Banzel (rufinamide) is a brand-name drug that’s prescribed for treating Lennox-Gastaut Syndrome. Banzel has interactions with alcohol and some other drugs. Examples include opioids and hormone-based birth control.
Banzel is prescribed for treating seizures related to Lennox-Gastaut Syndrome (LGS) in adults and children ages 1 year and older.
An interaction occurs when one substance causes another substance to have a different effect than expected.
Banzel comes in different forms, and they have the same interactions. The forms are:
- oral tablets
- oral liquid suspension
To learn more about Banzel’s interactions, keep reading. For additional information about Banzel, including details about its uses, see this article.
Before you start treatment with Banzel, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Banzel interacts with supplements, herbs, or vitamins, see the “Banzel and other interactions” section below.)
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Here’s a table of drugs that can interact with Banzel. Keep in mind that this table doesn’t include all drugs that may interact with Banzel. Some of these interactions are described in detail just below in “Drug interactions in depth.”
Drug class or drug name | Drug examples | Interaction result with Banzel |
---|---|---|
hormone-based birth control | • ethinyl estradiol/levonorgestrel(Ashlyna, others) • medroxyprogesterone (Depo-Provera, others) | Can make hormone-based birth control less effective |
opioids | • hydrocodone (Hysingla ER, others) • fentanyl (Fentora, others) | increased risk for respiratory depression, sedation, low blood pressure |
tricyclic antidepressants (TCAs) | • amitriptyline • nortriptyline (Pamelor) | can make Banzel less effective, and can increase the risk for side effects of Banzel and TCAs |
certain other antiepileptic drugs | • carbamazepine (Tegretol, others) • phenytoin (Dilantin) | can increase or decrease the effect of Banzel or certain other antiepileptic drugs |
cenobamate (Xcopri) | — | can increase the risk for QT-shortening as a side effect of Banzel and cenobamate |
hydroxychloroquine (Plaquenil, Sovuna) | — | can make Banzel less effective |
isavuconazonium (Cresemba) | can increase the risk for QT-shortening as a side effect of Banzel and isavuconazonium | |
lacosamide (Vimpat, Motpoly XR) | can increase the risk for QT-shortening as a side effect of Banzel and lacosamide |
In some cases, factors or conditions could prevent your doctor from prescribing Banzel due to the risk of harm. These are known as contraindications. The contraindications of Banzel include:
Having Short QT Syndrome
Short QT syndrome (SQTS) is a type of inherited heart arrhythmia. “Inherited” means the condition is passed through genetics. SQTS is rare but very serious, as having this condition raises your risk for cardiac arrest.
Doctors typically won’t prescribe Banzel to people with SQTS, as Banzel may worsen this condition. Banzel can shorten the QT interval, which refers to a specific part of your heart’s rhythm. Taking Banzel could further raise your risk for cardiac arrest, ventricular arrhythmia, and sudden death due to SQTS.
Be sure to let your doctor know if you (or your child) have SQTS before starting Banzel treatment. Your doctor will likely want to prescribe a different treatment for LGS.
Your doctor may recommend that you not drink alcohol while taking Banzel.
Consuming alcohol and taking Banzel may cause serious side effects, including:
- sleepiness
- decreased awareness
- problems with coordination and balance
The combination of alcohol and Banzel may also, in some cases, lead to a coma or breathing difficulties. This is more likely to happen if large amounts of alcohol are consumed.
If you have concerns about minimizing or avoiding alcohol while you’re taking Banzel, talk with your doctor before starting treatment.
Here’s a closer look at certain drug interactions of Banzel.
Opioids
Banzel can interact with opioids, which are prescribed for treating moderate to severe pain and certain other conditions.
Interaction result: Taking Banzel together with an opioid can raise the risk of side effects that can be caused by Banzel or opioids. These side effects include low blood pressure, sedation (slowed brain activity), and respiratory depression (slow, shallow breathing that can be life threatening).
Interaction explained: Both Banzel and opioids can cause central nervous system (CNS) depression. This refers to slowing activity in your CNS, which is made up of your brain and spinal cord. CNS depression can cause effects, including sedation, problems with coordination and balance, and dizziness. Combining medications that cause CNS depression can increase your risk for these side effects. It can also rarely result in respiratory depression, a rare but possibly life threatening side effect.
Examples of opioid drugs: Here are some opioids that may interact with Banzel:
- hydrocodone (Hysingla ER, others)
- fentanyl (Fentora, others)
- methadone (Methadose)
- buprenorphine (Butrans, others)
- morphine (MS Contin, others)
Steps you or your doctor may take: Due to the risks of this interaction, doctors typically avoid prescribing opioids together with Banzel unless there aren’t other treatments that work for your condition and needs.
If your doctor determines this treatment combination is necessary for you, they’ll prescribe the lowest dose of both Banzel and the opioid needed to treat your symptoms. Your doctor may also prescribe Narcan to you. Narcan is a medication that can treat respiratory depression caused by opioids, including an accidental or intentional opioid overdose.
Hormone-based birth control
Banzel can interact with hormone-based birth control, which is used to prevent pregnancy, treat certain symptoms of menopause, and other uses.
Interaction result: Taking Banzel together with hormone-based birth control can make hormone-based birth control less effective.
Interaction explained: Taking Banzel can increase the activity of enzymes that break down hormone-based birth control after you take a dose. Increasing the activity of these enzymes can lower the level of hormone-based birth control in your system, making the medication less effective.
Examples of hormone-based birth control drugs: Here are some hormone-based birth controls that may interact with Banzel:
- ethinyl estradiol/levonorgestrel(Ashlyna, others)
- ethinyl estradiol/norethindrone (Aranelle, others)
- ethinyl estradiol/desogestrel (Bekyree, others)
- estradiol/norethindrone (Amabelz, others)
- medroxyprogesterone (Depo-Provera, others)
Steps you or your doctor may take: If you’re prescribed Banzel and use hormone-based birth control to prevent pregnancy, your doctor will likely suggest using an additional form of birth control that is nonhormonal. Your doctor can provide more information about nonhormonal contraception to use.
If you use hormone-based birth control to treat menopause symptoms or another condition, your doctor can review other treatments for your condition that aren’t affected by taking Banzel. They may also choose to monitor symptoms of your condition to see if Banzel makes treatment less effective.
Certain other antiepileptic drugs
Banzel can interact with certain other antiepileptic drugs. Antiepileptic drugs, including Banzel, are prescribed to treat seizures and epilepsy, plus certain other conditions.
Interaction result: Taking Banzel and certain other antiepileptic drugs can increase or decrease the effect of Banzel or certain other antiepileptic drugs.
Interaction explained: Taking certain other antiepileptic drugs can decrease or increase the amount of Banzel in your system. Decreasing the amount of Banzel in your system can make Banzel less effective. Increasing the amount in your system can raise your risk for side effects from taking Banzel.
Similarly, taking Banzel can increase or decrease the amount of certain other antiepileptic drugs in your system. Depending on the effect, this could make other antiepileptic drugs less effective or increase your risk for side effects they may cause.
Examples of antiepileptic drugs: Here are some antiepileptic drugs that may interact with Banzel:
Steps you or your doctor may take: If you’re prescribed Banzel and another antiepileptic drug, your doctor may prescribe a lower or higher dose of Banzel or the other antiepileptic drug. This will depend on the specific interaction. Or, they may suggest switching to a different antiepileptic drug that doesn’t interact with Banzel.
Banzel may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Banzel.
Banzel interactions with supplements
It’s possible for drugs to interact with supplements such as vitamins and herbs.
Banzel interactions with herbs
There are no specific reports of herbs interacting with Banzel. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Banzel treatment.
Banzel interactions with vitamins
There are no specific reports of vitamins interacting with Banzel. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Banzel.
Banzel interactions with food
There were no reports of food interactions with Banzel. If you’d like to learn more about eating certain foods during treatment with Banzel, talk with your doctor.
Banzel interactions with vaccines
There aren’t any known interactions between Banzel and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.
Banzel interactions with lab tests
Banzel isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.
BANZEL INTERACTION WITH CANNABIS OR CBDCannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Banzel. Banzel may strengthen the effects of CBD or cannabis. This can increase your risk for excessive sleepiness and fatigue as a side effect of Banzel or cannabis.
Before you start treatment with Banzel, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.
Certain medical conditions and other factors may increase the risk of interactions with Banzel. Before you take this drug, be sure to talk with your doctor about your health history. Banzel may not be the right treatment option if you have certain medical conditions or other factors affecting your health.
Health conditions or factors that might interact with Banzel include:
- Dialysis: Be sure to let your doctor know if you receive kidney dialysis before you begin taking Banzel. Dialysis can remove Banzel from your system. Your doctor may want to adjust your Banzel dosage if you receive dialysis.
- Heart problem: Banzel can shorten the QT interval, which refers to a specific part of your heart’s rhythm. If you have an existing heart problem, you may be at higher risk for arrhythmia if you take Banzel. It’s also possible that Banzel could worsen your condition. Be sure to review your heart health with your doctor before you begin taking Banzel.
- Liver problem: If you have a severe liver problem, such as liver failure, Banzel may not be safe for you. Your body relies on your liver to break down Banzel after you take a dose. Liver problems can affect how well your body breaks down Banzel. This can increase the level of Banzel in your system, raising your risk for side effects caused by the drug. Your doctor can determine whether Banzel is safe for you to take based on the severity of your liver problem.
- Low white blood cell count (leukopenia): Treatment with Banzel can cause a low white blood cell count. If you already have leukopenia, taking Banzel could worsen your condition. Your doctor can help determine whether Banzel is safe for you to take.
- Allergic reaction: If you’ve had an allergic reaction to Banzel or any of its ingredients, your doctor will likely not prescribe Banzel. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
- Breastfeeding: It’s not known whether it’s safe to use Banzel while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Banzel may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Banzel. They can talk with you about treatment options and ways to feed your child.
- Pregnancy: There haven’t been enough clinical trials to determine whether Banzel is safe to use while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Banzel. They can advise you on the right treatment plan for you.
- Risk of suicidal thoughts and behaviors: Antiepileptic drugs, including Banzel, can increase the risk for suicidal thoughts and behaviors.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
You can take certain steps to help prevent interactions with Banzel. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:
- Let them know if you drink alcohol or use cannabis.
- Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
- Create a
medication list , which your doctor and pharmacist can help you fill out.
It’s also important to read the Banzel label and other
If Banzel doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.
You can also help prevent interactions with Banzel by taking it exactly as your doctor prescribes.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.