Select therapeutic use:
Indications for POTIGA:
Adjunctive treatment of partial-onset seizures in patients with inadequate response to alternative treatments and for whom the benefits outweigh the risk of retinal abnormalities and potential decline in visual acuity.
Swallow whole. Give in 3 equally divided doses daily. ≥18yrs: initially 300mg/day for 1 week; titrate at weekly intervals by no more than 150mg/day up to a maintenance dose of 600–1200mg/day. Elderly (>65yrs) or hepatic impairment (Child-Pugh 7–9): initially 150mg/day; max 750mg/day. Hepatic impairment (Child-Pugh >9) or renal impairment (CrCl <50mL/min or ESRD on hemodialysis): initially 150mg/day; max 600mg/day. After hemodialysis: give supplemental dose; if breakthrough seizures occur near end of dialysis, consider additional dose at the start of subsequent sessions. See full labeling.
<18yrs: not established.
Risk of retinal abnormalities and potential vision loss, including macular abnormalities (vitelliform lesions) have occurred. Discontinue if no substantial clinical benefit seen after adequate titration. Test visual function at baseline and every 6 months; discontinue if retinal abnormalities or vision changes are detected unless no other available treatment options. Increased risk of urinary retention; monitor closely in patients with BPH, cognitively impaired, or concomitant medications that may affect voiding (eg, anticholinergics). Consider alternative therapy if skin discoloration develops. Monitor for neuropsychiatric symptoms (eg, confusional state, psychosis, hallucinations), dizziness, somnolence. Monitor QT interval in patients with known prolonged QT interval, CHF, ventricular hypertrophy, hypokalemia, or hypomagnesemia. Monitor for emergence or worsening of depression, suicidal thoughts/behavior, and/or unusual changes in mood or behavior. Avoid abrupt cessation; withdraw gradually over at least 3 weeks. Elderly (esp. in men). Pregnancy (Cat.C). Nursing mothers: not recommended.
Caution with drugs known to increase the QT interval. Plasma levels reduced by concomitant phenytoin or carbamazepine; consider increasing ezogabine dose. May potentiate digoxin; monitor. Increased exposure with alcohol; caution. May interfere in clinical lab assays of serum and urine bilirubin.
Potassium channel opener.
Dizziness, somnolence, fatigue, confusional state, vertigo, tremor, abnormal coordination, diplopia, attention disturbance, memory impairment, asthenia, blurred vision, gait disturbance, aphasia, dysarthria, balance disorder; retinal abnormalities, skin discoloration.
To enroll in the North American Antiepileptic Drug Pregnancy Registry call (888) 223-2334.