Two medicines, side by side
Cenobamate vs felbamate
Cenobamate and felbamate are both labeled for seizures and epilepsy. Drugs@FDA records approvals of cenobamate since 2019 and of felbamate since 1993. Pharmacies paid $39.87 per Xcopri 100 mg tablet and $1.00 per felbamate 600 mg tablet (NADAC, October 7, 2026); the strengths differ and one is a brand and one a generic, so the two prices are not like for like. Only the felbamate label carries a boxed warning.
Check it at the source: the cenobamate FDA label on DailyMed (effective August 25, 2025); the felbamate FDA label on DailyMed (effective August 15, 2025).
Highlights of the cenobamate record
Cenobamate (Xcopri) · label of August 25, 2025
Used for
From the label: indicationsXCOPRI is indicated for the treatment of partial-onset seizures in adult patients. XCOPRI is indicated for the treatment of partial-onset seizures in adult patients.
On the market
- Earliest approval on file
- November 21, 2019
- Generic labelers
- none listed
- Pharmacy cost
- $39.87 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Highlights of the felbamate record
Felbamate (Felbatol) · label of August 15, 2025
APLASTIC ANEMIA THE USE OF FELBATOL ® (felbamate) IS ASSOCIATED WITH A MARKED INCREASE IN THE INCIDENCE OF APLASTIC ANEMIA. ACCORDINGLY, FELBATOL ® SHOULD ONLY BE USED IN PATIENTS WHOSE EPILEPSY IS SO SEVERE THAT THE RISK OF APLASTIC ANEMIA IS DEEMED ACCEPTABLE IN LIGHT OF THE BENEFITS CONFERRED BY ITS USE (SEE INDICATIONS ). ORDINARILY, A PATIENT SHOULD NOT BE PLACED ON AND/OR CONTINUED ON FELBATOL ® WITHOUT CONSIDERATION OF APPROPRIATE EXPERT HEMATOLOGIC CONSULTATION.
Used for
From the label: indicationsFelbatol ® is not indicated as a first line antiepileptic treatment (see Warnings ). Felbatol ® is recommended for use only in those patients who respond inadequately to alternative treatments and whose epilepsy is so severe that a substantial risk of aplastic anemia and/or liver failure is deemed acceptable in light of the benefits conferred by its use. […]
On the market
- Earliest approval on file
- July 29, 1993
- Generic labelers
- 9 labelers
- Pharmacy cost
- $1.00 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Source: FDA drug labels via openFDA (Cenobamate label of August 25, 2025, Felbamate label of August 15, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do cenobamate and felbamate differ on the record?
Only the felbamate label carries a boxed warning.
How each works, in its label's words: Cenobamate, “Cenobamate has been demonstrated to reduce repetitive neuronal firing by inhibiting voltage-gated sodium currents.”; Felbamate, “Mechanism of Action The mechanism by which felbamate exerts its anticonvulsant activity is unknown, but in animal test systems designed to detect anticonvulsant activity, felbamate has properties in …”
Half-life, in each label's words: Cenobamate, “Elimination The apparent terminal half-life of cenobamate is 50-60 hours and apparent oral clearance is approximately …”; Felbamate, “Felbamate is excreted with a terminal half-life of 20-23 hours, which is unaltered after multiple doses.”
Generics: cenobamate none approved; felbamate since 2011 (Drugs@FDA).
DEA schedule: cenobamate CV; felbamate none.
| Cenobamate | Felbamate | |
|---|---|---|
| Labeled for | Seizures and epilepsy | Seizures and epilepsy |
| Pharmacologic class | n/a | Anti-epileptic Agent |
| How it works (label) | The precise mechanism by which cenobamate exerts its therapeutic effects in patients with partial-onset seizures is unknown. Cenobamate has been demonstrated to reduce repetitive neuronal firing by inhibiting voltage-gated sodium currents. | Mechanism of Action The mechanism by which felbamate exerts its anticonvulsant activity is unknown, but in animal test systems designed to detect anticonvulsant activity, felbamate has properties in common with other marketed … |
| Half-life (label) | Elimination The apparent terminal half-life of cenobamate is 50-60 hours and apparent oral clearance is approximately 0.45-0.63 L/hour over a dose range from 100 mg/day to 400 mg/day. | Felbamate is excreted with a terminal half-life of 20-23 hours, which is unaltered after multiple doses. |
| Earliest approval on file (Drugs@FDA) | November 21, 2019 | July 29, 1993 |
| First generic approved | none | September 13, 2011 |
| Generic labelers (NDC) | none listed | 9 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $39.87 per tablet (Xcopri 100 mg tablet) | $1.00 per tablet (Felbamate 600 mg tablet) |
| 12-month price change | +3% | -29% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 0 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 8,296 | 1,751 |
| DEA schedule | CV | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Cenobamate label, drug interactionsDepressants and Alcohol Concomitant use of XCOPRI with other CNS depressants, including alcohol, may increase the risk of neurological adverse reactions, including sedation and somnolence [see Warnings and Precautions ( 5.5 )].
Source: FDA drug labels via openFDA
What next?
- Alternatives to cenobamate
- every medicine labeled for the same conditions