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Active ingredient:
Available from:
ATC code:
Pharmaceutical form:
Administration route:
Prescription type:
Manufactured by:
Therapeutic group:
Therapeutic area:
Therapeutic indications:
Treatment of epilepsy in adults and in treatment of the so called focal benign epilepsy of children, when other medication was not adequate.
Authorization number:
066 04 28222 00
Authorization date:

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Patient leaflet in accordance with the Pharmacists'

Regulations (Preparations) - 1986

This medicine is to be supplied by physician’s prescription only


Film-coated tablets

Active ingredient:

Each tablet contains:

Sulthiame 200 mg

Each tablet contains 50 mg lactose monohydrate.

Read the entire leaflet carefully before you start using this medicine. This leaflet contains essential information

about this medicine. If you have any further questions, refer to the physician or the pharmacist.

This medicine has been prescribed to treat your illness. Do not pass it on to others. It may harm them, even if it seems

to you that their illness is similar.

Ospolot is an anti-epileptic medicine with an anticonvulsant activity for the treatment of epilepsy.

What is this medicine used for?

Ospolot is indicated for the treatment of epilepsy in adults and in treatment of the so called focal benign epilepsy of

children, when other medication was not adequate.

Therapeutic group: Carbonic anhydrase inhibitors.

Before using this medicine

Special warnings regarding the use of this medicine

Do not use this medicine without consulting your physician prior to commencing treatment:

If you suffer or have previously suffered from impaired renal function

If you suffer or have previously suffered from psychiatric disorders

If you are pregnant, planning to become pregnant or breastfeeding

Consult your attending physician immediately if any one or more of the following appear:

Fever, sore throat, allergic skin reaction accompanied by lymph node swelling and/or occurance of flu-like

symptoms during treatment with Ospolot.

Changes in blood test results such as decrease in white blood cell count or platelet count (leucopenia or

thrombocytopenia) that occur with other symptoms such as fever and sore throat. Your physician may decide to

stop treatment with Ospolot immediately.

In case of severe allergic reaction, Ospolot must be discontinued immediately.

It is advisable to have your blood, liver function, and renal function tested before starting treatment with Ospolot;

once a week during the first month of treatment with Ospolot, and once a month after that. After the first six

months of treatment with Ospolot it is advisable to have these tests at least two to four times a year.

There are reports of some patients who were treated with anti-epileptic medicines such as Ospolot, who

expressed a wish to harm themselves, or experienced suicidal thoughts. If you have had such thoughts at any

time during treatment with Ospolot, consult your physician immediately.

Do not use this medicine if:

You have a known sensitivity to the active ingredient (Sulthiame), or to medicines from the sulphonamide

group, and/or to any of the other ingredients of this medicine (please refer to “Additional information”).

You suffer from hyperthyroidism.

You suffer or have previously suffered from acute porphyria.

You suffer from high blood pressure.

If you are taking or have recently taken other medicines, including non-prescription medications and

nutritional supplements, inform your physician or pharmacist.

In particular, inform the physician or the pharmacist

if you are taking:

Medicines for treating epilepsy:

Phenytoin - Levels of phenytoin in your blood may rise significantly. You must regularly have blood tests

during combination therapy with Ospolot and this medicine to monitor phenytoin levels in your blood. This

is particularly important if you have impaired renal function.

Lamotrigine - Levels of lamotrigine in your blood may rise. You must regularly have blood tests during

combination therapy with Ospolot and this medicine to monitor lamotrigine levels in your blood. This is

particularly important if you have impaired renal function.

Primidone - Combination therapy with Ospolot and primidone may cause severe side effects, especially

in children. These include dizziness, unstable gait, drowsiness, and psychotic reactions.

Carbamazepine - Combination therapy with Ospolot and carbamazepine may cause a decrease in

Ospolot levels in your blood.

Phenobarbitone - Ospolot may cause an increase in phenobarbitone levels in your blood.

Combination therapy with Ospolot and other carbonic anhydrase inhibitors, such as topiramate (used to treat

epilepsy and migraine) or acetazolamide (used to treat intraocular pressure) can increase the risk of side effects


Taking Ospolot and food

Ospolot can be taken with or without food. There are no restrictions on the types of food and drink you can have.

Taking Ospolot and alcohol

Do not drink alcoholic beverages during treatment with Ospolot.

Drinking alcoholic beverages during treatment with Ospolot can have an unexpected influence on the way Ospolot

affects you. It can also cause vasodilatation, pulsating headache, shortness of breath, nausea, vomiting, tachycardia,

hypotension, blurred vision, confusion, shock reaction, cardiac arrhythmia, loss of consciousness, and seizures.

Pregnancy and breastfeeding

Do not take Ospolot if you are pregnant or breastfeeding.

If you think you might be pregnant or you are planning to become pregnant, inform your physician so that he or she

may consider whether to stop treatment with Ospolot.

Ospolot passes into breast milk so do not take Ospolot if you are breastfeeding.

Driving and using machines

This medicine can cause changes in your reactions, so using Ospolot requires caution when driving a car,

operating dangerous machines and any other activity that requires alertness. Children must be warned from

riding bicycles, playing near roads, etc.

This warning applies especially when combining Ospolot with alcohol.

Important information about some of the medicine’s ingredients

Ospolot contains lactose. If you are intolerant to certain sugars consult your physician before starting treatment with


How should you use the medicine?

Always use according to the physician's instructions. You should check with the physician or with the pharmacist if you

are not sure.

The dosage and manner of treatment will be determined only by the physician. The recommended dose is


The accepted maintenance dosage is 5-10 mg per kilogram body weight, a day. This dose must be reached

gradually over the first week of Ospolot treatment.

Switching to Ospolot from another medicine or another combination must be done gradually, not all at once.

The tablets may be split on the score line.

Swallow the tablets with at least one glass of water.

Your daily dosage can be divided into three doses taken during the day.

Do not take Ospolot lying down.

If you have accidentally taken a higher dose, or if a child has accidentally swallowed the medicine, go

immediately to a hospital emergency room or to a physician and bring the medicine package with you. If this occurs,

the side effects listed in this leaflet can be intensified.

If you forget to take the medicine at the scheduled time, take the next dose at the usual time. Do not take a double

dose to compensate for the forgotten dose and inform your physician about it.

If you stop taking Ospolot you may compromise the success of your treatment and the seizures may return.

Do not stop treatment without consulting your physician about it. Treatment duration and dosage may vary between

patients; only your attending physician will determine duration and dosage.

If you have any further questions regarding the use of this medicine, consult the physician or the pharmacist.

Side effects

As with any medicine, the use of Ospolot may cause side effects in some users. Do not be alarmed by reading the list

of side effects. You may not experience any of them.

Please pay special attention to those side effects which require you to consult a physician immediately and/or

stop treatment immediately and that are listed in the section "Before using this medicine" under the heading

"Special warnings regarding the use of this medicine".

Very common side effects:

gastrointestinal disturbances, anorexia, breathing difficulties that may develop into shortness of breath

(hyperpnoea, dyspnoea(

Common side effects:

rapid breathing

chest pressure, palpitations

tingling in the limbs and in the face


double vision

persistent hiccups, weight loss

Uncommon side effects:

hallucinations, anxiety, lack of motivation, depression, behavioral problems such as: aggressiveness, irritability,

mood swings



muscle weakness, joint pain

increased number of seizures, grand-mal-status


sleeplessness (insomnia)

Stevens-Johnson syndrome

leucopenia (low number of white blood cells)

Side effects of unknown frequency:

Lyell's syndrome


acute renal failure

polyneuritis, significant deterioration of vision

toxic reactions of the liver, abnormal levels of enzymes related to liver function

In one case, administration of Ospolot led to an increasing weakness of the limbs, hypersalivation, slurred speech and

drowsiness up to coma.

These symptoms disappeared within hours of Ospolot discontinuation.

Ospolot is a medicine from the carbonic anhydrase inhibitor group; this group causes side effects such as renal stones

and changes in blood composition (metabolic acidosis, hemodilution, changes in blood serum electrolyte values).

If any side effect appears, if any of the side effects worsens, or if you suffer from a side effect not mentioned in this

leaflet, consult with the physician.

Reporting side effects:

Side effects can be reported to the Ministry of Health (MoH) by clicking on the "Report on side effects due to

medication therapy" link on the MoH home page (www.health.gov.il) which refers to the online form for side effects

reporting, or by entering the link


How to store the medicine?

Avoid poisoning! This medicine and any other medicine should be kept in a close place out of the reach of children

and/or infants in order to avoid poisoning. Do not induce vomiting without an explicit instruction from the physician.

Do not take medicines in the dark! Check the label and the dose each time you take the medicine. Wear glasses if

you need them.

Do not use the medicine after the expiry date (exp. date) appearing on the outer package. The expiry date refers to

the last day of that month.

Do not store at a temperature above 25°C.

Use the medicine within 12 weeks after first opening.

Keep the container tightly closed.

Do not use the medicine if you notice that the color of the tablets has changed or if the tablets have swelled or seem

more brittle.

Additional information

In addition to the active ingredient Sulthiame the medicine also contains:

Maize starch, Lactose monohydrate, Talc, Colloidal anhydrous silica, Gelatin, Magnesium stearate,

Hypromellose, Macrogol 4000, Titanium dioxide.

Each tablet contains 50 mg lactose monohydrate.

What does the medicine look like and what are the contents of the package:

Plastic or glass bottle containing 50 round, slightly curved, white film-coated tablets with a score line on one side and

the number "200" on the other side.

Registration holder and his address: MegaPharm Ltd., P.O.B. 519, Hod Hasharon 4510501.

Manufacturer and his address: Desitin Arzneimittel GmbH, Hamburg, Germany.

This leaflet was checked and approved by the Ministry of Health in January 2016.

Registration number of the medicine in the National Drug Registry of the Ministry of Health:


Summary of Product Characteristics (SPC)



200 mg, film-coated tablets



200 mg

1 film-coated tablet contains 200 mg sulthiame.

Excipient(s) with known effect: one tablet contains 50.0 mg lactose monohydrate

For the full list of excipients, see section 6.1.


Film-coated tablet


200 mg

White, round, slightly domed film-coated tablet with a dividing groove on one side and

marked “200” on the other side. The tablet can be divided into equal doses.


4.1 Therapeutic indications

Treatment of epilepsy in adults and in treatment of the so called focal benign epilepsy of

children, when other medication was not adequate


Treatment with Ospolot


should only be conducted by a paediatric neurologist with

sufficient experience in treating epilepsy.

Efficacy and safety of Ospolot


in the above-mentioned indication have not been

investigated in controlled studies. 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


4.2 Posology and method of administration


The dosage must be established and monitored by the doctor on an individual basis. The

maintenance dose is about 5 to 10 mg/kg body weight/day. It should be built up step-wise

(tapered in) over a one-week period. Ospolot

200 mg film-coated tablets have a dividing


Due to the short half-life of sulthiame, the daily dose should as far as possible be spread

over three single doses. 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.

Method of administration

The film-coated tablets should be swallowed whole (unchewed) with plenty of liquid

(approx. one glass of water), as far as possible spread over 3 single doses.

A change from another medication or from combination treatment should be done

gradually. Ospolot


should not be discontinued abruptly. A paediatric neurologist

experienced in treating epilepsy should decide on dose adjustment, 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.

It is recommendable to monitor the blood count, liver enzymes and renal function

parameters before treatment with Ospolot


, then at weekly intervals in the first month of

treatment, and thereafter at monthly intervals. After six months of treatment, two to four

checks per year are sufficient.

4.3 Contraindications


may not be used in cases of

known hypersensitivity to sulthiame, other sulphonamides or to any of the excipients

listed in section 6.1.

Sulthiame should not be used in patients with

known acute porphyria

hyperthyroidism or arterial hypertension.

4.4 Special warnings and precautions for use

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

adequate monitoring

in patients with impaired renal function

in patients with a history of psychiatric disorders

during pregnancy and lactation (see also section 4.6)

The patients, their caregivers, and families should be instructed to consult the attending

doctor immediately if fever, sore throat, allergic skin reactions with lymph node swelling

and/or flu-like symptoms occur during treatment with Ospolot. Progressive

thrombocytopenias or leukopenias that are accompanied by clinical symptoms, such as

fever or sore throat, require interruption of treatment. In cases of severe allergic reactions,

Ospolot must be discontinued immediately. Treatment should also be interrupted if a

lasting increase in creatinine occurs. The blood count, liver enzymes and urine should be

checked regularly (see also section 4.2).

Patients with rare hereditary problems of galactose intolerance, lactase deficiency or

glucose-galactose malabsorption should not take Ospolot®.

Suicidal ideation and suicidal behaviour

Suicidal ideation and behaviour have been reported in patients treated with antiepileptic

agents in several indications. A meta-analysis of randomised placebo controlled trials of

anti-epileptic drugs 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 treated with any antiepileptic drug (AED) for any indication should be

monitored for the emergence or worsening of depression, suicidal thoughts or behaviour,

and / or any unusual changes in mood or behaviour 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.

Anyone considering prescribing sulthiame or any other AED must balance this risk with

the risk of untreated illness. Epilepsy and many other illnesses for which AEDs are

prescribed are themselves associated with morbidity and mortality and an increased risk

of suicidal thoughts and behaviour. Should suicidal thoughts and behaviour emerge during

treatment, the prescriber needs to consider whether the emergence of these symptoms in

any given patient may be related to the illness being treated.

Patients, their caregivers, and families should be informed that AEDs increase the risk of

suicidal thoughts and behaviour and should be advised of the need to be alert for the

emergence or worsening of the signs and symptoms of depression, any unusual changes

in mood or behaviour, or the emergence of suicidal thoughts, behaviour, or thoughts about

self-harm. Behaviours of concern should be reported immediately to the treating doctor.

Effect on Laboratory Tests

Sulthiame may interfere with the estimation of barbiturates in laboratory tests on blood.

4.5 Interaction with other medicinal products and other forms of interaction

Prior to starting treatment with Ospolot


, the patient should be asked about other

medicines, including OTC products, he/she is using.


The concomitant use of sulthiame and primidone may lead to severe side-effects,

especially in children, including dizziness, unstable gait, drowsiness and psychotic



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



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.

Phenobarbitone: Sulthiame may also induce a rise in the serum level of phenobarbitone.


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.


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).


During treatment with sulthiame, the patient should abstain from alcohol, since

sulphonamides have an effect similar to that of disulfiram, and sulthiame, as a

sulphonamide derivative, can theoretically have a similar effect. 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

No systematically gained experience on administration of sulthiame in humans during

pregnancy and lactation is available, in animal studies, embryotoxic effects have been

revealed (see also section 5.3). Therefore Ospolot


may not be used during pregnancy

and lactation.

4.7 Effects on ability to drive and use machines

Even when used as directed, these medicinal products 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



1/100 to




1/1,000 to




1/10,000 to < 1/1,000)

Very rare



Not known (frequency cannot be estimated from the available data)

Metabolism and nutrition disorders

Very common: anorexia


weight loss

Psychiatric disorders


hallucinations, anxiety, lack of drive, psychic changes, depression,

behavioural anomaly (e.g. aggressiveness, irritability, mood swings)

Nervous system disorders


ataxia, paraesthesias in the extremities and in the face (dose

dependent), dizziness (giddiness),


headache, myasthenic phenomena, grand-mal status, increased

seizure activity, drooling, insomnia

Not known:


Eye disorders


double vision

Not known: significant deterioration of vision

Cardiac disorders


stenocardia, tachycardia

Respiratory, thoracic and mediastinal disorders

Very common: hyperpnoea, dyspnoea


tachypnoea, , singultus

Gastrointestinal disorders

Very common:

gastric complaints (in about 10% of patients)

Uncommon: abdominal pain, nausea

Hepatobiliary disorders

Not known:

hepatotoxic reactions, increase of liver enzymes

Skin and subcutaneous disorders

Uncommon: Stevens-Johnson syndrome,

Not Known: Rash, Lyell's syndrome

Musculoskeletal and connective tissue disorders


joint pain

Renal and urinary disorders

Not known:

acute renal failure

Blood and lymphatic system disorders

Uncommon: leucopenia

In one case, administration of Ospolot


led to progressive weakness of the limbs,

hypersalivation, slurred speech, increasing drowsiness up to coma. The symptoms abated

within hours of Ospolot


being discontinued.

Sulthiame is a carbonic anhydrase inhibitor. Therefore, undesirable effects of carbonic

anhydrase inhibition, such as renal stone formation, metabolic acidosis, haemodilution

and changes in serum electrolyte values, cannot be excluded during administration of

sulthiame (see also section 4.5).

Disturbances in calcium and Vitamin D metabolism have been occasionally reported in

association with long-term anticonvulsant therapy.

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


Any suspected adverse events should be reported to the Ministry of Health according to

the National Regulation by using an online form



4.9 Overdose

Symptoms of intoxication

Headache, vomiting, hypotension, dizziness, ataxia, impaired consciousness, metabolic

acidosis, crystals in the urine. Sulthiame has a low toxicity. Overdoses of 4 to 5 g

sulthiame have been survived. The intake of about 20 g sulthiame by adults with the

intention of committing suicide was fatal in one case. In another case, a restitutio ad

integrum was achieved.

Treatment of intoxications

A specific antidote is not known. The standard measures (gastric lavage and active

charcoal) for minimising absorption and for maintaining vital functions should be taken.

Sodium bicarbonate can be infused to treat acidosis. Alkalising diuretic therapy is

recommended for preventing renal damage and crystalluria.


5.1 Pharmacodynamic properties

Pharmacotherapeutic group: Antiepileptics

ATC code: N03AX03

Sulthiame belongs to the group of carbonic anhydrase inhibitors and displays an

anticonvulsant effect in the electroconvulsion test (rat and mouse) and in the convulsion

test with pentamethylene tetrazole (mouse).

5.2 Pharmacokinetic properties

Sulthiame pharmacokinetics were not systematically investigated in different age

categories in children and adolescents.


After oral administration, sulthiame is rapidly and completely absorbed, predominantly

from the upper section of the small intestine. Peak plasma concentrations are measured

after 1 - 5 hours.


About 29% of the active substance is bound to plasma proteins.


80 to 90% is eliminated with the urine and 10 to 20% with the faeces after biliary

secretion. Within 24 hours, 32% of the administered dose is excreted unchanged via the


5.3 Preclinical safety data

Acute toxicity

See section 4.9.

Chronic toxicity

Long-term investigations on various animal species (rat, dog) have revealed no evidence

of dose-dependent toxic changes. With high doses, renal damage has been observed due

to crystallisation of the substance.

Carcinogenic and mutagenic potential

In three different in vivo and in vitro experimental models, no mutagenic potential of

sulthiame has been revealed. Long-term carcinogenicity studies have not been


Reproductive toxicity

Reproductive toxic properties of sulthiame are not sufficiently investigated. In an

embryotoxicity study on rats, embryotoxic effects have been revealed at the lowest

investigated dose (30 mg/kg/day). Studies on fertility disorders and effects on peri- and

postnatal development of the off-spring are lacking.


6.1 List of excipients

Maize Starch, Lactose monohydrate, Talc, colloidal anhydrous Silica, Gelatin,

Magnesium stearate, Hypromellose, Macrogol 4000, Titanium dioxide.

One tablet contains 50.0 mg lactose monohydrate.

6.2 Incompatibilities

Not applicable.

6.3 Shelf life

3 years

The medicinal product should not be used after the expiry date (see folding box).

6.4 Special precautions for storage

Keep the container tightly closed.

Store below 25˚c

Use this medicine within 12 weeks after first opening

6.5 Nature and contents of container

Folding boxes containing 200 film-coated tablets in brown glass bottles with a child-proof

polyethylene stopper.

Folding boxes containing 200 film-coated tablets in polyethylene containers with a child-

proof polypropylene screw cap.

Not all pack sizes may be marketed.

6.6 Special precautions for disposal and other handling

No special requirements.



Weg beim Jäger 214

22335 Hamburg, Germany


Megapharm Ltd. Hod Hasharon P.O.Box 519 4510501



The format of this leaflet was determined by the ministry of health and its content was

checked and approved January 2016

OSP SPC 012016 P.1

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