cenobamate vs lacosamide
Side-by-side comparison of cenobamate and lacosamide Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Xcopri
Vimpat
Xcopri is a medicine used to treat partial-onset seizures in adults. It works by reducing the irregular electrical activity in the brain that causes seizures.
Lacosamide is a medicine that can help control seizures. It is used to treat partial-onset seizures and primary generalized tonic-clonic seizures in people 4 years and older.
Xcopri is used to treat partial-onset seizures in adults. Partial-onset seizures start in one area of the brain. This medicine can help reduce how often you have seizures.
Lacosamide is used to treat partial-onset seizures in patients 4 years of age and older. It is also used with other medicines to treat primary generalized tonic-clonic seizures in patients 4 years of age and older. Seizures are caused by unusual electrical activity in the brain.
Xcopri helps to control seizures by affecting brain activity. It reduces the excitability of brain cells. This helps to prevent the spread of seizure activity.
Lacosamide is an anticonvulsant. It is thought to work by slowing down the electrical signals in the brain that cause seizures. This helps to reduce how often seizures happen.
- • Feeling sleepy
- • Dizziness
- • Feeling tired
- • Double vision
- • Headache
- • Double vision
- • Headache
- • Dizziness
- • Feeling sick to your stomach
- • Sleepiness
- Seizure 1,815
- Missed dose 1,263
- Tiredness 672
- Sleepiness 660
- Dizziness 537
- Seizure 6,507
- Medicine not working 3,936
- Using medicine for unapproved purpose 3,757
- Feeling dizzy 1,611
- Sleepiness 1,404
This medicine can cause a serious allergic reaction called DRESS, which can affect multiple organs. It can also cause liver problems. Tell your doctor right away if you have a fever, rash, swollen lymph nodes, or yellowing of your skin or eyes. Xcopri may cause you to have suicidal thoughts or behaviors. Watch for changes in your mood.
Lacosamide and other anti-seizure medicines may increase the risk of suicidal thoughts or actions. Tell your doctor right away if you have any new or worsening symptoms of depression, suicidal thoughts, or unusual changes in mood or behavior. Lacosamide can also cause heart rhythm problems. Get an ECG before starting and during treatment.
Tell your doctor if you are pregnant or plan to become pregnant. Xcopri may harm your unborn baby. There is a pregnancy registry for women who take anti-seizure medicines like Xcopri.
Lacosamide may harm an unborn baby. If you are pregnant or plan to become pregnant, talk to your doctor about the risks and benefits of taking lacosamide. There is a pregnancy registry for women who take anti-epileptic drugs like lacosamide.
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How to Read This cenobamate vs lacosamide Comparison
cenobamate is classified in the Anticonvulsant drug class, while lacosamide sits within the Anticonvulsant class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, cenobamate has 4,947 submissions while lacosamide has 17,215. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between cenobamate and lacosamide — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.