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What Are The Repercussions Of Accidental Double Dosage Of Epilepsy Medication?
Question: Hi, I've accidentally taken a double of dose of all my epilepsy medicine: probably thought I missed a day or something - not sure how else to explain this. This has never happened to me before and I've been taken the meds for years. It's been over 10 hours since then, should I expect any side-effects and is there any point in going to the hospital now - only A&E is working and probably won't be able to see me for a few hours?
Thank you. XXXXXXX
Thank you. XXXXXXX
Brief Answer:
You should be fine.
Detailed Answer:
Hello XXXXXXX I read your question carefully and i understand your concern.
You probably forgot about it due to being anxious, but you should have included the names of the epilepsy drugs you are taking and their dosage, it's hard to speak of side effects without knowing their names and if you were on a low, average or maximum dose.
However I don't think you should panic especially since you haven't felt any unusual symptom up to now after it's been 10 hours. I wouldn't rush to the hospital either, apart from observing you they won't do much else. You are a young patient and unless there is some other condition like liver or kidney problems I think your body will be able to cope with this one time extra dose well.
I remain at your disposal for further questions, but please don't forget to mention drug names, dosage (including how many times daily) and your weight as well.
You should be fine.
Detailed Answer:
Hello XXXXXXX I read your question carefully and i understand your concern.
You probably forgot about it due to being anxious, but you should have included the names of the epilepsy drugs you are taking and their dosage, it's hard to speak of side effects without knowing their names and if you were on a low, average or maximum dose.
However I don't think you should panic especially since you haven't felt any unusual symptom up to now after it's been 10 hours. I wouldn't rush to the hospital either, apart from observing you they won't do much else. You are a young patient and unless there is some other condition like liver or kidney problems I think your body will be able to cope with this one time extra dose well.
I remain at your disposal for further questions, but please don't forget to mention drug names, dosage (including how many times daily) and your weight as well.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Taka
Many thanks for your advice. The main reason I was confused about first missing my meds and then taking more than I would ever take, is because all my meds are devided into daily morning & night portions. I've got a cocktail of fycompa, zonegram, clobazam & phenytoin. I was first worried about taking a large dose of phenytoin - as it's the drug that absorbs fast. The other meds should be absorbing now as well, so I'm wondering when I'm safe from the extra side-effects and when I should take my normal morning meds. Thanks, XXXXXXX
Many thanks for your advice. The main reason I was confused about first missing my meds and then taking more than I would ever take, is because all my meds are devided into daily morning & night portions. I've got a cocktail of fycompa, zonegram, clobazam & phenytoin. I was first worried about taking a large dose of phenytoin - as it's the drug that absorbs fast. The other meds should be absorbing now as well, so I'm wondering when I'm safe from the extra side-effects and when I should take my normal morning meds. Thanks, XXXXXXX
Brief Answer:
You're past the peak concentration, should be safe.
Detailed Answer:
Thank you for providing some more information. You still made no mention about the drugs dosage though regrettably. The dosage of a drug can vary a lot from one patient to the other, some can take 3-4 times the dose of another patient.
Regarding the side effect by the drug, I still think you are safe after 10 hours. You mention the other 3 apart from phenytoin are absorbing but I believe they have been absorbed by now. Their peak concentration in the blood is for Fycompa up to 2.5 hours, Zonegran up to 6 hours, Clobazam up to 4 hours. So while they remain in your body for much longer, days actually, their peak level has already been reached by now, if feeling good you should have no problems.
As about the morning dosage, it's a tricky question, if it was only the one or two drugs I would have said to take it, but with four there is a degree of uneasiness about it, that's why the drug dosages would have been useful.
The approaches would be two, one would be to take the morning dose 2-4 hours later than usual, would maintain seizure efficacy but some slight safety concerns, the other approach would be to skip the morning dose and take the evening one 2-4 hours earlier than usual, safer way, in theory potential for slightly lower protection for some hours, but since all these drugs have very long half lives I don't think it would be the case, you'd still have adequate protection if you're not into the habit of missing doses often.
So I would go with the second approach, skip the morning dose and take it earlier in the evening.
I hope to have been of help.
You're past the peak concentration, should be safe.
Detailed Answer:
Thank you for providing some more information. You still made no mention about the drugs dosage though regrettably. The dosage of a drug can vary a lot from one patient to the other, some can take 3-4 times the dose of another patient.
Regarding the side effect by the drug, I still think you are safe after 10 hours. You mention the other 3 apart from phenytoin are absorbing but I believe they have been absorbed by now. Their peak concentration in the blood is for Fycompa up to 2.5 hours, Zonegran up to 6 hours, Clobazam up to 4 hours. So while they remain in your body for much longer, days actually, their peak level has already been reached by now, if feeling good you should have no problems.
As about the morning dosage, it's a tricky question, if it was only the one or two drugs I would have said to take it, but with four there is a degree of uneasiness about it, that's why the drug dosages would have been useful.
The approaches would be two, one would be to take the morning dose 2-4 hours later than usual, would maintain seizure efficacy but some slight safety concerns, the other approach would be to skip the morning dose and take the evening one 2-4 hours earlier than usual, safer way, in theory potential for slightly lower protection for some hours, but since all these drugs have very long half lives I don't think it would be the case, you'd still have adequate protection if you're not into the habit of missing doses often.
So I would go with the second approach, skip the morning dose and take it earlier in the evening.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Taka
Thank you for such a detailed reply. In case it makes a difference, my dosages are 150 morning and 100 evening of phenytoin, 150 morning and 150 evening of zonegran, 10 morning and 10 evening of clobazan, 12 evening of fycompa.
I hope the above detailes help as my rather high gosages are the reason why I was worried about taking extra meds.
Many thanks XXXXXXX
Thank you for such a detailed reply. In case it makes a difference, my dosages are 150 morning and 100 evening of phenytoin, 150 morning and 150 evening of zonegran, 10 morning and 10 evening of clobazan, 12 evening of fycompa.
I hope the above detailes help as my rather high gosages are the reason why I was worried about taking extra meds.
Many thanks XXXXXXX
Brief Answer:
Read below.
Detailed Answer:
Thank you very much for completing the picture. Apart from Fycompa which is the highest given dose, the others are at medium dosage, not the maximum but not a low dose either and since you have to take three of them this morning some safety concerns exist.
So I will stick with my previous recommendation, skip the morning dose and take them in the evening, Fycompa at the usual time, the others a couple of hours earlier than usual, you should be alright.
Wishing you all the best.
Read below.
Detailed Answer:
Thank you very much for completing the picture. Apart from Fycompa which is the highest given dose, the others are at medium dosage, not the maximum but not a low dose either and since you have to take three of them this morning some safety concerns exist.
So I will stick with my previous recommendation, skip the morning dose and take them in the evening, Fycompa at the usual time, the others a couple of hours earlier than usual, you should be alright.
Wishing you all the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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