This medicine is an anticonvulsant used for treating tonic-clonic (grand mal) and partial seizures. It is also used to prevent and treat seizures that may occur during or after brain or nervous system surgery. It may also be used for other conditions as determined by your doctor.
Follow the directions for taking this medicine provided by your doctor. This medicine has a MEDICATION GUIDE approved by the U.S. Food and Drug Administration. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. Take this medicine by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation. YOU MAY EITHER swallow this medicine whole or chew well before swallowing. IF YOU TAKE A CALCIUM PRODUCT (eg, certain antacids), colesevelam, or molindone, ask your doctor or pharmacist how to take it with this medicine. DO NOT CHANGE BRANDS or dosage forms (eg, capsules, suspension, injection) of this medicine without talking with your doctor. STORE THIS MEDICINE at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. KEEP THIS MEDICINE out of the reach of children and away from pets. DO NOT SUDDENLY STOP TAKING THIS MEDICINE. You may have an increased risk of seizures if you stop taking it. If you need to stop this medicine, your doctor will gradually lower your dose. DO NOT EXCEED THE RECOMMENDED DOSE or change your dose without checking with your doctor. CONTINUE TO TAKE THIS MEDICINE even if you feel well. Do not miss any doses. TAKING THIS MEDICINE at the same time each day will help you remember to take it. IF YOU MISS A DOSE of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE THIS MEDICINE if you are also taking cabazitaxel, crizotinib, delavirdine, dronedarone, etravirine, lurasidone, nifedipine, nisoldipine, praziquantel, ranolazine, rilpivirine, rivaroxaban, roflumilast, ticagrelor, or vandetanib. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking other prescription and nonprescription medicines (eg, used for allergic reactions, asthma or other breathing problems, blood thinning, diabetes, infections, inflammation, aches and pains, ADHD, alcoholism, cancer, high blood pressure, indigestion, irregular heartbeat or other heart problems, hepatitis C, high blood iron levels, high cholesterol, HIV, birth control, hormone replacement, immune system suppression, mental or mood problems, pain, sleep, seizures, stomach or bowel problems), multivitamin products, or herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John's wort). Ask your doctor if you are unsure if any of your medicines might interact with this medicine. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions, including the blood disease porphyria, liver disease, diabetes, weakened immune system, bone problems (eg, weak bones, osteoporosis), very poor health, allergies, pregnancy, or breast-feeding. Tell your doctor if you have a history of lymph gland problems, alcohol abuse, mental or mood problems (eg, depression), or suicidal thoughts or attempts. Tell your doctor if you drink alcohol, if you or a family member has had anticonvulsant hypersensitivity syndrome (AHS), if you receive nutrition through an enteral tube (eg, G-tube), or if you have been tested and know whether or not you have a gene type called HLA-B*1502. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine.
SIDE EFFECTS that may occur while taking this medicine include constipation, dizziness, drowsiness, headache, mild nervousness, nausea, trouble sleeping, or vomiting. If they continue or are bothersome, check with your doctor. THIS MEDICINE MAY RAISE YOUR BLOOD SUGAR. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away. THERE HAVE BEEN REPORTS OF LYMPH NODE PROBLEMS, including cancer, in patients who take this medicine. It is not known if this medicine may be the cause. Contact your doctor right away if you develop swollen lymph nodes. PATIENTS WHO TAKE THIS MEDICINE MAY BE AT INCREASED RISK FOR SUICIDAL THOUGHTS OR ACTIONS. The risk may be greater in patients who have had suicidal thoughts or actions in the past. Watch patients who take this medicine closely. Contact the doctor at once if new, worsened, or sudden symptoms occur (eg, agitation, anxiety, depression, restlessness, irritability, panic attacks, behavior changes). Contact the doctor right away if any signs of suicidal thoughts or actions occur. LONG-TERM TREATMENT WITH THIS MEDICINE may cause low blood vitamin D levels. This may increase the risk of low blood calcium or phosphate levels. It may also increase the risk of bone softening, weak bones, or other bone problems (eg, fractures). A SERIOUS AND SOMETIMES FATAL REACTION has been reported in patients taking medicines for seizures, including this medicine. Contact your doctor right away if you develop swollen lymph nodes, fever, rash, chest pain, symptoms of kidney problems (eg, decreased urination), or symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, stomach pain, yellowing of the skin or eyes). CONTACT YOUR DOCTOR IMMEDIATELY if you experience bone pain; burning, numbness, or tingling; butterfly-shaped rash on the face; clumsiness or unsteadiness; confusion; delirium; new or worsening seizures; red, swollen, blistered, or peeling skin; severe muscle pain; severe or persistent trouble sleeping; shortness of breath; signs of infection (eg, chills, fever, sore throat); slurred speech; sores in the mouth or around the eyes; swollen or tender gums; tremor; trouble walking; unusual bruising or bleeding; unusual eye movements; unusual muscle movements; or unusual tiredness or weakness. AN ALLERGIC REACTION to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; or swelling of the mouth, eyes, face, lips, or tongue. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your healthcare provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms may include confusion; decreased coordination; fainting; loss of consciousness; severe dizziness or drowsiness; severe or persistent nausea or vomiting; slow or difficult breathing; sluggishness; speech problems (eg, slurred speech); tremor; or unusual eye movements.
Carry an identification card at all times that says you taking this medication. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. IF YOU WILL BE USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, be sure to obtain necessary refills before your supply runs out. CHECK WITH YOUR PHARMACIST about how to dispose of unused medicine.