Rufinamide
Antiseizure medicines
Antiseizure medicines
A triazole antiseizure medicine used together with others for the many seizure types of Lennox-Gastaut syndrome. It can shorten the QT interval.
Quick facts
- Group
- Antiseizure medicines
- Target
- Voltage-gated sodium channels
- Used for
- Seizures of Lennox-Gastaut syndrome
- Key effects
- Sleepiness · Poor coordination and difficulty walking
- Monitor
- ECG if there is a heart rhythm risk · Fever
- ATC
- N03AF03
No doses: the clinician sets them by the current guideline.
Mechanism of action
Rufinamide is a triazole derivative unrelated in structure to other antiseizure medicines. It prolongs the slow inactivation of voltage-gated sodium channels and limits sustained repetitive firing; its complete mechanism is still unclear.
- Rufinamide prolongs Na⁺ channel slow inactivation
- Sustained repetitive firing is limited
- Fewer drop attacks and other LGS seizures
Indications
- Seizures of Lennox-Gastaut syndrome, as add-on treatment Epilepsy and seizures →
Adverse effects
Common
- Sleepiness, dizziness and headache
- Poor coordination and difficulty walking
- Nausea, vomiting and loss of appetite
- Nystagmus and tremor
Contraindications
- Familial short QT syndrome
Key interactions
- Hormonal contraceptives
- May work less well; another method is discussed
- Alcohol
- Worse side effects
What is monitored
- ECG if there is a heart rhythm risk
- Fever, rash and liver signs
- Seizure diary
- Mood and suicidal thoughts
Administration and safety
- Oral tablets that can be swallowed whole, split on the score or crushed; also an oral suspension
- Raised gradually
- Not stopped suddenly
Pregnancy and breastfeeding
Its safety in pregnancy is not established, and it can reduce hormonal contraceptive effect; family planning is discussed with the treating team.
Nursing care
- Ask about familial short QT syndrome before starting
- Watch for fever and rash in the first weeks
- Check gait and fall risk
- Advise on non-hormonal contraception when relevant
Pharmacokinetics
- Absorption
- Well absorbed by mouth
- Metabolism
- By carboxylesterases, not mainly by CYPs
- Elimination
- Metabolites in the urine
- Half-life
- Short; usually given twice a day
Test yourself
Think of the answer, then tap the question to see it.
Which epilepsy syndrome is rufinamide used for?
Lennox-Gastaut syndrome (as add-on treatment).
Which ECG change contraindicates rufinamide when inherited?
Familial short QT syndrome.
How does rufinamide act on sodium channels?
It prolongs their slow inactivation and limits sustained repetitive firing.
Connections
← Back to the class: Antiseizure medicines
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Rufinamide: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.