+

oxycodone

1 interaction

Avoid/Use Alternative

cenobamate + oxycodone

use alternative or monitor withdrawal sx, monitor resp. rate; decr. oxycodone start dose by at least 50%, consider decr. cenobamate dose, use lowest effective doses and shortest duration of concomitant tx: combo may decr. oxycodone levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, oxycodone may decr. seizure threshold)

• palbociclib
Xcopri (cenobamate)

+

palbociclib

1 interaction

Avoid/Use Alternative

cenobamate + palbociclib

avoid combo: combo may decr. palbociclib levels, efficacy (hepatic metab. induced)

• palovarotene
Xcopri (cenobamate)

+

palovarotene

1 interaction

Avoid/Use Alternative

cenobamate + palovarotene

avoid combo: combo may decr. palovarotene levels, efficacy (hepatic metab. induced)

• pemigatinib
Xcopri (cenobamate)

+

pemigatinib

1 interaction

Avoid/Use Alternative

cenobamate + pemigatinib

avoid combo: combo may decr. pemigatinib levels, efficacy (hepatic metab. induced)

• phenelzine
Xcopri (cenobamate)

+

phenelzine

1 interaction

Avoid/Use Alternative

cenobamate + phenelzine

use alternative: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, phenelzine may decr. seizure threshold)

• pimavanserin
Xcopri (cenobamate)

+

pimavanserin

1 interaction

Avoid/Use Alternative

cenobamate + pimavanserin

avoid combo: combo may decr. pimavanserin levels, efficacy (hepatic metab. induced)

• pirfenidone
Xcopri (cenobamate)

+

pirfenidone

1 interaction

Avoid/Use Alternative

cenobamate + pirfenidone

avoid combo if also combined w/ mod-strong CYP1A2 inhibitor; otherwise, caution advised: combo may incr. pirfenidone levels, risk of adverse effects (hepatic metab. inhibited)

• pirtobrutinib
Xcopri (cenobamate)

+

pirtobrutinib

1 interaction

Avoid/Use Alternative

cenobamate + pirtobrutinib

use alternative or incr. pirtobrutinib dose as follows: if on pirtobrutinib 200 mg qd, incr. to 300 mg; if on pirtobrutinib 100 mg qd, incr. to 150 mg; if on pirtobrutinib 50 mg qd, incr. to 100 mg: combo may decr. pirtobrutinib levels, efficacy (hepatic metab. induced)

• ponatinib
Xcopri (cenobamate)

+

ponatinib

1 interaction

Avoid/Use Alternative

cenobamate + ponatinib

use alternative: combo may decr. ponatinib levels, efficacy (hepatic metab. induced)

• pralsetinib
Xcopri (cenobamate)

+

pralsetinib

1 interaction

Avoid/Use Alternative

cenobamate + pralsetinib

if adding pralsetinib to ongoing cenobamate tx or 7 days after adding cenobamate to ongoing pralsetinib tx, use alternative or incr. pralsetinib dose as follows: if on pralsetinib 400 mg qd, incr. to 600 mg qd; if on pralsetinib 300 mg qd, incr. to 500 mg qd; if on pralsetinib 200 mg qd, incr. to 300 mg qd: combo may decr. pralsetinib levels, efficacy (hepatic metab. induced)

• praziquantel
Xcopri (cenobamate)

+

praziquantel

1 interaction

Avoid/Use Alternative

cenobamate + praziquantel

use alternative or D/C cenobamate at least 2wk prior to praziquantel start; if immediate schistosomiasis tx required, monitor anthelmintic efficacy: combo may decr. praziquantel levels, efficacy (hepatic metab. induced)

• pretomanid
Xcopri (cenobamate)

+

pretomanid

1 interaction

Avoid/Use Alternative

cenobamate + pretomanid

avoid combo: combo may decr. pretomanid levels, efficacy (hepatic metab. induced)

• promethazine
Xcopri (cenobamate)

+

promethazine

1 interaction

Avoid/Use Alternative

cenobamate + promethazine

use alternative or monitor resp. rate; decr. dose of one or both drugs: combo may incr. risk of CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, promethazine may decr. seizure threshold)

• quizartinib
Xcopri (cenobamate)

+

quizartinib

1 interaction

Avoid/Use Alternative

cenobamate + quizartinib

avoid combo: combo may decr. quizartinib levels, efficacy (hepatic metab. induced)

• repotrectinib
Xcopri (cenobamate)

+

repotrectinib

1 interaction

Avoid/Use Alternative

cenobamate + repotrectinib

avoid combo: combo may decr. repotrectinib levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• revumenib
Xcopri (cenobamate)

+

revumenib

1 interaction

Avoid/Use Alternative

cenobamate + revumenib

avoid combo: combo may decr. revumenib levels, efficacy; may incr. revumenib active metabolite levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. induced; incr. active metabolite formation)

• ribociclib
Xcopri (cenobamate)

+

ribociclib

1 interaction

Avoid/Use Alternative

cenobamate + ribociclib

consider alternative: combo may decr. ribociclib levels, efficacy (hepatic metab. induced)

• rilpivirine
Xcopri (cenobamate)

+

rilpivirine

1 interaction

Avoid/Use Alternative

cenobamate + rilpivirine

avoid combo: combo may decr. rilpivirine levels, efficacy (hepatic metab. induced)

• rimegepant
Xcopri (cenobamate)

+

rimegepant

1 interaction

Avoid/Use Alternative

cenobamate + rimegepant

avoid combo: combo may decr. rimegepant levels, efficacy (hepatic metab. induced)

• ripretinib
Xcopri (cenobamate)

+

ripretinib

1 interaction

Avoid/Use Alternative

cenobamate + ripretinib

use alternative or incr. ripretinib dose to 150 mg bid: combo may decr. ripretinib and active metabolite levels, efficacy (hepatic metab. induced)

• ritonavir
Xcopri (cenobamate)

+

ritonavir

1 interaction

Avoid/Use Alternative

cenobamate + ritonavir

use alternative: combo may decr. ritonavir levels, efficacy (hepatic metab. induced)

• rivaroxaban
Xcopri (cenobamate)

+

rivaroxaban

1 interaction

Avoid/Use Alternative

cenobamate + rivaroxaban

avoid combo if also combined w/ P-gp inducer; otherwise, caution advised: combo may decr. rivaroxaban levels, efficacy (hepatic metab. induced)

• roflumilast
Xcopri (cenobamate)

+

roflumilast

1 interaction

Avoid/Use Alternative

cenobamate + roflumilast

consider alternative: combo may decr. roflumilast levels, efficacy (hepatic metab. induced)

• rolapitant
Xcopri (cenobamate)

+

rolapitant

1 interaction

Avoid/Use Alternative

cenobamate + rolapitant

consider alternative: combo may decr. rolapitant levels, efficacy (hepatic metab. induced)

• ropeginterferon alfa-2b
Xcopri (cenobamate)

+

ropeginterferon alfa-2b

1 interaction

Avoid/Use Alternative

cenobamate + ropeginterferon alfa-2b

use alternative: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• samidorphan
Xcopri (cenobamate)

+

samidorphan

1 interaction

Avoid/Use Alternative

cenobamate + samidorphan

consider alternative: combo may decr. samidorphan levels, efficacy (hepatic metab. induced)

• segesterone (contraceptive)
Xcopri (cenobamate)

+

segesterone (contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + segesterone (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cenobamate tx: combo may decr. segesterone levels, contraceptive efficacy (hepatic metab. induced)

• selpercatinib
Xcopri (cenobamate)

+

selpercatinib

1 interaction

Avoid/Use Alternative

cenobamate + selpercatinib

avoid combo: combo may decr. selpercatinib levels, efficacy (hepatic metab. induced)

• selumetinib
Xcopri (cenobamate)

+

selumetinib

1 interaction

Avoid/Use Alternative

cenobamate + selumetinib

avoid combo: combo may decr. selumetinib levels, efficacy (hepatic metab. induced)

• simvastatin
Xcopri (cenobamate)

+

simvastatin

1 interaction

Avoid/Use Alternative

cenobamate + simvastatin

consider alternative: combo may decr. simvastatin levels, efficacy (hepatic metab. induced)

• siponimod
Xcopri (cenobamate)

+

siponimod

1 interaction

Avoid/Use Alternative

cenobamate + siponimod

if CYP2C9 *1/*3 or *2/*3 genotype or if also combined w/ moderate or strong CYP2C9 inducer, avoid combo; otherwise, caution advised: combo may decr. siponimod levels, efficacy (hepatic metab. induced)

• sonidegib
Xcopri (cenobamate)

+

sonidegib

1 interaction

Avoid/Use Alternative

cenobamate + sonidegib

avoid combo: combo may decr. sonidegib levels, efficacy (hepatic metab. induced)

• sufentanil
Xcopri (cenobamate)

+

sufentanil

1 interaction

Avoid/Use Alternative

cenobamate + sufentanil

use alternative or monitor resp. rate, decr. sufentanil start dose, consider decr. cenobamate dose, use lowest effective doses: combo may decr. sufentanil levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, sufentanil may decr. seizure threshold)

• suzetrigine
Xcopri (cenobamate)

+

suzetrigine

1 interaction

Avoid/Use Alternative

cenobamate + suzetrigine

avoid combo: combo may decr. suzetrigine and active metabolite levels, efficacy (hepatic metab. induced)

• tadalafil
Xcopri (cenobamate)

+

tadalafil

1 interaction

Avoid/Use Alternative

cenobamate + tadalafil

PULMONARY HTN: consider alternative; ERECTILE DYSFUNCTION and BENIGN PROSTATIC HYPERPLASIA: caution advised: combo may decr. tadalafil levels, efficacy (hepatic metab. induced)

• tamoxifen
Xcopri (cenobamate)

+

tamoxifen

1 interaction

Avoid/Use Alternative

cenobamate + tamoxifen

avoid combo: combo may decr. tamoxifen and active metabolite levels, efficacy (hepatic metab. induced)

• tasimelteon
Xcopri (cenobamate)

+

tasimelteon

1 interaction

Avoid/Use Alternative

cenobamate + tasimelteon

consider alternative: combo may decr. tasimelteon levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• tazemetostat
Xcopri (cenobamate)

+

tazemetostat

1 interaction

Avoid/Use Alternative

cenobamate + tazemetostat

avoid combo: combo may decr. tazemetostat levels, efficacy (hepatic metab. induced)

• tezacaftor/ivacaftor
Xcopri (cenobamate)

+

tezacaftor/ ivacaftor

1 interaction

Avoid/Use Alternative

cenobamate + tezacaftor/ ivacaftor

avoid combo: combo may decr. tezacaftor/ivacaftor levels, efficacy (hepatic metab. induced)

• thalidomide
Xcopri (cenobamate)

+

thalidomide

1 interaction

Avoid/Use Alternative

cenobamate + thalidomide

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, thalidomide may decr. seizure threshold)

• thiotepa
Xcopri (cenobamate)

+

thiotepa

1 interaction

Avoid/Use Alternative

cenobamate + thiotepa

use alternative or monitor CBC: combo may decr. thiotepa levels, efficacy; may incr. thiotepa active metabolite levels, risk of serious infection, myelosuppression, other adverse effects; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced, incr. metabolite formation; additive effects; antagonistic effects, thiotepa may decr. seizure threshold)

• ticagrelor
Xcopri (cenobamate)

+

ticagrelor

1 interaction

Avoid/Use Alternative

cenobamate + ticagrelor

avoid combo: combo may decr. ticagrelor levels, efficacy (hepatic metab. induced)

• tipranavir
Xcopri (cenobamate)

+

tipranavir

1 interaction

Avoid/Use Alternative

cenobamate + tipranavir

avoid combo: combo may decr. tipranavir levels, efficacy (hepatic metab. induced)

• tofacitinib
Xcopri (cenobamate)

+

tofacitinib

1 interaction

Avoid/Use Alternative

cenobamate + tofacitinib

consider alternative: combo may incr. or decr. tofacitinib levels, incr. risk of serious infection, myelosuppression, other adverse effects or decr. efficacy (hepatic metab. altered)

• tolvaptan
Xcopri (cenobamate)

+

tolvaptan

1 interaction

Avoid/Use Alternative

cenobamate + tolvaptan

consider alternative: combo may decr. tolvaptan levels, efficacy (hepatic metab. induced)

• toremifene
Xcopri (cenobamate)

+

toremifene

1 interaction

Avoid/Use Alternative

cenobamate + toremifene

avoid combo: combo may decr. toremifene levels, efficacy (hepatic metab. induced)

• tramadol
Xcopri (cenobamate)

+

tramadol

1 interaction

Avoid/Use Alternative

cenobamate + tramadol

avoid combo: combo may decr. tramadol levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, tramadol may decr. seizure threshold)

• tranylcypromine
Xcopri (cenobamate)

+

tranylcypromine

1 interaction

Avoid/Use Alternative

cenobamate + tranylcypromine

use alternative: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, tranylcypromine may decr. seizure threshold)

• trimethobenzamide
Xcopri (cenobamate)

+

trimethobenzamide

1 interaction

Avoid/Use Alternative

cenobamate + trimethobenzamide

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ulipristal (post-coital contraceptive)
Xcopri (cenobamate)

+

ulipristal (post-coital contraceptive)

1 interaction

Avoid/Use Alternative

cenobamate + ulipristal (post-coital contraceptive)

avoid combo: combo may decr. ulipristal levels, post-coital contraceptive efficacy (hepatic metab. induced)

• valbenazine
Xcopri (cenobamate)

+

valbenazine

1 interaction

Avoid/Use Alternative

cenobamate + valbenazine

avoid combo: combo may decr. valbenazine levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• vanzacaftor/tezacaftor/deutivacaftor
Xcopri (cenobamate)

+

vanzacaftor/ tezacaftor/ deutivacaftor

1 interaction

Avoid/Use Alternative

cenobamate + vanzacaftor/ tezacaftor/ deutivacaftor

avoid combo: combo may decr. vanzacaftor/tezacaftor/deutivacaftor levels, efficacy (hepatic metab. induced)

• velpatasvir
Xcopri (cenobamate)

+

velpatasvir

1 interaction

Avoid/Use Alternative

cenobamate + velpatasvir

avoid combo: combo may decr. velpatasvir levels, efficacy (hepatic metab. induced)

• venetoclax
Xcopri (cenobamate)

+

venetoclax

1 interaction

Avoid/Use Alternative

cenobamate + venetoclax

avoid combo: combo may decr. venetoclax levels, efficacy (hepatic metab. induced)

• verapamil
Xcopri (cenobamate)

+

verapamil

1 interaction

Avoid/Use Alternative

cenobamate + verapamil

use alternative: combo may decr. verapamil levels, efficacy (hepatic metab. induced)

• voclosporin
Xcopri (cenobamate)

+

voclosporin

1 interaction

Avoid/Use Alternative

cenobamate + voclosporin

avoid combo: combo may decr. voclosporin levels, efficacy (hepatic metab. induced)

• vonoprazan
Xcopri (cenobamate)

+

vonoprazan

1 interaction

Avoid/Use Alternative

cenobamate + vonoprazan

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metab. induced)

• voriconazole
Xcopri (cenobamate)

+

voriconazole

1 interaction

Avoid/Use Alternative

cenobamate + voriconazole

use alternative or monitor ECG, breakthrough fungal infection: combo may incr. or decr. voriconazole levels, incr. risk of QT prolongation, cardiac arrhythmias, other adverse effects or decr. efficacy (hepatic metab. altered)

• voxelotor
Xcopri (cenobamate)

+

voxelotor

1 interaction

Avoid/Use Alternative

cenobamate + voxelotor

ADULTS or >12 YO: use alternative or incr. voxelotor dose to 2000 mg qd; PEDS: use alternative or incr. voxelotor dose as follows: if wt >40 kg, incr. voxelotor dose to 2000-2100 mg qd; if wt 20-39 kg, incr. voxelotor dose to 1200 mg qd; if wt 10-19 kg, incr. voxelotor dose to 900 mg qd: combo may decr. voxelotor levels, efficacy (hepatic metab. induced)

• voxilaprevir
Xcopri (cenobamate)

+

voxilaprevir

1 interaction

Avoid/Use Alternative

cenobamate + voxilaprevir

avoid combo: combo may decr. voxilaprevir levels, efficacy (hepatic metab. induced)

• zanubrutinib
Xcopri (cenobamate)

+

zanubrutinib

1 interaction

Avoid/Use Alternative

cenobamate + zanubrutinib

use alternative or incr. zanubrutinib dose to 320 mg bid: combo may decr. zanubrutinib levels, efficacy (hepatic metab. induced)

• zuranolone
Xcopri (cenobamate)

+

zuranolone

1 interaction

Avoid/Use Alternative

cenobamate + zuranolone

avoid combo: combo may decr. zuranolone levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

Monitor/Modify Tx

• abiraterone acetate
Xcopri (cenobamate)

+

abiraterone acetate

1 interaction

Monitor/Modify Tx

cenobamate + abiraterone acetate

if abiraterone coformulated w/ niraparib, caution advised; otherwise, consider abiraterone dose adjustment: combo may decr. abiraterone levels, efficacy (hepatic metab. induced)

• acalabrutinib
Xcopri (cenobamate)

+

acalabrutinib

1 interaction

Monitor/Modify Tx

cenobamate + acalabrutinib

consider acalabrutinib dose adjustment: combo may decr. acalabrutinib levels, efficacy (hepatic metab. induced)

• aldesleukin
Xcopri (cenobamate)

+

aldesleukin

1 interaction

Monitor/Modify Tx

cenobamate + aldesleukin

withhold aldesleukin if mod-severe somnolence occurs; otherwise, caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, aldesleukin may decr. seizure threshold)

• alprazolam
Xcopri (cenobamate)

+

alprazolam

1 interaction

Monitor/Modify Tx

cenobamate + alprazolam

monitor resp. rate: combo may decr. alprazolam levels, efficacy; may incr. risk of CNS and resp. depression, psychomotor impairment (hepatic metab. induced; additive effects)

• amlodipine
Xcopri (cenobamate)

+

amlodipine

1 interaction

Monitor/Modify Tx

cenobamate + amlodipine

monitor BP: combo may decr. (lev)amlodipine levels, efficacy (hepatic metab. induced)

• avatrombopag
Xcopri (cenobamate)

+

avatrombopag

1 interaction

Monitor/Modify Tx

cenobamate + avatrombopag

CHRONIC IMMUNE THROMBOCYTOPENIA: if also combined w/ mod-strong CYP2C9 inducer, incr. start dose to 40 mg po qd and monitor platelets; otherwise, monitor platelets; CHRONIC LIVER DZ: monitor platelets: combo may decr. avatrombopag levels, efficacy (hepatic metab. induced)

• baclofen intrathecal
Xcopri (cenobamate)

+

baclofen intrathecal

1 interaction

Monitor/Modify Tx

cenobamate + baclofen intrathecal

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, baclofen may decr. seizure threshold)

• belzutifan
Xcopri (cenobamate)

+

belzutifan

1 interaction

Monitor/Modify Tx

cenobamate + belzutifan

monitor Hgb, hypoxia s/sx: combo may incr. belzutifan levels, risk of anemia, hypoxia, other adverse effects (hepatic metab. inhibited)

• betamethasone
Xcopri (cenobamate)

+

betamethasone

1 interaction

Monitor/Modify Tx

cenobamate + betamethasone

consider betamethasone dose adjustment: combo may decr. betamethasone levels, efficacy; may alter seizure control (hepatic metab. induced; antagonistic effects, betamethasone may decr. seizure threshold)

• brexpiprazole
Xcopri (cenobamate)

+

brexpiprazole

1 interaction

Monitor/Modify Tx

cenobamate + brexpiprazole

consider incr. brexpiprazole dose: combo may decr. brexpiprazole levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, brexpiprazole may decr. seizure threshold)

• butorphanol
Xcopri (cenobamate)

+

butorphanol

1 interaction

Monitor/Modify Tx

cenobamate + butorphanol

monitor for withdrawal sx, resp. rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. butorphanol levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, butorphanol may decr. seizure threshold)

• calcitriol
Xcopri (cenobamate)

+

calcitriol

1 interaction

Monitor/Modify Tx

cenobamate + calcitriol

monitor vitamin D levels: combo may decr. vitamin D levels, efficacy (hepatic metab. induced)

• carbamazepine
Xcopri (cenobamate)

+

carbamazepine

1 interaction

Monitor/Modify Tx

cenobamate + carbamazepine

monitor carbamazepine levels; consider decr. dose of one or both drugs: combo may decr. carbamazepine levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• chlordiazepoxide
Xcopri (cenobamate)

+

chlordiazepoxide

1 interaction

Monitor/Modify Tx

cenobamate + chlordiazepoxide

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• chlorpromazine
Xcopri (cenobamate)

+

chlorpromazine

1 interaction

Monitor/Modify Tx

cenobamate + chlorpromazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, chlorpromazine may decr. seizure threshold)

• cholecalciferol (vitamin D3)
Xcopri (cenobamate)

+

cholecalciferol (vitamin D3)

1 interaction

Monitor/Modify Tx

cenobamate + cholecalciferol (vitamin D3)

monitor vitamin D levels: combo may decr. vitamin D levels, efficacy (hepatic metab. induced)

• cilostazol
Xcopri (cenobamate)

+

cilostazol

1 interaction

Monitor/Modify Tx

cenobamate + cilostazol

decr. cilostazol dose to 50 mg bid: combo may incr. cilostazol levels, risk of adverse effects (hepatic metab. inhibited)

• citalopram
Xcopri (cenobamate)

+

citalopram

1 interaction

Monitor/Modify Tx

cenobamate + citalopram

adjust max citalopram dose to 20 mg/day: combo may incr. citalopram levels, risk of QT prolongation, cardiac arrhythmias, CNS depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metab. inhibited, additive effects; antagonistic effects, citalopram may decr. seizure threshold)

• clobazam
Xcopri (cenobamate)

+

clobazam

1 interaction

Monitor/Modify Tx

cenobamate + clobazam

monitor resp. rate; consider decr. clobazam dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. clobazam and active metabolite levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, additive effects)

• clonazepam
Xcopri (cenobamate)

+

clonazepam

1 interaction

Monitor/Modify Tx

cenobamate + clonazepam

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• clorazepate
Xcopri (cenobamate)

+

clorazepate

1 interaction

Monitor/Modify Tx

cenobamate + clorazepate

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• clozapine
Xcopri (cenobamate)

+

clozapine

1 interaction

Monitor/Modify Tx

cenobamate + clozapine

consider incr. clozapine dose: combo may decr. clozapine levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, clozapine may decr. seizure threshold)

• crinecerfont
Xcopri (cenobamate)

+

crinecerfont

1 interaction

Monitor/Modify Tx

cenobamate + crinecerfont

ADULTS: keep 100 mg morning dose unchanged, incr. crinecerfont evening dose to 200 mg; PEDS 4 YO AND OLDER: incr. crinecerfont dose based on weight as follows: if 10-19 kg, keep 25 mg morning dose unchanged, incr. crinecerfont evening dose to 50 mg; if 20-54 kg, keep 50 mg morning dose unchanged, incr. crinecerfont evening dose to 100 mg; if 55 kg or greater, keep 100 mg morning dose unchanged, incr. crinecerfont evening dose to 200 mg: combo may decr. crinecerfont levels, efficacy (hepatic metab. induced)

• cyclophosphamide
Xcopri (cenobamate)

+

cyclophosphamide

1 interaction

Monitor/Modify Tx

cenobamate + cyclophosphamide

monitor CBC, renal, cardiac fxn: combo may incr. cyclophosphamide active metabolite levels, risk of serious infection, myelosuppression, nephrotoxicity, cardiotoxicity, other adverse effects (hepatic metab. possibly induced, incr. active metabolite formation)

• cyclosporine
Xcopri (cenobamate)

+

cyclosporine

1 interaction

Monitor/Modify Tx

cenobamate + cyclosporine

monitor cyclosporine levels: combo may decr. cyclosporine levels, efficacy; may alter seizure control (hepatic metab. induced; antagonistic effects, cyclosporine may decr. seizure threshold)

• desflurane
Xcopri (cenobamate)

+

desflurane

1 interaction

Monitor/Modify Tx

cenobamate + desflurane

monitor resp. rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• dexmedetomidine
Xcopri (cenobamate)

+

dexmedetomidine

1 interaction

Monitor/Modify Tx

cenobamate + dexmedetomidine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dexmedetomidine injection
Xcopri (cenobamate)

+

dexmedetomidine injection

1 interaction

Monitor/Modify Tx

cenobamate + dexmedetomidine injection

monitor resp. rate, consider decr. dose of one or both drugs: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• diazepam
Xcopri (cenobamate)

+

diazepam

1 interaction

Monitor/Modify Tx

cenobamate + diazepam

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. or decr. diazepam levels, incr. risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects or decr. efficacy (hepatic metab. altered; additive effects)

• digoxin
Xcopri (cenobamate)

+

digoxin

1 interaction

Monitor/Modify Tx

cenobamate + digoxin

monitor ECG: combo may incr. risk of shortened QT interval, cardiac arrhythmias (additive effects)

• disopyramide
Xcopri (cenobamate)

+

disopyramide

1 interaction

Monitor/Modify Tx

cenobamate + disopyramide

monitor disopyramide levels: combo may decr. disopyramide levels, efficacy (hepatic metab. induced)

• doxercalciferol
Xcopri (cenobamate)

+

doxercalciferol

1 interaction

Monitor/Modify Tx

cenobamate + doxercalciferol

monitor calcium, iPTH: combo may alter doxercalciferol and active metabolite levels, efficacy (hepatic metab. induced, net effect on vitamin D activation/inactivation unknown)

• droperidol
Xcopri (cenobamate)

+

droperidol

1 interaction

Monitor/Modify Tx

cenobamate + droperidol

decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• esketamine
Xcopri (cenobamate)

+

esketamine

1 interaction

Monitor/Modify Tx

cenobamate + esketamine

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• esomeprazole
Xcopri (cenobamate)

+

esomeprazole

1 interaction

Monitor/Modify Tx

cenobamate + esomeprazole

consider decr. esomeprazole dose if dose >40 mg, especially if also combined w/ a CYP3A4 inhibitor: combo may incr. esomeprazole levels, risk of adverse effects (hepatic metab. inhibited)

• estazolam
Xcopri (cenobamate)

+

estazolam

1 interaction

Monitor/Modify Tx

cenobamate + estazolam

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• eszopiclone
Xcopri (cenobamate)

+

eszopiclone

1 interaction

Monitor/Modify Tx

cenobamate + eszopiclone

consider decr. dose of one or both drugs: combo may decr. eszopiclone levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• ethanol (in some formulations)
Xcopri (cenobamate)

+

ethanol (in some formulations)

1 interaction

Monitor/Modify Tx

cenobamate + ethanol (in some formulations)

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• ethosuximide
Xcopri (cenobamate)

+

ethosuximide

1 interaction

Monitor/Modify Tx

cenobamate + ethosuximide

monitor ethosuximide levels: combo may decr. ethosuximide levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• etomidate
Xcopri (cenobamate)

+

etomidate

1 interaction

Monitor/Modify Tx

cenobamate + etomidate

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• fexinidazole
Xcopri (cenobamate)

+

fexinidazole

1 interaction

Monitor/Modify Tx

cenobamate + fexinidazole

monitor ECG: combo may incr. fexinidazole active metabolite levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. induced, incr. conversion to active metabolites)

• flibanserin
Xcopri (cenobamate)

+

flibanserin

1 interaction

Monitor/Modify Tx

cenobamate + flibanserin

monitor BP: combo may incr. or decr. flibanserin levels, incr. risk of CNS depression, psychomotor impairment, severe hypotension (incl. syncope), other adverse effects or decr. efficacy (hepatic metab. altered, additive effects)

• fludrocortisone
Xcopri (cenobamate)

+

fludrocortisone

1 interaction

Monitor/Modify Tx

cenobamate + fludrocortisone

consider fludrocortisone dose adjustment: combo may decr. fludrocortisone levels, efficacy (hepatic metab. induced)

• fluphenazine
Xcopri (cenobamate)

+

fluphenazine

1 interaction

Monitor/Modify Tx

cenobamate + fluphenazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, fluphenazine may decr. seizure threshold)

• flurazepam
Xcopri (cenobamate)

+

flurazepam

1 interaction

Monitor/Modify Tx

cenobamate + flurazepam

monitor resp. rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• fosphenytoin
Xcopri (cenobamate)

+

fosphenytoin

1 interaction

Monitor/Modify Tx

cenobamate + fosphenytoin

monitor phenytoin levels, gradually decr. phenytoin dose up to 50% during cenobamate initiation/titration: combo may incr. phenytoin levels, risk of toxicity; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. inhibited; additive effects)

• gabapentin
Xcopri (cenobamate)

+

gabapentin

1 interaction

Monitor/Modify Tx

cenobamate + gabapentin

monitor resp. rate: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• gabapentin enacarbil
Xcopri (cenobamate)

+

gabapentin enacarbil

1 interaction

Monitor/Modify Tx

cenobamate + gabapentin enacarbil

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• guanfacine
Xcopri (cenobamate)

+

guanfacine

1 interaction

Monitor/Modify Tx

cenobamate + guanfacine

consider incr. guanfacine ER dose up to double, consider incr. dose for immed.-release form: combo may decr. guanfacine levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• haloperidol
Xcopri (cenobamate)

+

haloperidol

1 interaction

Monitor/Modify Tx

cenobamate + haloperidol

consider haloperidol dose adjustment: combo may decr. haloperidol levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, haloperidol may decr. seizure threshold)

• hydrocortisone
Xcopri (cenobamate)

+

hydrocortisone

1 interaction

Monitor/Modify Tx

cenobamate + hydrocortisone

consider hydrocortisone dose adjustment: combo may decr. hydrocortisone levels, efficacy (hepatic metab. induced)

• hydromorphone
Xcopri (cenobamate)

+

hydromorphone

1 interaction

Monitor/Modify Tx

cenobamate + hydromorphone

monitor resp. rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• hydroxyzine
Xcopri (cenobamate)

+

hydroxyzine

1 interaction

Monitor/Modify Tx

cenobamate + hydroxyzine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ifosfamide
Xcopri (cenobamate)

+

ifosfamide

1 interaction

Monitor/Modify Tx

cenobamate + ifosfamide

monitor CBC, renal, cardiac fxn; consider ifosfamide dose adjustment; D/C one or both drugs if encephalopathy occurs: combo may incr. ifosfamide active and toxic metabolite levels, risk of myelosuppression, serious infection, encephalopathy, nephrotoxicity, cardiotoxicity, other adverse effects; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced, incr. metabolite formation; additive effects; antagonistic effects, ifosfamide may decr. seizure threshold)

• imipramine
Xcopri (cenobamate)

+

imipramine

1 interaction

Monitor/Modify Tx

cenobamate + imipramine

monitor imipramine levels: combo may decr. imipramine levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, imipramine may decr. seizure threshold)

• isoflurane
Xcopri (cenobamate)

+

isoflurane

1 interaction

Monitor/Modify Tx

cenobamate + isoflurane

monitor resp. rate: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• ketamine
Xcopri (cenobamate)

+

ketamine

1 interaction

Monitor/Modify Tx

cenobamate + ketamine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression (incl. life-threatening), psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, ketamine may decr. seizure threshold)

• lamotrigine
Xcopri (cenobamate)

+

lamotrigine

1 interaction

Monitor/Modify Tx

cenobamate + lamotrigine

consider lamotrigine dose adjustment: combo may decr. lamotrigine levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (mechanism unknown; additive effects)

• lapatinib
Xcopri (cenobamate)

+

lapatinib

1 interaction

Monitor/Modify Tx

cenobamate + lapatinib

consider lapatinib dose adjustment: combo may decr. lapatinib levels, efficacy (hepatic metab. induced)

• levorphanol
Xcopri (cenobamate)

+

levorphanol

1 interaction

Monitor/Modify Tx

cenobamate + levorphanol

monitor resp. rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, levorphanol may decr. seizure threshold)

• lorazepam
Xcopri (cenobamate)

+

lorazepam

1 interaction

Monitor/Modify Tx

cenobamate + lorazepam

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• lurasidone
Xcopri (cenobamate)

+

lurasidone

1 interaction

Monitor/Modify Tx

cenobamate + lurasidone

consider lurasidone dose adjustment: combo may decr. lurasidone levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, lurasidone may decr. seizure threshold)

• macimorelin
Xcopri (cenobamate)

+

macimorelin

1 interaction

Monitor/Modify Tx

cenobamate + macimorelin

D/C cenobamate, allowing sufficient washout time before diagnostic test: combo may decr. macimorelin levels, result in false positive test (hepatic metab. induced)

• methohexital
Xcopri (cenobamate)

+

methohexital

1 interaction

Monitor/Modify Tx

cenobamate + methohexital

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• mirtazapine
Xcopri (cenobamate)

+

mirtazapine

1 interaction

Monitor/Modify Tx

cenobamate + mirtazapine

consider decr. dose of one or both drugs: combo may decr. mirtazapine levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, mirtazapine may decr. seizure threshold)

• morphine
Xcopri (cenobamate)

+

morphine

1 interaction

Monitor/Modify Tx

cenobamate + morphine

monitor resp. rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, morphine may decr. seizure threshold)

• nalbuphine
Xcopri (cenobamate)

+

nalbuphine

1 interaction

Monitor/Modify Tx

cenobamate + nalbuphine

monitor resp. rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, nalbuphine may decr. seizure threshold)

• nelarabine
Xcopri (cenobamate)

+

nelarabine

1 interaction

Monitor/Modify Tx

cenobamate + nelarabine

withhold nelarabine if Grade 2 or greater somnolence occurs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, nelarabine may decr. seizure threshold)

• nimodipine
Xcopri (cenobamate)

+

nimodipine

1 interaction

Monitor/Modify Tx

cenobamate + nimodipine

monitor BP: combo may decr. nimodipine levels, efficacy (hepatic metab. induced)

• nortriptyline
Xcopri (cenobamate)

+

nortriptyline

1 interaction

Monitor/Modify Tx

cenobamate + nortriptyline

monitor nortriptyline levels: combo may decr. nortriptyline levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, nortriptyline may decr. seizure threshold)

• olanzapine
Xcopri (cenobamate)

+

olanzapine

1 interaction

Monitor/Modify Tx

cenobamate + olanzapine

monitor BP: combo may incr. risk of CNS depression, psychomotor impairment, hypotension, incl. orthostasis; may alter seizure control (additive effects; antagonistic effects, olanzapine may decr. seizure threshold)

• omeprazole
Xcopri (cenobamate)

+

omeprazole

1 interaction

Monitor/Modify Tx

cenobamate + omeprazole

consider decr. omeprazole dose if dose >40 mg, especially if also combined w/ a CYP3A4 inhibitor: combo may incr. omeprazole levels, risk of adverse effects (hepatic metab. inhibited)

• opicapone
Xcopri (cenobamate)

+

opicapone

1 interaction

Monitor/Modify Tx

cenobamate + opicapone

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• opium
Xcopri (cenobamate)

+

opium

1 interaction

Monitor/Modify Tx

cenobamate + opium

monitor resp. rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, morphine in opium may decr. seizure threshold)

• oxazepam
Xcopri (cenobamate)

+

oxazepam

1 interaction

Monitor/Modify Tx

cenobamate + oxazepam

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• oxybutynin
Xcopri (cenobamate)

+

oxybutynin

1 interaction

Monitor/Modify Tx

cenobamate + oxybutynin

decr. dose of one or both drugs or consider oxybutynin transdermal patch: combo may incr. risk of CNS depression, psychomotor impairment; somnolence less likely w/ oxybutynin transdermal patch (additive effects)

• oxymorphone
Xcopri (cenobamate)

+

oxymorphone

1 interaction

Monitor/Modify Tx

cenobamate + oxymorphone

monitor resp. rate; decr. oxymorphone start dose by at least 50%, consider decr. cenobamate dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, oxymorphone may decr. seizure threshold)

• pentazocine
Xcopri (cenobamate)

+

pentazocine

1 interaction

Monitor/Modify Tx

cenobamate + pentazocine

monitor resp. rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, pentazocine may decr. seizure threshold)

• pentobarbital
Xcopri (cenobamate)

+

pentobarbital

1 interaction

Monitor/Modify Tx

cenobamate + pentobarbital

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• perampanel
Xcopri (cenobamate)

+

perampanel

1 interaction

Monitor/Modify Tx

cenobamate + perampanel

incr. perampanel start dose to 4 mg/day: combo may decr. perampanel levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• perphenazine
Xcopri (cenobamate)

+

perphenazine

1 interaction

Monitor/Modify Tx

cenobamate + perphenazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, perphenazine may decr. seizure threshold)

• phenobarbital
Xcopri (cenobamate)

+

phenobarbital

1 interaction

Monitor/Modify Tx

cenobamate + phenobarbital

monitor ECG, resp. rate, phenobarbital levels if seizure disorder use: combo may incr. phenobarbital levels, risk of CNS and resp. depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metab. possibly inhibited, additive effects)

• phenytoin
Xcopri (cenobamate)

+

phenytoin

1 interaction

Monitor/Modify Tx

cenobamate + phenytoin

monitor phenytoin levels, gradually decr. phenytoin dose up to 50% during cenobamate initiation/titration: combo may incr. phenytoin levels, risk of toxicity; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. inhibited; additive effects)

• pregabalin
Xcopri (cenobamate)

+

pregabalin

1 interaction

Monitor/Modify Tx

cenobamate + pregabalin

monitor resp. rate: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• primidone
Xcopri (cenobamate)

+

primidone

1 interaction

Monitor/Modify Tx

cenobamate + primidone

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• propofol
Xcopri (cenobamate)

+

propofol

1 interaction

Monitor/Modify Tx

cenobamate + propofol

monitor resp. rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, propofol may decr. seizure threshold)

• quazepam
Xcopri (cenobamate)

+

quazepam

1 interaction

Monitor/Modify Tx

cenobamate + quazepam

monitor resp. rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• quetiapine
Xcopri (cenobamate)

+

quetiapine

1 interaction

Monitor/Modify Tx

cenobamate + quetiapine

consider quetiapine dose adjustment: combo may decr. quetiapine levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, quetiapine may decr. seizure threshold)

• quinidine (antiarrhythmic)
Xcopri (cenobamate)

+

quinidine (antiarrhythmic)

1 interaction

Monitor/Modify Tx

cenobamate + quinidine (antiarrhythmic)

monitor quinidine levels: combo may decr. quinidine levels, efficacy (hepatic metab. induced)

• remifentanil
Xcopri (cenobamate)

+

remifentanil

1 interaction

Monitor/Modify Tx

cenobamate + remifentanil

monitor resp. rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, remifentanil may decr. seizure threshold)

• remimazolam
Xcopri (cenobamate)

+

remimazolam

1 interaction

Monitor/Modify Tx

cenobamate + remimazolam

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• repaglinide
Xcopri (cenobamate)

+

repaglinide

1 interaction

Monitor/Modify Tx

cenobamate + repaglinide

monitor glucose: combo may decr. repaglinide levels, efficacy (hepatic metab. induced)

• rufinamide
Xcopri (cenobamate)

+

rufinamide

1 interaction

Monitor/Modify Tx

cenobamate + rufinamide

monitor ECG: combo may incr. risk of shortened QT interval, cardiac arrhythmias, CNS depression, psychomotor impairment (additive effects)

• sevoflurane
Xcopri (cenobamate)

+

sevoflurane

1 interaction

Monitor/Modify Tx

cenobamate + sevoflurane

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, sevoflurane may decr. seizure threshold)

• sildenafil
Xcopri (cenobamate)

+

sildenafil

1 interaction

Monitor/Modify Tx

cenobamate + sildenafil

PULMONARY HTN: consider sildenafil dose adjustment; ED: caution advised: combo may decr. sildenafil levels, efficacy (hepatic metab. induced)

• sirolimus
Xcopri (cenobamate)

+

sirolimus

1 interaction

Monitor/Modify Tx

cenobamate + sirolimus

monitor sirolimus levels: combo may decr. sirolimus levels, efficacy (hepatic metab. induced)

• stiripentol
Xcopri (cenobamate)

+

stiripentol

1 interaction

Monitor/Modify Tx

cenobamate + stiripentol

consider stiripentol dose adjustment: combo may decr. stiripentol levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. possibly induced; additive effects)

• suvorexant
Xcopri (cenobamate)

+

suvorexant

1 interaction

Monitor/Modify Tx

cenobamate + suvorexant

consider dose adjustment of one or both drugs: combo may decr. suvorexant levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• tacrolimus
Xcopri (cenobamate)

+

tacrolimus

1 interaction

Monitor/Modify Tx

cenobamate + tacrolimus

monitor tacrolimus levels: combo may decr. tacrolimus levels, efficacy; may alter seizure control (hepatic metab. induced; antagonistic effects, tacrolimus may decr. seizure threshold)

• tapentadol
Xcopri (cenobamate)

+

tapentadol

1 interaction

Monitor/Modify Tx

cenobamate + tapentadol

monitor resp. rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, tapentadol may decr. seizure threshold)

• temazepam
Xcopri (cenobamate)

+

temazepam

1 interaction

Monitor/Modify Tx

cenobamate + temazepam

monitor resp. rate: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• temsirolimus
Xcopri (cenobamate)

+

temsirolimus

1 interaction

Monitor/Modify Tx

cenobamate + temsirolimus

consider temsirolimus dose adjustment: combo may decr. temsirolimus and active metabolite sirolimus levels, efficacy (hepatic metab. induced)

• thioridazine
Xcopri (cenobamate)

+

thioridazine

1 interaction

Monitor/Modify Tx

cenobamate + thioridazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, thioridazine may decr. seizure threshold)

• thiothixene
Xcopri (cenobamate)

+

thiothixene

1 interaction

Monitor/Modify Tx

cenobamate + thiothixene

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, thiothixene may decr. seizure threshold)

• tiagabine
Xcopri (cenobamate)

+

tiagabine

1 interaction

Monitor/Modify Tx

cenobamate + tiagabine

consider tiagabine dose adjustment if not on concurrent enzyme-inducing AEDs; titrate tiagabine dose to effect if already on enzyme-inducing AEDs: combo may decr. tiagabine levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; further induction possible if on concurrent enzyme-inducing AEDs; additive effects)

• triazolam
Xcopri (cenobamate)

+

triazolam

1 interaction

Monitor/Modify Tx

cenobamate + triazolam

monitor resp. rate: combo may decr. triazolam levels, efficacy; may incr. risk of CNS and resp. depression, psychomotor impairment (hepatic metab. induced; additive effects)

• ubrogepant
Xcopri (cenobamate)

+

ubrogepant

1 interaction

Monitor/Modify Tx

cenobamate + ubrogepant

increase ubrogepant dose to 100 mg, may give second 100 mg dose after 2h if needed: combo may decr. ubrogepant levels, efficacy (hepatic metab. induced)

• vilazodone
Xcopri (cenobamate)

+

vilazodone

1 interaction

Monitor/Modify Tx

cenobamate + vilazodone

consider vilazodone dose adjustment: combo may decr. vilazodone levels, efficacy; may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (hepatic metab. induced; additive effects; antagonistic effects, vilazodone may decr. seizure threshold)

• vortioxetine
Xcopri (cenobamate)

+

vortioxetine

1 interaction

Monitor/Modify Tx

cenobamate + vortioxetine

consider vortioxetine dose adjustment: combo may decr. vortioxetine levels, efficacy (hepatic metab. induced)

• warfarin
Xcopri (cenobamate)

+

warfarin

1 interaction

Monitor/Modify Tx

cenobamate + warfarin

monitor INR: combo may decr. warfarin levels, efficacy (hepatic metab. induced)

• zaleplon
Xcopri (cenobamate)

+

zaleplon

1 interaction

Monitor/Modify Tx

cenobamate + zaleplon

consider decr. dose of one or both drugs: combo may decr. zaleplon levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)

• ziconotide
Xcopri (cenobamate)

+

ziconotide

1 interaction

Monitor/Modify Tx

cenobamate + ziconotide

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• zolpidem
Xcopri (cenobamate)

+

zolpidem

1 interaction

Monitor/Modify Tx

cenobamate + zolpidem

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may decr. zolpidem levels, efficacy (additive effects; hepatic metab. induced)

• zonisamide
Xcopri (cenobamate)

+

zonisamide

1 interaction

Monitor/Modify Tx

cenobamate + zonisamide

consider zonisamide dose adjustment: combo may decr. zonisamide levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metab. induced; additive effects)