Xcopri (cenobamate) is a prescription drug that’s prescribed for adults to treat focal onset seizures. These are also known as partial seizures. Xcopri comes as an oral tablet.
Xcopri basics
Xcopri contains the active ingredient cenobamate. (An active ingredient is what makes a drug work.) Xcopri belongs to a group of drugs called antiepileptics. It’s a brand-name drug that isn’t currently available in a generic version.
Xcopri is a Schedule V controlled substance, which means it carries a low risk of misuse or dependence. To learn more, see the “Can Xcopri cause withdrawal or dependence?” section below.
Like most drugs, Xcopri may cause mild or serious side effects. The lists below describe some of the more common side effects that Xcopri may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Xcopri. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects that Xcopri can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Xcopri’s prescribing information.
Mild side effects of Xcopri that have been reported include:
- drowsiness
- low energy
- dizziness
- headache
- weight loss
- decreased appetite
- dry mouth
- nausea and vomiting
- abdominal pain
- constipation or diarrhea
- changes in the way things taste
- increased liver enzymes
- mild allergic reaction*
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
* To learn more about this side effect, see the “Allergic reaction” section below.
Serious side effects
Serious side effects from Xcopri can occur, but they aren’t common. If you have serious side effects from Xcopri, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Xcopri that have been reported include:
- eye problems, such as double vision or uncontrolled eye movements
- severe drowsiness
- changes in neurologic (brain) function, which may lead to:
- confusion
- memory problems
- difficulty with balance and coordination
- decreased mental alertness
- difficulty speaking or understanding others
- changes in heart rhythm
- severe allergic reaction*
- suicidal thoughts or behaviors
* To learn more about this side effect, see the “Allergic reaction” section below.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Text Line at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Allergic reaction
Some people may have an allergic reaction to Xcopri.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
In rare cases, seizure drugs such as Xcopri can also cause a serious type of allergic reaction called drug reaction with eosinophilia and systemic symptoms (DRESS). Symptoms of this reaction can vary but may include:
- trouble breathing
- swelling of the face, lymph nodes, or lower legs
- skin rash
- dark urine
- fever
- yellowing of the skin or eyes
Call your doctor right away if you have an allergic reaction to Xcopri. Or if you think you’re having a medical emergency, call 911 or your local emergency number.
Whether you have health insurance or not, price may be a factor when you’re considering Xcopri. What you’ll pay for Xcopri may depend on several things, such as your treatment plan and the pharmacy you use.
Here are a few things to consider regarding cost:
- Cost information and savings coupons: You can visit Optum Perks* to get price estimates of what you’d pay for Xcopri when using coupons from the site.
- Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called SK Life Science Navigator may also be available.
You can check out this article to learn more about saving money on prescriptions.
* Optum Perks is a sister site of Healthline. Optum Perks coupons cannot be used with insurance copays or benefits.
Find answers to some commonly asked questions about Xcopri.
What is Xcopri’s mechanism of action (how does it work)?
It isn’t known how Xcopri works to treat focal onset seizures.
During a seizure, certain brain cells seem to be misfiring, sending out faulty electric signals repeatedly. This causes seizure symptoms, such as convulsions and muscle contractions.
Xcopri works by helping brain cells stop this erratic signaling. To learn more about how Xcopri works, talk with your doctor.
Does Xcopri’s manufacturer provide patient reviews?
Yes, you can find patient stories on the Xcopri website. On the site, you can also choose to share your experience taking Xcopri.
Taking Xcopri may decrease how often you experience seizures. But as with most drugs, individual results can vary. And it can take a while before you and your doctor find the dosage that effectively manages your seizures. If you have questions about what to expect with Xcopri treatment, talk with your doctor.
Your doctor will recommend the dosage of Xcopri that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Form and strengths
Xcopri comes as a tablet that you’ll swallow. It’s available in several strengths:
- 12.5 milligrams (mg)
- 25 mg
- 50 mg
- 100 mg
- 150 mg
- 200 mg
Recommended dosage
You’ll take Xcopri once daily. When you first start taking Xcopri, you’ll take a low dose. Then your doctor will increase your dose over time to reach the amount that’s right for you.
To learn more about Xcopri’s dosage, see this article.
Questions about taking Xcopri
Below are some common questions about taking Xcopri.
- Can Xcopri be chewed, crushed, or split? No. You should swallow the tablets whole. If you have trouble swallowing the tablets, ask your doctor or pharmacist for suggestions or whether they could recommend a different treatment.
- Should I take Xcopri with food? You can take Xcopri with or without food.
- Is there a best time of day to take Xcopri? No, there isn’t a best time of day to take Xcopri.
- What if I miss a dose of Xcopri? Contact your doctor right away. They’ll let you know what your next steps should be. It’s important not to miss any doses of Xcopri. Missing doses (or stopping the drug suddenly) could make your seizures more frequent or more severe.
- Will I need to use Xcopri long term? Probably. You’ll likely take Xcopri long term if the drug is effective for your condition, as long as you don’t develop severe or bothersome side effects.
- How long does Xcopri take to work? Xcopri starts working right away, but it may take a few weeks before you start having fewer seizures. This is because you’ll start with a low dose that will slowly increase over the first 12 weeks of treatment.
Overdose
Do not take more Xcopri than your doctor prescribes. Using more than this can lead to serious side effects.
What to do in case you take too much Xcopri
Call your doctor if you think you’ve taken too much Xcopri. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
Xcopri is prescribed to treat focal onset seizures (also called partial seizures) in adults. Taking Xcopri may decrease how often you experience these seizures.
With focal onset seizures, an abnormal surge of electrical activity begins in one area of the brain. The symptoms can vary depending on the area of the brain being affected.
Symptoms of focal seizures may include:
- convulsions
- muscle contractions
- tingling or numbness
- vision changes, such as blurred vision or seeing sparks of light
- unusual movements, such as staring into space or jerking motions
To learn more about taking Xcopri, talk with your doctor.
Below is important information you should consider before taking Xcopri.
Interactions
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before taking Xcopri, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Xcopri.
For information about drug-condition interactions, see the “Warnings” section below.
Drug interactions
Below is a list of medications that can interact with Xcopri. This list doesn’t contain all drugs that may interact with Xcopri. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
| Drug group or drug name | Drug examples |
| certain forms of hormonal birth control | • birth control pills, such as ethinyl estradiol/drospirenone (Yasmin, others) and ethinyl estradiol/norethindrone (Loestrin, others) • etonogestrel/ethinyl estradiol vaginal ring (NuvaRing, EluRyng) |
| certain other antiepileptic drugs | • phenytoin (Dilantin) • clobazam (Onfi, Sympazan) • lamotrigine (Lamictal) • carbamazepine (Tegretol, others) • rufinamide (Banzel) |
| drugs that cause drowsiness | • benzodiazepines, such as clonazepam (Klonopin) and diazepam (Valium, others) • sleeping pills, such as suvorexant (Belsomra) and zolpidem (Ambien and Ambien CR, others) |
Interaction with alcohol
Your doctor may recommend that you limit or avoid consuming alcohol while taking Xcopri. Drinking alcohol during your Xcopri treatment could raise your risk of certain side effects. These include severe drowsiness, difficulty with coordination, and decreased mental alertness.
If you drink alcohol, talk with your doctor about how much (if any) alcohol may be safe to drink while taking Xcopri.
Pregnancy and breastfeeding
It’s not known whether Xcopri is safe to take while pregnant or breastfeeding.
If you’re pregnant or can become pregnant, talk with your doctor. They can discuss your treatment options and the risks and benefits each may have if used during pregnancy.
If you and your doctor agree that you’ll take Xcopri while pregnant, consider joining the drug’s pregnancy registry. A pregnancy registry gathers information about the safety of taking drugs such as Xcopri during pregnancy. You can learn more or sign up on the registry website or by calling 888-233-2334.
If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Birth control
Xcopri may affect how well certain types of birth control work to prevent pregnancy. If you can become pregnant, talk with your doctor about which types of birth control are most effective during Xcopri treatment.
Warnings
Xcopri can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Xcopri is a good treatment option for you.
Talk with your doctor about your health history before you take Xcopri. Be sure to tell them if any of the following apply to you:
- kidney or liver problems
- mental health conditions
- familial short QT syndrome
- previous allergic reaction to Xcopri
- pregnancy
- breastfeeding
Other drugs are available that can treat focal onset seizures. If you’d like to explore an alternative to Xcopri, talk with your doctor. They can tell you about other medications that might work well for you.
The following drugs are similar to Xcopri:
Xcopri is a Schedule V controlled substance, which means it carries a low risk of misuse or dependence. Misuse refers to using a drug in a way other than how it was prescribed. With dependence, your body needs the drug to function as usual.
Also, suddenly stopping Xcopri treatment may cause withdrawal symptoms. Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on.
These withdrawal symptoms may include:
- insomnia (trouble sleeping)
- reduced appetite
- depression
- tremors
- memory problems
If your doctor recommends stopping Xcopri, they’ll gradually lower your dose to help prevent withdrawal symptoms.
If you have concerns about the risk of misuse, dependence, or withdrawal with Xcopri, talk with your doctor.
If you have questions about taking Xcopri, talk with your doctor or pharmacist. Questions you may want to ask include:
- How should Xcopri be stored?
- Should I continue taking my other medications with Xcopri?
- What alternatives could I try if Xcopri isn’t working for me?
To learn more about Xcopri dosage, see this article:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
