Two medicines, side by side

Cenobamate vs lamotrigine

Cenobamate and lamotrigine are both labeled for seizures and epilepsy. Drugs@FDA records approvals of cenobamate since 2019 and of lamotrigine since 1994. Pharmacies paid $39.87 per Xcopri 100 mg tablet and $0.0268 per lamotrigine 25 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. Lamotrigine's other strengths are brand-only: $2.86 per mL (Subvenite 10 mg/mL suspension). Only the lamotrigine label carries a boxed warning.

Check it at the source: the cenobamate FDA label on DailyMed (effective August 25, 2025); the lamotrigine FDA label on DailyMed (effective October 10, 2025).

Highlights of the cenobamate record

Cenobamate (Xcopri) · label of August 25, 2025

Used for

From the label: indications
XCOPRI 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 lamotrigine record

Lamotrigine (Lamictal) · label of October 10, 2025

Boxed warning

SERIOUS SKIN RASHES LAMICTAL can cause serious rashes requiring hospitalization and discontinuation of treatment. The incidence of these rashes, which have included Stevens-Johnson syndrome, is approximately 0.3% to 0.8% in pediatric patients (aged 2 to 17 years) and 0.08% to 0.3% in adults receiving LAMICTAL. One rash-related death was reported in a prospectively followed cohort of 1,983 pediatric patients (aged 2 to 16 years) with epilepsy taking LAMICTAL as adjunctive therapy.

Used for

From the label: indications
LAMICTAL is indicated for: Epilepsy–adjunctive therapy in patients aged 2 years and older: • partial-onset seizures. • primary generalized tonic-clonic (PGTC) seizures. • generalized seizures of Lennox-Gastaut syndrome. […]

On the market

Earliest approval on file: December 27, 1994
Generic labelers: 49 labelers
Pharmacy cost: $0.0268 per tablet

Supply and safety

Shortage: A presentation being discontinued
Recalls: 10

Source: FDA drug labels via openFDA (Cenobamate label of August 25, 2025, Lamotrigine label of October 10, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do cenobamate and lamotrigine differ on the record?

Only the lamotrigine 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.”; Lamotrigine, “The precise mechanism(s) by which lamotrigine exerts its anticonvulsant action are unknown.”

Generics: cenobamate none approved; lamotrigine since 2006 (Drugs@FDA).

DEA schedule: cenobamate CV; lamotrigine none.

	Cenobamate	Lamotrigine
Labeled for	Seizures and epilepsy	Seizures and epilepsy, Bipolar disorder
Pharmacologic class	n/a	Anti-epileptic Agent, Mood Stabilizer
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.	The precise mechanism(s) by which lamotrigine exerts its anticonvulsant action are unknown.
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.	n/a
Earliest approval on file (Drugs@FDA)	November 21, 2019	December 27, 1994
First generic approved	none	June 21, 2006
Generic labelers (NDC)	none listed	49 labelers
Pharmacy cost (NADAC, each one's most listed form; strengths differ)	$39.87 per tablet (Xcopri 100 mg tablet)	$0.0268 per tablet (Lamotrigine 25 mg tablet)
12-month price change	+3%	-12%
Boxed warning	No	Yes
Shortage now	No current entry	A presentation being discontinued
Recalls recorded	0	10
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)	8,296	130,994
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)

Do their labels mention each other?

Cenobamate label, drug interactions
Reduce dosage as needed when used concomitantly with XCOPRI. ( 7.1 ) Lamotrigine, Carbamazepine:

Source: FDA drug labels via openFDA

What do the labels say about using others of their kind?

Cenobamate label, drug interactions
Depressants 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?

Cenobamate: the full record
Lamotrigine: the full record
Alternatives to cenobamate: every medicine labeled for the same conditions