I forgot to take my seizure medicine this morning. What should I do?

Even though you know that it's important to take your medicine on time, now and then you might forget. What you should do about it depends on when the next dose is due.

  • If you are supposed to take your medicine just once a day, take the pill(s) as soon as you remember. If you don't remember until it's time for the next day's dose, just take your usual dose. Don't double up and take 2 day’s worth of medicine at the same time unless instructed by your doctor.
  • If you take your medicine two to four times each day, take the missed dose as soon as you remember it. Then space out the rest of your medicine that day so you can get all of your medicines in that day. However, if you have been having more seizures that day, call your doctor or nurse. They may ask you to make up the missed dose in another way, for example taking 2 doses closer together than usual.

How can I remember to take my medicine?

  • Talk to your doctor to see if there is a different form of your medicine that can be taken less often. For example, some medicines have long-acting forms that can be taken once or twice a day.
  • Set a plan to take your pills the same time each day. Ideally, take them at the same time you do something else, like before or after a meal or when you brush your teeth.
  • Set up reminders of when to take your pills. For example use alarms on an alarm clock or cell phone. Have text reminders or emails sent to you using Texting 4 Control program or your online seizure diary
  • Use a pillbox and fill it for a week at a time. Check the pillbox daily to make sure you didn’t miss a dose.
  • Carry a day’s worth of medicine with you in case you aren’t home at pill time.
  • Talk to your pharmacy about having pills pre-packed in a ‘blisterpak’ or some other form. Then you don’t need to worry about filling a pillbox and can easily tell if you or your loved one have missed a dose.
  • Write down when you miss a dose. Better yet, check off when you take the pills on a calendar. Then you can easily check your progress and see if missed pills occur before a seizure.

Can I take a generic seizure medicine?

Sometimes generic forms of a seizure medication are not exactly the same as the brand name.  The amount that gets absorbed into the body could be slightly different from one maker of a generic form to another, or between the brand name drug and a generic version.  So what should people do?

  • Never make a change in your medicines without checking with your doctor or nurse first (not just the pharmacist).
  • If your seizures are very well controlled or if you are taking a medicine like phenobarbital, you will probably be safe switching to a generic form.
  • If you have hard-to-control seizures, it may be risky making a change. Talk to your doctor first. He or she may want you to stay on the brand name drug.
  • If you take a generic form of seizure medicine, ask your pharmacist to give you medicine from the same manufacturer each time you refill the seizure medicine.
  • When you refill your prescription, look at the pills before you leave the pharmacy. If they look different, ask the pharmacist if you were given a generic instead of the brand name, or a different generic than before. If so, check with your doctor to see whether he or she approves.  
  • If you do make a switch in medicine, talk to your doctor or nurse.  They may want to check the level of medication in your blood before and after the switch.

The Epilepsy Foundation has published a statement recommending that switches involving generic medications should not be made without the permission of the doctor and the patient. If you do have seizures or other bad effects due to taking a generic seizure medicine, you or your doctor should report the problem to the FDA through its MedWatch program.

Should I take my medicine on an empty stomach?

Most seizure medicines can be taken either with food or between meals. There are a few exceptions, however.

  • Look up your medicine in our seizure medicine list (link to new database of seizure medicines) to find out how to take your medicine.
  • Be consistent. Take your medicine the same way every day. If it’s okay to take before food, always take before food. If you take it after food, do it this way all the time. Your body may absorb the medication differently (for example faster or slower) if you take it before or after food.
  • If you take your medicine on an empty stomach and side effects bother you, try taking it with food instead. Food may even out how fast the medicine is absorbed and lessen side effects.

What should I do if a medicine I am taking doesn't stop my seizures?

In the United States, many new drugs have been approved to treat epilepsy in the past 20 years. This means that there are different drugs available to treat different types of epilepsy.  If your current seizure medicine doesn't work for you, talk to your doctor about other options.

  • Your doctor may suggest trying a different medicine. Or a second medicine may be added to what you are already taking.  These decisions should always be made with the help of your doctor.  You should not stop or change a seizure medicine on your own; sudden changes or stopping a medicine can trigger dangerous seizures. 
  • If you have tried at least two seizure medicines at the highest doses you can tolerate and they don’t work to control seizures, the chance that a different medicine will work is small.  (Your doctor may say that your epilepsy is "intractable" or "medically refractory.")
  • If medicines don't work, you should see an epilepsy specialist to make sure that your seizures have been diagnosed correctly. If your diagnosis is correct and your seizures still cannot be controlled with medicines, it may be time to try something else. Other types of treatment (such as surgery, devices, or dietary therapy) are available. An epilepsy center can help you find out if any of these may be possible for you.
Authored by: Steven C. Schachter, MD | Patricia O. Shafer, RN, MN | Joseph I. Sirven, MD on 7/2013
Reviewed by: Joseph I. Sirven, MD | Patricia O. Shafer, RN, MN on 3/2014
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