Question About Evening Epilepsy Medication After a Dosing Mistake
My husband, a 56-year-old weighing 230 pounds, is diagnosed with epilepsy. Typically, he follows a regimen that includes 2000 mg of Levetiracetam and 400 mg of Carbamazepine ER each morning, and in the evenings, he takes 2000 mg of Levetiracetam, 400 mg of Carbamazepine ER, along with 300 mg of Xcopri. This morning, however, he accidentally consumed 4000 mg of Levetiracetam, 800 mg of Carbamazepine ER, and 150 mg of Xcopri since one Xcopri pill remained in his medication container. It's been nearly six hours since this incident, and he reports feeling well. He plans to take the last Xcopri pill, but should he proceed with his usual doses of Levetiracetam and Carbamazepine tonight, or should he skip them and resume his normal schedule in the morning? Beyond these medications, he also takes 1000 mg of Calcium, 1000 IU of Vitamin D, 30 ml of Lactulose, a B Complex supplement, and 0.125 mg of Levothyroxine daily. We have reached out to his neurologist but are anxious that we might not receive feedback before the office closes today.
Answers (1)
2/5/2026, 9:20:37 PM
OpenHealth AI
It’s understandable to feel anxious after a medication dosing mistake, especially with multiple medications involved. Based on the information provided, your husband has taken an excess dose of Levetiracetam, Carbamazepine, and Xcopri, but he is currently feeling well.
Considerations:
- Levetiracetam: The maximum recommended dosage for adults is often around 3000 mg per day, so 4000 mg within a single day exceeds this limit.
- Carbamazepine: Taking 800 mg also exceeds his regular daily intake.
- Xcopri (Lacosamide): Taking 150 mg instead of 100 mg is a slightly elevated dose.
Next Steps:
-
Monitor Symptoms:
- Be vigilant for any unusual symptoms, such as increased drowsiness, confusion, dizziness, irritability, or seizures. It’s important to note any changes.
-
Skip Tonight's Doses:
- Given the overdose today, it is advisable to skip the evening doses of Levetiracetam, Carbamazepine, and Xcopri. Resuming your regular medication schedule tomorrow morning is typically safer.
-
Hydration:
- Ensure he stays well-hydrated, as this can help with overall wellness and potentially dilute medication effects.
-
Consult the Neurologist:
- Even if you have already reached out, if symptoms arise, or you have concerns later tonight, you can consider calling an emergency line or seeking immediate assistance if needed.
-
Plan for Tomorrow:
- Plan to discuss today's incident with your neurologist to get guidance tailored to his specific situation and medication regimen.
Reassurance:
It’s good that he is feeling well at this moment, but remaining cautious is key. Avoid taking his evening doses tonight, and monitor closely for any changes in his condition. If you're able, follow up with your healthcare provider when possible for further personalized advice.
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