Taking Epilim Crushable with other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines
you buy without a prescription, including herbal medicines. This is because Epilim Crushable can affect the way some other
medicines work. Also some medicines can affect the way Epilim Crushable works.
The following medicines can increase the chance of you getting side effects, when taken with Epilim Crushable:
- Some medicines used for pain and inflammation (salicylates) such as aspirin.
- Some other medicines used to treat fits (epilepsy) – see page 2, section 3, “Patients taking other medicines for ‘fits’”. This includes medicines such as phenobarbital, primidone, phenytoin, carbamazepine, topiramate, lamotrigine and felbamate
Epilim Crushable may increase the effect of the following medicines:
- Medicines used for thinning the blood (such as warfarin)
- Zidovudine used to treat HIV infection
- Temozolomide used to treat cancer
- Medicines for depression
- Monoamine oxidase inhibitors (MAOI) such as moclobemide, selegiline, linezolid
- Medicines used to calm emotional and mental conditions such as diazepam and olanzapine
The following medicines can affect the way Epilim Crushable works:
- Some medicines used for the prevention and treatment of malaria such as mefloquine and chloroquine
- Cimetidine used for stomach ulcers
- Carbapenem agents (antibiotics used to treat bacterial infections) such as imipenem, meropenem, rifampicin and erythromycin. The combination of Epilim Crushable and carbapenems should be avoided because it may decrease the effect of your medicine.
- Colestyramine used to lower blood fat (cholesterol) levels
Pregnancy and breast-feeding
Women who could become pregnant
You should not take this medicine if you are pregnant or a women of child-bearing age unless explicitly advised by your doctor.
Before you start taking Epilim Crushable, your doctor should discuss with you the possible problems when it is taken in pregnancy.
- Unplanned pregnancy is not desirable in women taking Epilim Crushable
You should use an effective method of contraception and talk to your doctor before planning pregnancy.
Epilim Crushable has no effect on how well the oral contraceptive pill works.
Well before you become pregnant it is important to discuss pregnancy and epilepsy with your doctor and, if you have one, your epilepsy specialist. This is to make sure that you and your doctor agree that you should have Epilim if you become pregnant. Women taking Epilim during pregnancy have a higher risk than other women of having a child with an abnormality. The chance of abnormalities is increased if you are also taking other medicines for epilepsy at the same time. These abnormalities include:
- Head and face deformities including cleft palate (a gap or depression in the lip)
- Deformities of the bones, including hip dislocation
- Malformations of the arms and legs
- Deformities of the tube from the bladder to the penis, where the opening is formed in a different place
- Heart and blood vessel malformations, including heart defects
- Defects of the lining of the spinal cord
- An abnormality of the spinal cord called ‘Spina bifida’
- Malformations of the urethra
Women who take Epilim Crushable during pregnancy may be more likely to have a baby with spina bifida. Taking folic acid 5mg each day as soon as you stop contraception may lower the risk of having a baby with spina bifida.
There is also an increased risk of other birth defects. These other defects can usually be detected in the first 3 months of the pregnancy using routine antenatal screening blood tests and ultrasound scans.
Pregnant mothers who take Epilim Crushable may have babies with:
- blood clotting problems (such as blood not clotting or not clotting very well). This may appear as bruising or bleeding which takes a long time to stop.
- Hypoglycaemia (low blood sugar)
- Hypothyroidism (underactive thyroid gland, which can cause tiredness or weight gain).
Some babies born to mothers who took Epilim Crushable during pregnancy may develop less quickly than normal or have autistic disorders. These children may require additional educational support.
Talk to your doctor before you stop taking Epilim Crushable if you want to become pregnant. Do not stop taking Epilim
Crushable suddenly, as it is likely that your fits will come back.
Women who are planning to get Pregnant
If you become pregnant, think you may be pregnant or plan to become pregnant while taking Epilim Crushable, you must tell your doctor straight away.
- Your doctor will give you appropriate counselling and will suggest changes to your treatment or dose
- He or she will also want to check your progress while you are pregnant
It is very important that you discuss your treatment with your doctor well before you become pregnant.
Very little Epilim Crushable gets into the breast milk. However, talk to your doctor about whether you should breast-feed your baby. Ask your doctor or pharmacist for advice before taking any medicine.