Stiripentol and Anesthesia

Q:  My daughter is having surgery.  What type of anesthesia can be used with stiripentol?  Are there interactions between stiripentol and anesthesia?  I called Biocodex, the maker of stiripentol, and they didn’t have the answer. 

A:    Pharmaceutical companies don’t generally give information out on questions that have not been studied or documented with literature. 

Most anesthetics  are metabolized in the liver and will interact with stiripentol, and to what extent is unknown, making it impossible for a recommendation to decrease stiripentol dose or decrease anesthetic dose. 

It is important that your child gets regularly scheduled anti-epileptic drugs if at all possible.  If your child cannot have regularly scheduled anti-epileptic drugs during surgery, an alternative plan involving your child’s neurologist should be determined. 

 The anesthetic is likely to work longer than anticipated, so recovery may take a little longer.  The anesthesiologists will have to be aware of this and the fact that coming off the breathing tube may take a little longer.  Subsequently, your daughter  may be a little more sleepy and lethargic for longer than anticipated during recovery,  but careful monitoring by the anesthesia staff will minimize risk of complications.  Making them aware of these facts increases their awareness of the situation and what to look for. 

 Equally importantly, caution in extent of pain relivers, especially opiates, after surgery should be used.  Stiripentol will interact with these drugs as well and may delay discharge from hospital due to lethargy or respiratory depression.  Again, these drugs will last longer and the effects will be intensified if an interaction occurs.

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