Alternatives to Fintepla If You Can't Fill Your Prescription

When a prescription can't be filled quickly — whether due to insurance delays, REMS logistics, or a temporary gap in care — it's critical that families and caregivers know what other options exist. Uncontrolled seizures in conditions like Dravet syndrome and Lennox-Gastaut syndrome (LGS) can be life-threatening. Here's what the evidence says about alternatives to Fintepla.

Important: Never stop or switch antiseizure medications without guidance from your neurologist. Abrupt changes can trigger status epilepticus, a medical emergency.

FDA-Approved Drugs for Dravet Syndrome

Dravet syndrome has three FDA-approved add-on therapies. Treatment guidelines recommend them in a specific order:

1. Diacomit (Stiripentol) — Second-Line Option, Same Tier as Fintepla

Stiripentol (brand name: Diacomit) was FDA-approved for Dravet syndrome in August 2018. Like Fintepla, it's positioned as a second-line add-on therapy. It's typically used in combination with clobazam (Onfi). A placebo-controlled trial showed 71% of children treated with stiripentol had greater than 50% decrease in seizures, compared to only 5% treated with placebo.

A 2024 network meta-analysis found Diacomit was "at least as effective" as Fintepla for seizure control in Dravet syndrome, and both were more effective than Epidiolex. Stiripentol is also a Schedule IV controlled substance and also requires specialty pharmacy access (though not a REMS program).

Best for: Patients who need a second-line Dravet syndrome option alongside clobazam

Note: Can also be used together with Fintepla; when on both, Fintepla dose must be reduced (max 17 mg/day)

2. Epidiolex (Cannabidiol) — Third-Line Option for DS and LGS

Epidiolex is a pharmaceutical-grade cannabidiol (CBD) oral solution approved by the FDA in June 2018 for Dravet syndrome, and also approved for LGS and tuberous sclerosis complex (TSC). It is a Schedule V controlled substance, which makes it somewhat easier to access than Fintepla or Diacomit.

International treatment guidelines position Epidiolex as a third-line option for Dravet syndrome (after valproate, fenfluramine, and stiripentol), but it's widely used and generally more accessible since it doesn't require a REMS program. In Dravet-specific trials, 43% of patients on Epidiolex had greater than 50% decrease in seizures versus 27% on placebo.

Best for: Patients with both DS and LGS; easier access due to no REMS requirement

Note: May cause elevated liver enzymes; monitor LFTs if also on valproate

3. Onfi (Clobazam) — Broad Adjunctive Option for DS and LGS

Clobazam (Onfi) is a benzodiazepine-type antiseizure medication FDA-approved as an adjunct treatment for LGS in patients 2 years and older. It is widely used in both Dravet syndrome and LGS as a second-line option. Clobazam is a Schedule IV controlled substance, available at many pharmacies (including retail), though some patients may still need specialty pharmacy access.

Best for: Patients on Diacomit (the two are often paired); broad availability

Note: Risk of tolerance over time; do not stop abruptly

4. Depakote/Depakene (Valproate/Valproic Acid) — First-Line for DS

Valproate is the first-line treatment for Dravet syndrome. If a patient is not already on it, valproate (available as Depakote, Depakene, or generic valproic acid) is typically tried before adding Fintepla. It is widely available in generic form, making it significantly more affordable and accessible.

Best for: First-line use in newly diagnosed Dravet syndrome

Note: Requires regular liver function and blood level monitoring; avoid in women of childbearing age if possible

Drugs to Avoid in Dravet Syndrome

This is critically important: several commonly prescribed antiseizure medications are

contraindicated in Dravet syndrome because they are sodium channel blockers that can actually worsen seizures. These include:

Lamotrigine (Lamictal)

Carbamazepine (Tegretol)

Oxcarbazepine (Trileptal)

Phenytoin (Dilantin)

Rufinamide (Banzel)

If someone is prescribed these medications before a Dravet syndrome diagnosis is confirmed, talk to a neurologist immediately about transitioning away from them.

Non-Drug Options: Ketogenic Diet and VNS

For patients who continue to have inadequate seizure control despite multiple medications, non-pharmacological options may be considered. The ketogenic diet has demonstrated the ability to decrease seizure frequency in DS. Vagus nerve stimulation (VNS) is an implantable device listed as a fourth-line option in treatment guidelines.

Still Trying to Get Fintepla? medfinder Can Help

If you haven't been able to get Fintepla filled, medfinder can contact certified specialty pharmacies on your behalf to verify which ones can fill your prescription. Read more in our guide to how to find Fintepla in stock near you.