cenobamate
Brand names: Xcopri
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.
Drug Pricing (NADAC)
Brand Price
$37.71/unit
Generic Available
No
SK LIFE
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Xcopri is used to treat partial-onset seizures in adults.
Common side effects
Feeling sleepy, Dizziness, Feeling tired
Key warnings
This medicine can cause a serious allergic reaction called DRESS, which can affect multiple organs.
How It Works
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.
How to Take It
Take Xcopri once a day by mouth, with or without food. Start with a low dose of 12.5 mg each day. Your doctor will slowly increase the dose every two weeks. Do not increase your dose faster than your doctor tells you to. The maximum dose is 400 mg once daily.
Pregnancy & Breastfeeding
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.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.
Storage
Store Xcopri tablets at room temperature, between 68°F to 77°F.
Side Effects (from patient reports)
Based on 6,822 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 6,460 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2019–2025.
Total Reports
6,460
Death-Related Reports
156
Hospitalization Reports
1,300
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | SEIZURE | 1,815 |
| 2 | PRODUCT DOSE OMISSION ISSUE | 1,263 |
| 3 | FATIGUE | 672 |
| 4 | SOMNOLENCE | 660 |
| 5 | DIZZINESS | 537 |
| 6 | OFF LABEL USE | 493 |
| 7 | PRODUCT USE ISSUE | 386 |
| 8 | FALL | 368 |
| 9 | HEADACHE | 317 |
| 10 | DRUG INTERACTION | 311 |
| 11 | DRUG INEFFECTIVE | 284 |
| 12 | WRONG TECHNIQUE IN PRODUCT USAGE PROCESS | 277 |
| 13 | FEELING ABNORMAL | 245 |
| 14 | GAIT DISTURBANCE | 242 |
| 15 | BALANCE DISORDER | 219 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
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.
Known Drug Interactions
( 7.1 ) Phenobarbital and Clobazam: Reduce dosage as needed when used concomitantly with XCOPRI. phenobarbital ↑ plasma concentrations Because of a potential for an increase in the risk of adverse reactions from these drugs, consider a reduction in dosage of phenobarbital or clobazam, as clinically appropriate, when used concomitantly with XCOPRI.
Mechanism: Cenobamate causes the levels of phenobarbital in your blood to go up. This makes it more likely that you will have a bad reaction to the phenobarbital.
What to do: Your doctor may need to lower your dose of phenobarbital to keep you safe while you take cenobamate.
( 7.1 ) Phenobarbital and Clobazam: Reduce dosage as needed when used concomitantly with XCOPRI. phenobarbital ↑ plasma concentrations Because of a potential for an increase in the risk of adverse reactions from these drugs, consider a reduction in dosage of phenobarbital or clobazam, as clinically appropriate, when used concomitantly with XCOPRI. desmethylclobazam, the active metabolite of clobazam ↑ plasma concentrations CYP2B6 Substrates ↓ plasma concentrations Because of a potential for reduced efficacy of these drugs, increase the dosage of CYP2B6 or CYP3A4 substrates, as needed, when ...
Mechanism: Cenobamate increases the level of the active part of clobazam in your bloodstream. This can lead to more side effects from the clobazam.
What to do: Your doctor should consider lowering your clobazam dose if you are taking both of these medications.
( 7.1 ) Lamotrigine, Carbamazepine: Increase dosage as needed when used concomitantly with XCOPRI. Table 5: Pharmacokinetic Drug Interactions Drug or Substrate Type Effect of XCOPRI on Drug or Substrate Clinical Recommendation Antiepileptic Drugs lamotrigine ↓ plasma concentrations Because of a potential for reduced efficacy of these drugs, increase the dosage of lamotrigine or carbamazepine, as needed, when used concomitantly with XCOPRI.
Mechanism: Cenobamate speeds up how quickly your body breaks down lamotrigine, which lowers the amount of medicine in your blood. This can make the lamotrigine less effective at preventing seizures.
What to do: Your doctor may need to increase your dose of lamotrigine to make sure it still works correctly. Monitor your symptoms closely and report any changes to your healthcare provider.
( 7.1 ) Lamotrigine, Carbamazepine: Increase dosage as needed when used concomitantly with XCOPRI. Table 5: Pharmacokinetic Drug Interactions Drug or Substrate Type Effect of XCOPRI on Drug or Substrate Clinical Recommendation Antiepileptic Drugs lamotrigine ↓ plasma concentrations Because of a potential for reduced efficacy of these drugs, increase the dosage of lamotrigine or carbamazepine, as needed, when used concomitantly with XCOPRI. carbamazepine ↓ plasma concentrations phenytoin ↑ plasma concentrations Because of a potential 2-fold increase in phenytoin levels, gradually decrease ph...
Mechanism: Cenobamate causes your body to process carbamazepine more quickly, leading to lower levels of the drug in your system. This could mean the medicine will not work as well to control your condition.
What to do: Your healthcare provider might need to raise your carbamazepine dose to keep it at the right level. Watch for any changes in how well your seizures are controlled while taking both drugs.
7 DRUG INTERACTIONS Phenytoin: Gradually decrease phenytoin dosage by up to 50%. carbamazepine ↓ plasma concentrations phenytoin ↑ plasma concentrations Because of a potential 2-fold increase in phenytoin levels, gradually decrease phenytoin dosage by up to 50% as XCOPRI is being titrated.
Mechanism: Cenobamate slows down the body's ability to clear phenytoin, which can cause the drug to build up to dangerous levels. This can lead to a two-fold increase in the amount of phenytoin in your blood.
What to do: Your doctor should gradually decrease your phenytoin dose by up to 50% while you are starting the new medication. They will likely monitor your blood levels to ensure they stay in a safe range.
Common Questions
Can I crush Xcopri tablets?
What should I do if I experience side effects?
Can I drink alcohol while taking Xcopri?
Will Xcopri interact with my birth control?
How often will my doctor check my liver function?
Can I drive while taking Xcopri?
What happens if I stop taking Xcopri suddenly?
How will my dose be adjusted?
What if I have kidney problems?
What if I have liver problems?
What are the common side effects of cenobamate?
Does cenobamate interact with other medications?
What drug class is cenobamate?
Is cenobamate safe during pregnancy?
Related Medications in Anticonvulsant
Other drugs grouped near cenobamate — same-class peers and common alternatives.
brivaracetam
Briviact
Brivaracetam is a medicine used to treat partial-onset seizures.
Compare with cenobamate →
cannabidiol
Epidiolex
Epidiolex is a medicine that contains cannabidiol.
Compare with cenobamate →
carbamazepine
Tegretol
Carbamazepine is a medicine used to control seizures and treat nerve pain.
Compare with cenobamate →
clobazam
Onfi, Sympazan
Clobazam oral suspension is a medicine used with other medicines to treat seizures caused by Lennox-Gastaut syndrome.
Compare with cenobamate →
clonazepam
Klonopin
Clonazepam is a medicine that belongs to the benzodiazepine class.
Compare with cenobamate →
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What the FDA Data Shows for cenobamate
The FDA label for cenobamate (sold under brand names such as Xcopri) classifies it as a prescription-only medication in the Anticonvulsant class. Xcopri is used to treat partial-onset seizures in adults. Official labeling lists 5 commonly reported side effects, including Feeling sleepy, Dizziness, Feeling tired.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 6,822 voluntary reports. The database also lists 5 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: September 25, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages