Home Drug Guide Stiripentol

Drug Guide

Generic Name

Stiripentol

Brand Names Diacomit

Classification

Therapeutic: Anticonvulsant

Pharmacological: GABAergic agent

FDA Approved Indications

  • Treatment of seizures associated with Dravet syndrome in pediatric patients 2 years of age and older.

Mechanism of Action

Stiripentol enhances GABAergic transmission by inhibiting the enzymatic degradation of GABA, increasing GABA levels in the brain, and modulating neuronal excitability to reduce seizure activity.

Dosage and Administration

Adult: Not approved for adult use; dosing primarily for pediatric patients with Dravet syndrome.

Pediatric: Initial dose: 50 mg/kg/day divided into three doses. Dose may be titrated based on response and tolerability. Maximum dose: 100 mg/kg/day.

Geriatric: Limited data; use with caution and appropriate dose adjustments.

Renal Impairment: No specific dosage adjustment recommended; monitor closely.

Hepatic Impairment: Use with caution; monitor for adverse effects, as hepatic metabolism is involved.

Pharmacokinetics

Absorption: Rapid absorption after oral administration.

Distribution: Widely distributed; high plasma protein binding.

Metabolism: Extensively metabolized in the liver, primarily via glucuronidation.

Excretion: Primarily via urine as metabolites.

Half Life: Approximately 4-7 hours.

Contraindications

  • Hypersensitivity to stiripentol or any component of the formulation.

Precautions

  • Monitor liver function during therapy.
  • Use with caution in patients taking medications that affect hepatic enzyme activity.
  • Potential for anemia; monitor blood counts.
  • Careful use in patients with concomitant medications that can cause CNS depression.

Adverse Reactions - Common

  • Somnolence (Common)
  • Decreased appetite (Common)
  • Diarrhea (Common)
  • Vomiting (Common)

Adverse Reactions - Serious

  • Liver enzyme elevation (Serious; monitor liver function)
  • Hematologic abnormalities (e.g., anemia) (Serious)
  • Severe hypersensitivity reactions (Rare)

Drug-Drug Interactions

  • CYP450 enzyme inducers or inhibitors may alter stiripentol levels.
  • Other CNS depressants may have additive sedative effects.

Drug-Food Interactions

  • No specific food interactions identified.

Drug-Herb Interactions

  • Limited data; consult healthcare provider before use of herbal supplements.

Nursing Implications

Assessment: Monitor seizure frequency, liver function tests, blood counts, and signs of adverse effects.

Diagnoses:

  • Risk for injury related to seizures or adverse effects.
  • Impaired liver function.

Implementation: Administer with food to reduce gastrointestinal upset; educate caregivers about adherence and monitoring.

Evaluation: Assess seizure control, adverse effects, and laboratory parameters regularly.

Patient/Family Teaching

  • Take medication exactly as prescribed; do not adjust dose without consulting healthcare provider.
  • Report signs of liver dysfunction (jaundice, dark urine), unusual bleeding, or severe rash.
  • Be aware of potential drowsiness; avoid activities requiring alertness until tolerated.
  • Maintain regular follow-up appointments for laboratory testing.

Special Considerations

Black Box Warnings:

  • Potential to cause increased liver enzymes and hematologic abnormalities.

Genetic Factors: No specific genetic factors identified affecting dosing.

Lab Test Interference: May elevate liver function tests; interpret with clinical context.

Overdose Management

Signs/Symptoms: Seizures, somnolence, gastrointestinal symptoms, hepatic dysfunction.

Treatment: Supportive care, activated charcoal if ingestion is recent, monitor vital signs, and provide symptomatic management. Dialysis is not effective for stiripentol elimination.

Storage and Handling

Storage: Store at room temperature away from moisture and light.

Stability: Stable for recommended shelf life when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.