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Pharmacy Guide

Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.

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Ospolot 20 mg/ml Oral suspension

⚠ This medicine appears to have been discontinued

The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.

If you were prescribed this medicine, other products containing Sulthiame may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.

Active substance: Sulthiame
Source: electronic medicines compendium (emc)
Official leaflet: Read the PIL on emc

What it is and what it is used for

for

Ospolot contains the active substance 'sulthiame', an antiepileptic medicine used for the treatment of a certain form of epilepsy in childhood called Rolandic epilepsy (also known as benign childhood epilepsy with centrotemporal spikes). Treatment with Ospolot should only be performed by specialist paediatric neurologists who are experienced in epilepsy treatment. 2.

What you need to know before you take it

ing Ospolot

Do not give Ospolot if the child: is allergic to sulthiame or similar medicines (sulphonamides), to sodium methyl parahydroxybenzoate (E219), sodium propyl parahydroxybenzoate (E217) or any of the other ingredients in this medicine (listed in section 6)

  • has an overactive thyroid
  • has high blood pressure has a metabolic condition called acute porphyria. Warnings and precautions Talk to your doctor before giving Ospolot, if the child has impaired kidney function, if the child is suffering from any psychiatric disorder, if you or one of your family members suffers from inherited Leber hereditary optic neuropathy (LHON). Seek urgent medical advice if the child develops a fever, sore throat, rash with lymph node swelling and/or flu-like symptoms during treatment with Ospolot. These could be signs of an allergic, or other, reaction to the medicine which can become serious, in which case your doctor may decide to stop Ospolot.

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Before treatment with Ospolot starts, blood tests will be carried out to check liver and kidney function. These will be repeated weekly for the first month of treatment then monthly up to six months after which they only need to be repeated two to four times a year. A small number of patients being treated with anti-epileptics such as Ospolot have had thoughts of harming or killing themselves. If at any time such thoughts arise, immediately contact your doctor for advice. Other medicines and Ospolot Tell your doctor or pharmacist if the child is taking, has recently taken or might take any other medicines. Ospolot and the following medicines or groups of medicine may interact with each other during combined treatment. –

–

Phenytoin: Blood levels of phenytoin may be affected by Ospolot, especially if kidney function is reduced, so close monitoring will be carried out. Lamotrigine: Ospolot may increase lamotrigine blood levels. This will be carefully checked if this combination treatment is started. Clobazam: Blood levels of clobazam may increase. Your doctor will check this. Primidone: This may worsen side-effects with Ospolot , particularly unsteadiness, dizziness and drowsiness. Carbamazepine: This may reduce levels of Ospolot in the blood. Topiramate: Side effects with Ospolot may be increased. Acetazolamide: Side effects with Ospolot may be increased.

Ospolot with alcohol Alcohol should be avoided during treatment with Ospolot as it can cause unpleasant symptoms which may include flushing, a throbbing headache, nausea and vomiting, palpitations and blurred vision. The symptoms can sometimes be more serious and include difficulty breathing, disturbances in heart rhythm and a fall in blood pressure with possible collapse and loss of consciousness. Seizures may also occur. Pregnancy and breast-feeding If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Pregnancy There is an increased risk that this medicine may harm your unborn baby. You should therefore not use this medicine during pregnancy unless it has been specifically prescribed by your doctor. If you are of childbearing age and are taking Ospolot, you must use an effective method of contraception. Do not interrupt your treatment with Ospolot before consulting with your doctor first. Any sudden discontinuation of treatment or unsupervised reduction of the dose may result in a return of epileptic seizures that may harm you and/or your unborn child. Breast-feeding It is not known whether the active substance contained in Ospolot passes into breast milk. For this reason, you should not take Ospolot while breast-feeding. Driving and using machines Even when used as directed, this medicine may affect your responsiveness to such an extent as to impair, for example, your ability to drive or use machines. In particular, this applies in combination with alcohol. Ospolot contains sodium methyl parahydroxybenzoate (E219), sodium propyl parahydroxybenzoate (E217), sulphur dioxide (E220), sodium, fructose, glucose and sucrose Sodium methyl parahydroxybenzoate (E219) and sodium propyl parahydroxybenzoate (E217) may cause allergic reactions (possibly delayed).

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Sulphur dioxide (E 220) may rarely cause severe hypersensitivity reactions and bronchospasm. This medicine contains 0.0026 mg fructose in each ml. Glucose and sucrose: if you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine. Glucose, fructose and sucrose may be harmful to the teeth. This medicine contains less than 1 mmol sodium (23 mg) per ml, that is to say it is essentially 'sodium-free'. 3.

How to take it

Ospolot

Always use this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. Dose Your doctor will usually start on a low dose, and gradually increase it over one week until the right dose is found (this is called the maintenance dose). The usual maintenance dose is 5 – 10 mg (0.25 – 0.5 ml) per kilogram of body weight per day, usually divided into three doses. Table 1: dosing examples for a starting dose of 2.5 mg sulthiame per kg per day Starting dose: 2.5 mg* sulthiame per kg per day Patient-Weight Single dose Total daily dose (given 3 x daily) 0.5 – 0.75 ml 1.5 – 2.25 ml 12 – 18 kg (equivalent to 10 – 15 mg sulthiame) (equivalent to 30 – 45 mg sulthiame) 0.75 – 1.0 ml 2.25 – 3.0 ml 18 – 24 kg (equivalent to 15 – 20 mg sulthiame) (equivalent to 45 – 60 mg sulthiame) 1.0 – 1.25 ml 3.0 – 3.75 ml 24 – 30 kg (equivalent to 20 – 25 mg sulthiame) (equivalent to 60 – 75 mg sulthiame) 1.25 – 1.5 ml 3.75 – 4.5 ml 30 – 36 kg (equivalent to 25 – 30 mg sulthiame) (equivalent to 75 – 90 mg sulthiame) 1.5 ml and above 4.5 and above 36 – and above (equivalent to 30 mg sulthiame and above) (equivalent to 90 mg sulthiame and above) *1 ml Ospolot oral suspension contains 20 mg sulthiame => 0.25 ml = 5 mg sulthiame

Table 2: dosing examples for a maintenance dose of 5 mg sulthiame per kilogram per day: Maintenance dose: 5 mg* sulthiame per kg per day Patient-Weight Single dose Total daily dose (given 3 x daily) 1.0 – 1.5 ml 3.0 – 4.5 ml 12 – 18 kg (equivalent to 20 – 30 mg sulthiame) (equivalent to 60 – 90 mg sulthiame) 1.5 – 2.0 ml 4.5 – 6.0 ml 18 – 24 kg (equivalent to 30 – 40 mg sulthiame) (equivalent to 90 – 120 mg sulthiame) 2.0 – 2.5 ml 6.0 – 7.5 ml 24 – 30 kg (equivalent to 40 – 50 mg sulthiame) (equivalent to 120 – 150 mg sulthiame) 2.5 – 3.0 ml 7.5 – 9.0 ml 30 – 36 kg (equivalent to 50 – 60 mg sulthiame) (equivalent to 150 – 180 mg sulthiame) 36 – and above 3.0 ml and above 9.0 and above -3-

(equivalent to 60 mg sulthiame and above)

(equivalent to 180 mg sulthiame and above)

*1 ml Ospolot oral suspension contains 20 mg sulthiame => 0.25 ml = 5 mg sulthiame

Method and route of administration Ospolot is for oral use. Instructions for use Read these instructions carefully so that you know how to use this medicine. Components of the medicine kit There are three parts to the medicine kit: 1. A plastic adapter 2. A 10 ml oral dosing syringe which fits into the plastic adapter.

3. A bottle containing the oral suspension, with a child resistant cap. Always replace the cap after use.

Preparing a dose of medicine

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1. Shake the bottle vigorously for 30 seconds in a bottom up position. If a sediment is detected at the bottom of the bottle, shake the bottle for another 30 seconds. 2. Open the child-resistant closure by firmly pressing it down and twisting it anti-clockwise (see top of cap). Note: Keep the cap nearby to close the bottle after each use.

3. Hold the bottle upright on a table. Firmly push the plastic adapter with the oral syringe into the bottle opening, as far as you can. Note: You may not be able to push the adapter down fully but it will be forced into the bottle when you screw the cap back on. After the first use the adapter remains in the bottle.

4. Hold the oral syringe firmly and turn the bottle upside down carefully. Slowly pull out the plunger, so that the oral syringe fills up with the suspension. Then completely push the plunger back, in order to remove any large air bubbles that might be inside the oral syringe.

5. Drawing the prescribed dose: Slowly pull out the syringe plunger, until the top of the wider part of the plunger is exactly on a level with the marker on the oral syringe barrel that indicates the prescribed dose.

Ask your pharmacist if you are unsure.

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6. Carefully turn the bottle and oral syringe the right way up. Remove the oral syringe by gently twisting it out of the adapter. The adapter must always stay in the bottle.

-6-

7. Administer the dose directly into the mouth of the patient, who should be sitting in an upright position. Press the plunger slowly in order to allow for easy swallowing. The patient should drink a glass of water, juice or milk directly after intake.

Also, the dose can be mixed preferably with a small amount of water, or alternatively with orange juice, milk, yoghurt or wheat porridge just prior to administration. Do not take carbonated beverages or hot food with the suspension to avoid eructation or slowed swallowing. Stir and take the entire mixture right away.

8. Replace the child resistant cap after use, leaving the adapter in place. 9. Cleaning: After each use, rinse the syringe thoroughly with running water and wipe the outside with a dry, clean tissue. Ospolot may be taken with or without food. Ideally the same routine should be followed each day. Ospolot may also be given via a feeding tube which should be rinsed with at least 15 ml of water immediately after giving the medicine. If given this way, the dose should be prepared as for oral use immediately before administration. How long should Ospolot be taken? Anti-epileptic treatment is essentially long-term therapy. In each individual case, a paediatric neurologist experienced in the treatment of epilepsy should decide how to adjust the treatment, how long it should last and when it should be discontinued. Ospolot should not be stopped suddenly. If you give more Ospolot than you should Side-effects may be increased (see "Possible side effects", below). Seek urgent medical advice and show this medicine and leaflet if possible. If you forget a dose of Ospolot Do not take a double dose to make up for a forgotten dose. Take the dose at your next scheduled time, as prescribed by your doctor. Your treating physician should be informed. -7-

If you stop Ospolot If you wish to interrupt or stop treatment with Ospolot, discuss it with your doctor first. Do not stop treatment with this medicine by yourself without medical advice, as it might cause the epileptic fits to return. The length of treatment and the dose will vary depending on the individual patient and will be decided by your doctor. If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse. 4.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. Very common side effects (may affect more than 1 in 10 people):

  • upset stomach (e.g. nausea, vomiting) Common side effects (may affect up to 1 in 10 people): breathing difficulties chest tightness, palpitations or racing heart tingling in the arms, legs or face dizziness headache double vision hiccups loss of appetite weight loss Uncommon side effects (may affect up to 1 in 100 people): hallucinations anxiety listlessness muscle weakness joint pain increased seizures, grand mal status –

Not known (frequency cannot be estimated from the available data): delayed hypersensitivity reaction affecting several organ systems with fever, skin rash, inflamed blood vessels (vasculitis), lymph node swelling, abnormal white blood cell count, as well as enlarged liver or spleen and severe skin reactions (Stevens-Johnson syndrome, Toxic Epidermal Necrolysis) acute kidney failure significant deterioration of vision, polyneuritis (multiple nerve inflammation) toxic reactions on the liver and/or increased liver enzyme levels depressive mood/depression, personality changes, abnormal behaviour (e.g. aggressiveness, irritability, mood swings) and impaired cognitive ability diarrhoea –

In one patient with long-standing treatment-resistant epilepsy, taking Ospolot led to increasing weakness of the limbs, increased salivation, slurred speech and increasing drowsiness to the point of coma. The symptoms resolved within hours after discontinuation of Ospolot. The active ingredient in Ospolot (sulthiame) belongs to a group of medicines called 'carbonic anhydrase inhibitors' that have been associated with the formation of kidney stones, changes detected on certain blood tests and fatigue/exhaustion.

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Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme: Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine. 5.

How to store it

Ospolot

Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the bottle and the carton after EXP. The expiry date refers to the last day of that month. After first opening of the bottle do not use for longer than 3 months. Do not use this medicine if you notice any damage to the bottle, closure or carton. Return the pack to your pharmacist. Do not throw away any medicines via wastewater. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment. 6.

Contents of the pack and other information

What Ospolot contains The active substance is sulthiame. The other ingredients are: sodium methyl parahydroxybenzoate (E219), sodium propyl parahydroxybenzoate (E217), sucralose, docusate sodium, xanthan gum, sodium dihydrogen phosphate dihydrate, dipotassium phosphate, strawberry flavour, sweetness modulator flavour (containing fructose, glucose, sucrose and sulphur dioxide (E220)), masking flavour, phosphoric acid 85%, purified water What Ospolot looks like and contents of the pack Ospolot is a white liquid with strawberry flavour. The glass bottle with child-resistant closure contains 200 ml or 250 ml of Ospolot. It is packed in a cardboard box containing an oral syringe of 10 ml graduated every 0.25 ml and an adapter. Not all pack sizes may be marketed. Marketing Authorisation Holder and Manufacturer Desitin Arzneimittel GmbH Weg beim Jäger 214 22335 Hamburg Germany This leaflet was last revised in 11/2025.

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Frequently asked questions about Ospolot 20 mg/ml Oral suspension

How do I take Ospolot 20 mg/ml Oral suspension?

Ospolot 20 mg/ml Oral suspension comes as oral solution containing 20mg/ml. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.

What is the active substance in Ospolot 20 mg/ml Oral suspension?

The active substance in Ospolot 20 mg/ml Oral suspension is sulthiame.

Where does this information come from?

This leaflet reproduces the patient information leaflet approved for Ospolot 20 mg/ml Oral suspension, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.

Can I get Ospolot 20 mg/ml Oral suspension without a prescription?

Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.

About this leaflet

The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.

Medical disclaimer: This page is for information only and does not replace advice from your doctor or pharmacist. Always read the leaflet supplied with your medicine. If you are unwell, call NHS 111; in an emergency, call 999.

Medicines with the same active substance: Sulthiame (1 medicine)
See every medicine containing this substance, or browse the full A–Z of active substances.
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
Technical information intended for healthcare professionals (doctors and pharmacists). The Summary of Product Characteristics (SmPC) is the official document approved by the MHRA/EMA. It does not replace the patient leaflet or a doctor’s advice.

4.1. Therapeutic indications

For treatment of Rolandic epilepsy (benign childhood epilepsy with centrotemporal spikes).

Note:

Treatment with Ospolot should only be conducted by a paediatric neurologist with sufficient experience in treating epilepsy.

There is limited evidence from controlled clinical trials on the efficacy and safety of Ospolot. Prior to starting treatment with sulthiame, a thorough differential diagnostic procedure regarding other types of childhood epilepsies is indicated. Rolandic epilepsies demonstrate a high percentage of spontaneous remissions – even without drug treatment – and usually show a favourable course of disease and a good prognosis.

4.2. Posology and method of administration

Posology

The dose must be established and monitored by the doctor on an individual basis. The maintenance dose is about 5 to 10 mg per kg body weight per day. It should be built up step-wise (tapered in) over a one-week period.

Due to the short half-life of sulthiame, the daily dose should as far as possible be spread over three single doses (see tables 1 and 2 with dosing examples). If the daily dose is spread over the day in this way, constant plasma levels are to be expected after five to six days. Therapeutic plasma concentrations of sulthiame have not yet been determined.

A switch from another medicinal product or from combination treatment should be done gradually.

Paediatric population

Ospolot is suitable for use in children and adolescents weighing 12 kg or more. For dosing examples, refer to tables 1 and 2. However, dose titration must be carried out on an individual basis.

Table 1

Patient-Weight

Build-up dose: 2.5 mg* sulthiame per kg per day

Single dose

(given 3 x daily)

Total daily dose

12 - 18 kg

0.5 – 0.75 ml

(equivalent to 10 – 15 mg sulthiame)

1.5 – 2.25 ml

(equivalent to 30 – 45 mg sulthiame)

18 - 24 kg

0.75 – 1.0 ml

(equivalent to 15 – 20 mg sulthiame)

2.25 – 3.0 ml

(equivalent to 45 – 60 mg sulthiame)

24 - 30 kg

1.0 – 1.25 ml

(equivalent to 20 – 25 mg sulthiame)

3.0 – 3.75 ml

(equivalent to 60 – 75 mg sulthiame)

30 - 36 kg

1.25 – 1.5 ml

(equivalent to 25 – 30 mg sulthiame)

3.75 – 4.5 ml

(equivalent to 75 – 90 mg sulthiame)

36 – and above

1.5 ml and above

(equivalent to 30 mg sulthiame and above)

4.5 and above

(equivalent to 90 mg sulthiame and above)

*1 ml Ospolot oral suspension contains 20 mg sulthiame => 0.25 ml = 5 mg sulthiame

Table 2

Patient-Weight

Maintenance dose: 5 mg* sulthiame per kg per day

Single dose

(given 3 x daily)

Total daily dose

12 - 18 kg

1.0 – 1.5 ml

(equivalent to 20 – 30 mg sulthiame)

3.0 – 4.5 ml

(equivalent to 60 – 90 mg sulthiame)

18 - 24 kg

1.5 – 2.0 ml

(equivalent to 30 – 40 mg sulthiame)

4.5 – 6.0 ml

(equivalent to 90 – 120 mg sulthiame)

24 - 30 kg

2.0 – 2.5 ml

(equivalent to 40 – 50 mg sulthiame)

6.0 – 7.5 ml

(equivalent to 120 – 150 mg sulthiame)

30 - 36 kg

2.5 – 3.0 ml

(equivalent to 50 – 60 mg sulthiame)

7.5 – 9.0 ml

(equivalent to 150 – 180 mg sulthiame)

36 – and above

3.0 ml and above

(equivalent to 60 mg sulthiame and above)

9.0 and above

(equivalent to 180 mg sulthiame and above)

*1 ml Ospolot oral suspension contains 20 mg sulthiame => 0.25 ml = 5 mg sulthiame

Duration of treatment

Ospolot should not be discontinued abruptly. A paediatric neurologist experienced in treating epilepsy should decide on the duration of treatment and discontinuation on an individual basis.

If therapy is not successful, treatment with sulthiame should be discontinued after about one to two months.

Method of administration

Ospolot is for oral use.

A graduated 10 ml oral syringe with a corresponding adapter, and instructions for use within the package leaflet, are provided.

Before taking Ospolot, the bottle should be shaken very well (at least once for 30 seconds) and the dose drawn-up immediately afterwards (to avoid sedimentation). The oral suspension may be swallowed directly from the oral syringe, or taken straight after mixing it, preferably with a small volume of water or alternatively with orange juice, milk, yoghurt or wheat porridge. When taking the oral suspension directly from the oral syringe, the patient should drink some water, juice or milk immediately afterwards due to the bitter taste of sulthiame. Ospolot may be taken with or without food but carbonated beverages or hot food should be avoided as these can cause eructation or slowed swallowing. It is preferable that the way Ospolot is taken remains constant during therapy.

The oral suspension may also be administered via a feeding tube that should be flushed with a minimum of 15 ml of water immediately after administration. If this method of administration is used, the dose should be prepared as above immediately before administration.

4.3. Contraindications

- Hypersensitivity to the active substance, other sulphonamides, sodium methyl parahydroxybenzoate (E219), sodium propyl parahydroxybenzoate (E217) or to any of the excipients listed in section 6.1,

- Hyperthyroidism,

- Hypertension,

- Known acute porphyria.

4.4. Special warnings and precautions for use

Sulthiame should not be administered, or only administered with special caution

- in patients with impaired renal function

- in patients with a history of psychiatric disorders.

Laboratory monitoring

It is recommended that blood count, liver enzymes and renal function are measured before starting treatment with Ospolot. They should then be monitored weekly for the first month then at monthly intervals during the first six months. After six months of treatment, two to four checks per year are sufficient.

Note:

Treatment should be discontinued if a persistent increase in creatinine occurs.

Hypersensitivity reactions:

Instructions should be given to seek urgent medical advice if fever, sore throat, allergic skin reactions with lymph node swelling and/or flu-like symptoms occur during treatment with Ospolot. In cases of severe allergic reactions Ospolot must be discontinued immediately.

Progressive thrombocytopenia or leukopenia accompanied by clinical symptoms require discontinuation of Ospolot.

LHON:

In two patients with the inherited Leber hereditary optic neuropathy (LHON), sulthiame was considered a trigger for visual loss.

Suicidal ideation and suicidal behaviour

Suicidal ideation and behaviour have been reported in patients treated with antiepileptic medicinal products in several indications. A meta-analysis of randomised placebo controlled trials of anti-epileptic medicinal products has also shown a small increased risk of suicidal ideation and behaviour. The mechanism of this risk is not known and the available data do not exclude the possibility of an increased risk for sulthiame.

Therefore patients should be monitored for signs of suicidal ideation and behaviours and appropriate treatment should be considered. Patients (and caregivers of patients) should be advised to seek medical advice should signs of suicidal ideation or behaviour emerge.

Excipients

Sodium methyl parahydroxybenzoate (E219) and sodium propyl parahydroxybenzoate (E217) may cause allergic reactions (possibly delayed).

Sulphur dioxide (E 220) may rarely cause severe hypersensitivity reactions and bronchospasm.

This medicine contains glucose, sucrose and 0.0026 mg fructose in each ml. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltase insufficiency should not take this medicine. Glucose, fructose and sucrose may be harmful to the teeth.

This medicinal product contains less than 1 mmol sodium (23 mg) per ml, that is to say it is essentially “sodium-free”.

4.5. Interaction with other medicinal products and other forms of interaction

Before starting treatment with Ospolot it should be ascertained whether any other medicines are being used, including any obtained 'over-the-counter'.

Influence of other medicinal products on sulthiame

Primidone

If sulthiame is combined with primidone, the intensity of undesirable effects of sulthiame may increase; especially in children, dizziness, unstable gait and drowsiness may occur.

Carbamazepine

There are indications that sulthiame serum levels may decrease if carbamazepine is taken concomitantly.

Influence of sulthiame on other medicinal products

Phenytoin

If sulthiame is combined with phenytoin, the plasma levels of phenytoin can be markedly elevated. This combination requires especially strict monitoring and frequent controls of phenytoin plasma levels, particularly in the case of impaired renal function.

Lamotrigine

In combination with lamotrigine, an elevation of lamotrigine levels in the blood has also been observed in individual cases. Therefore, lamotrigine levels should be checked more frequently at the beginning of such a treatment.

Clobazam

Concomitant use of sulthiame and clobazam may result in elevated levels of the active metabolite of clobazam. Serum levels should be monitored.

CYP2C19

There is evidence that sulthiame inhibits CYP2C19 enzyme activity. When combining sulthiame with CYP2C19 substrates, serum levels of the substrates should be monitored.

Carboanhydrase-Inhibitors

Concomitant use of sulthiame and other carbonic anhydrase inhibitors (e.g. topiramate, acetazolamide) may increase the risk of undesirable effects due to carbonic anhydrase inhibition (see also section 4.8).

Alcohol

During treatment with sulthiame, the patient should abstain from alcohol. Sulthiame, as a sulphonamide derivative, theoretically may have an effect similar to that of disulfiram. These symptoms include a very unpleasant, although generally self-limiting systemic reaction caused by vasodilatation, with pulsating headache, respiratory depression, nausea, vomiting, tachycardia, hypotension, amblyopia, confusion, shock reactions, arrhythmias, loss of consciousness and seizures. The degree and duration of these symptoms can vary to a great extent.

4.6. Fertility, pregnancy and lactation

Pregnancy

There are no, or limited, data on the use of sulthiame in pregnant women. Animal studies are insufficient with respect to reproductive toxicity, but revealed embryotoxic effects (see section 5.3). Administration of antiepileptics during pregnancy has been generally associated with an increased risk for malformations, which may be increased if different antiepileptics are combined. Therefore, Ospolot is not recommended during pregnancy and in women of childbearing potential not using contraception.

In the case of pregnancy, the lowest seizure-controlling dose of Ospolot should be administered, if possible, as monotherapy. Prenatal diagnostic measures for early detection of malformations (high-resolution ultrasound and alpha-fetoprotein determination) are recommended. In no case should treatment with antiepileptics be discontinued without medical consent, as uncontrolled seizures can have serious consequences for both the mother and the unborn child.

Breastfeeding

It is unknown whether sulthiame or its metabolites are excreted in human milk and a risk to newborns and infants cannot be excluded. Ospolot should not therefore be taken while breast-feeding.

Fertility

There are no data on the effects of sulthiame on fertility.

4.7. Effects on ability to drive and use machines

Even when used as directed, this medicinal product can affect reactions to such an extent - especially at the start of treatment - that the ability to drive a vehicle or use machines may be impaired. This applies to a greater extent in combination with alcohol.

4.8. Undesirable effects

The following frequency categories are used for the evaluation of undesirable effects:

Very common

Common

Uncommon

Rare

Very rare

Not known

(≥ 1/10)

(≥ 1/100 to < 1/10)

(≥ 1/1,000 to < 1/100)

(≥ 1/10,000 to < 1/1,000)

(< 1/10,000)

(frequency cannot be estimated from the available data)

Metabolism and nutrition disorders

Common:

weight loss, lack of appetite

Psychiatric disorders

Uncommon:

hallucinations, anxiety, lack of drive

Not known:

depressive mood/depression, personality change and behavioural anomaly (e.g. aggressiveness, irritability, mood swings), cognitive impairment

Nervous system disorders

Common:

paraesthesias in the extremities and in the face*, dizziness, headache

Uncommon:

myasthenic phenomena, grand-mal status, increased seizure activity

Not known:

polyneuritis

Eye disorders

Common:

double vision

Not known:

visual impairment, that may be significant

Cardiac disorders

Common:

stenocardia, tachycardia

Respiratory, thoracic and mediastinal disorders

Common:

tachypnoea*, hyperpnoea*, dyspnoea, hiccups

Gastrointestinal disorders

Very common:

gastric complaints like e.g. nausea, vomiting (in about 10% of patients)

Not known:

diarrhoea

Hepatobiliary disorders

Not known:

hepatotoxic reactions, increase in liver enzymes

Skin and subcutaneous disorders

Not known:

Stevens-Johnson syndrome, TEN (toxic epidermal necrolysis)

Musculoskeletal and connective tissue disorders

Uncommon:

joint pain

Renal and urinary disorders

Not known:

acute renal failure

*Dose-dependent, if necessary the dose should be adjusted.

One patient with long-standing refractory epilepsy experienced progressive weakness of the limbs, hypersalivation, slurred speech, increasing drowsiness up to coma. The symptoms abated within hours of sulthiame being discontinued.

Sulthiame is a carbonic anhydrase inhibitor. Therefore, undesirable effects of carbonic anhydrase inhibition, such as renal stone formation, metabolic acidosis, tiredness/exhaustion, haemodilution and changes in serum electrolyte values (e.g. hypocalcaemia), may occur during administration of sulthiame (see also section 4.5).

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme, website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

4.9. Overdose

Sulthiame has a low toxicity and adults have survived overdoses of 4 to 5 g. Anecdotally, 20 g was reported to be fatal in one case but in another the patient recovered.

Symptoms of overdose

Headache, dizziness, ataxia, impaired consciousness, metabolic acidosis, crystalluria.

Treatment of overdose

No specific antidote is known. Gastric lavage and activated charcoal should be used to minimise absorption and supportive measures should be instigated to maintain vital functions. Sodium bicarbonate can be infused to treat acidosis. Alkalising diuretic therapy is recommended for preventing renal damage and crystalluria.

💬 Ask about this leaflet

Ask anything about Ospolot 20 mg/ml Oral suspension. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.

Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.

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