Ezogabine (Oral)

Ezogabine is used together with other medications to treat patients with epilepsy. The drug helps to control partial seizures.

Overview

In the US, ezogabine is known by the brand name, Potiga. The drug is given in tablet form and is only obtainable through prescription from your treating physician.

Ezogabine is used in combination with certain other drugs in order to regulate the partial focal seizures that are suffered by patients who have epilepsy. This medication is one of a group of drugs called anticonvulsants. The medicine works by acting on the brain, effectively preventing the spread of seizure activity. Ezogabine will not cure epilepsy and will only continue to be effective while you are taking your prescribed dosage.

It should be noted that ezogabine can cause visual changes and should therefore only be used when other drugs have failed to be effective in controlling seizures.

Conditions treated

  • Focal epileptic seizures

Type of medicine

  • Anticonvulsant
  • Tablet

Side effects

In addition to the effects that ezogabine is designed to have, it may cause a number of unwanted effects in some patients. You may not notice any of these effects, but if they do appear, you may need to seek medical attention.

You should consult your GP straight away if you notice any of the following effects:

  • Vomiting
  • Unexpected weight gain or loss
  • Feeling unusually tired or weak
  • Unusual bruising or bleeding
  • Tingling of the feet and hands
  • Tightness of the chest
  • Swollen glands
  • Stiff neck
  • White spots, sores, ulcers, on the lips or in the mouth
  • Sore throat
  • Shakiness in the hands, legs, arms, or feet
  • Rhythmic muscle movement
  • Rapid weight gain
  • Red pinpoint skin spots
  • Painful urination
  • Pain in the side or lower back
  • Muscle jerking or twitching
  • Loss of consciousness
  • Irritability
  • Headaches
  • General feeling of discomfort or being unwell
  • Fever
  • Fainting
  • Drowsiness
  • Dizziness
  • Difficult urination
  • Difficult or labored breathing
  • Decrease in the urine volume or frequency
  • Cough
  • Confusion
  • Cloudy urine
  • Chills
  • Chest pain
  • Change in consciousness
  • Feelings of crawling, burning, itching, prickling, numbness, tingling, or "pins and needles" on the skin
  • Burning sensation while urinating
  • Blurred vision
  • Blood in the urine
  • Swelling or bloating of the face, hands, arms, feet, or lower legs
  • Bleeding gums
  • Black, tarry stools
  • Back pain
  • Agitation

Ezogabine can cause some side effects that generally resolve themselves, without the need for further medical assistance, once your body gets used to the new medicine. Your doctor should be able to recommend ways of preventing or managing some of these effects. However, you should check with your GP if the following effects persist or if they are especially troublesome:

  • Weight gain
  • Unusual behavior
  • Uncontrolled eye movement
  • Problems with walking
  • Trouble sleeping
  • Sweating
  • Stomach upset, discomfort, or pain
  • Slurred speech
  • Sleepiness or unusual drowsiness
  • Shivering
  • Severe mood or mental changes
  • Sensation of spinning
  • Seeing double
  • Runny nose
  • Rash
  • Problems with speaking or speech
  • Muscle spasms
  • Muscle aches and pains
  • Memory loss
  • Poor appetite
  • Loss or lack of strength
  • Joint pain
  • Indigestion
  • Increased sweating
  • Increased appetite
  • Heartburn
  • Hair loss or thinning
  • Hallucinating
  • Paranoia
  • Feeling of constant movement of self or surroundings
  • False sense of wellbeing
  • Dry mouth
  • Double vision
  • Dizziness or lightheadedness
  • Difficulty swallowing
  • Constipation
  • Diarrhea
  • Cough
  • Confusion about place, time, or identity
  • Being clumsy or unsteady
  • Changes in speech rhythm and patterns
  • Belching
  • Being forgetful
  • Sour or acid stomach
  • Lack or loss of bodily activity

The list of side effects that may be caused by ezogabine included in this guide is not exhaustive. If you notice any other effects, you should mention them to your doctor.

Dosage

You should take ezogabine only as you are told to by your GP. Do not take more or less of the medication, take it more frequently, or over a longer period of time than you have been told to.

Be sure to read the medication guide that you will be given with your prescription and follow the instructions that it contains.

You can take your tablets with or without a meal or just with water if you prefer. Do not crush, chew, or break the tablets; swallow them whole.

In order to reduce the risk of side effects, your GP may start your course of treatment with a low dose, which will gradually be increased. Follow your GP's directions carefully. Do not suddenly stop taking ezogabine unless your doctor tells you to, as this could cause your seizures to become worse.

This medicine is most effective if it is present in constant levels in your body. It is therefore important that you take the drug at regular intervals, preferably at the same times each day.

Note that ezogabine can sometimes be addictive. This risk is increased in people who have a history of substance abuse. Take the medication exactly as prescribed to avoid the risk of addiction.

If you think that your condition is not improving or if you begin to feel worse, tell your treating physician immediately.

The dose of this medication will vary between patients. The information that follows is based on the typical average dose only. If your dose is not the same as this, do not change it unless your treating physician instructs you to do so. Your dose will depend on the potency of the tablets. The amount of medicine, the frequency of use, and the duration of your course will all be determined by the condition for which you are being treated and on how responsive your body is to the drug.

For the prevention and control of focal seizures:

  • Adults: Initially, take 100 mg three times daily. This may be adjusted by your GP as required. You would not normally expect to take in excess of 400 mg three times daily.
  • Older adults: Initially, take 50 mg three times daily. This may be adjusted by your GP as required. You would not normally expect to take in excess of 250 mg three times daily.
  • Children: Your child's doctor will calculate the use and dose of ezogabine for your child.

If you miss one of your doses, try to take it right away. However, if it's nearly time for the next one, omit the forgotten dose and revert to your usual schedule. Do not take twice the amount of medication to try to catch up.

This medication should only be taken if prescribed by a doctor. Do not share your ezogabine tablets with anyone else.

Interactions

Some medicines must never be used in combination, as doing so could result in a nasty interaction between them. In other cases, it may be appropriate to use multiple drugs together, but at an adjusted dose rate or frequency. Be sure to tell your GP if you are using any other medications, including other prescription drugs, over the counter products, vitamin or herbal preparations.

It is not advisable to take ezogabine at the same time as using any of the drugs listed below, although your GP may decide that this is necessary in your case. You may find that the dose or usage instructions for one or more of these medicines is changed:

  • Phenytoin
  • Orlistat
  • Lamotrigine
  • Fosphenytoin
  • Carbamazepine
  • Calcifediol

Some drugs should not be used when you are eating certain foods, drinking alcohol, or smoking tobacco. This is an aspect of your treatment that should be discussed with your doctor before you begin taking ezogabine tablets.

You should not drink alcohol with ezogabine, as doing so can cause unwanted side effects. The use of ethanol should also be avoided.

Medical interactions

Some existing or historical health problems can affect your use of ezogabine. You must discuss your medical history fully with your GP before you begin using this drug.

Ezogabine should be used with caution in patients who have any of the following conditions, as side effects may be exacerbated:

  • Hypomagnesemia (low magnesium in the blood
  • Hypokalemia (low potassium in the blood)
  • Congestive heart failure

It is not recommended that patients with any of the conditions listed below use ezogabine, as doing so may make these conditions worse:

It should be noted that patients with kidney or liver disease may experience increased effects of ezogabine, because of the slower removal of the drug from the body.

Warnings

Before you begin using ezogabine, it is important that you are fully appraised of the benefits and risks of doing so. For this reason, it is important that you discuss this with your treating physician.

If you have any known allergies to this or any other medication, including non-prescription products, you must notify your GP. You should also allude to any bad reactions that you have had to food preservatives, colorant, animal derivatives, or particular food groups.

Throughout the time that you are using ezogabine, you should attend your doctor for regular updates. These appointments will be used by your GP to check that the drug is working properly and that you are not suffering from any unwanted effects.

Geriatric

There are no specific studies into the effects of ezogabine on elderly patients. However, geriatric patients are more likely to suffer from age-related kidney and prostate conditions, meaning that the dose of this drug may need adjustment accordingly.

Pregnancy and breastfeeding

Ezogabine should only be used by pregnant women when clearly needed. Untreated are a serious condition that can be very harmful to both the pregnant woman and to the fetus. However, if you are pregnant, you should tell your GP before you start taking this drug so that the risks and benefits of doing so can be discussed fully.

There is no evidence to show that ezogabine could pass into breast milk where it could present a danger to a nursing infant. However, you may wish to discuss the pros and cons of with your GP or midwife if you are currently breastfeeding.

Medical conditions

If you notice that your vision has changed or that your vision is blurred while you are taking ezogabine, you should tell your GP. You may be referred to an ophthalmologist for an eye check.

Some patients taking ezogabine experience problems with urinating. If you have difficulty emptying your bladder or find urination painful, check with your GP right away.

Long term use of ezogabine can cause your nails, lips, skin, eyes, or mouth to develop a brown or blue color. If you notice this phenomenon, tell your GP immediately.

Some patients experience mental changes while taking ezogabine. If you experience any of the following effects, tell your treating physician immediately:

  • Feeling sad or hopeless
  • Becoming easily upset
  • Feeling very nervous, agitated, or aggressive
  • Having suicidal thoughts
  • Depression

Some patients find that taking ezogabine makes them feel drowsy or dizzy and causes visual disturbances. If you are affected in this way, refrain from driving, operating machinery, or taking part in any other potentially dangerous activities. If these effects persist, talk to your doctor.

Tell your doctor right away if you begin to experience any signs that could indicate a heart problem, including:

  • Dizziness
  • Feeling faint
  • Fast, pounding or irregular heartbeat

You should also mention if anyone in your family has a history of heart rhythm problems, such as QT prolongation.

Note that stopping taking ezogabine suddenly can cause an increase in your seizures. If you have been told to stop using this medicine, your doctor will explain to you how to gradually reduce the dose.

You should not use any other medication unless you have discussed its use first with your doctor. This also includes over the counter medicines, vitamin supplements, and herbal remedies.

Storage

Your prescription of ezogabine tablets should be kept in their original container and at room temperature. Do not place the tablets near to sources of heat or in a place where they could be exposed to the sun. Do not freeze or refrigerate the tablets.

Make sure that children and pets cannot gain access to the tablets. If a pet does eat any of your ezogabine medication, you should contact your vet immediately.

Do not use any tablets that appear to be damaged or whose packaging has been interfered with. Do not use any drugs that are out of date.

Dispose of any unwanted medication carefully. Place the tablets in a bag, seal it, and place it at the bottom of your trash can where it cannot be reached by children or pets. Do not throw the tablets down the toilet or drain.

Summary

Ezogabine is an anticonvulsant drug that is often used in combination with some other drugs in order to control the focal seizures that are suffered by patients with epilepsy. The drug acts on the brain, controlling the spread of seizure activity and helping to reduce the severity and number of seizures that are suffered by the patient. Ezogabine will not cure your epilepsy, but it will be effective in controlling some of the side effects of the condition.

Ezogabine can cause interference with vision, and it is therefore usually only used as a last resort when other medicines have not proven effective in managing epileptic convulsions.

Although there are only a small number of drugs that should not be used with ezogabine, there are many medical conditions that can be affected by its use. This medication can also cause a wide range of unpleasant side effects. It is therefore important that patients discuss the risks and benefits of using the drug with their GP. A full disclosure of your medical history is also essential.

Throughout the course of your treatment, you must attend your doctor for regular reviews to make sure that the drug is doing its job properly and to discuss any side effects that it may be causing.