Comprehensive medication guide to Fintepla including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
About 99% of commercially insured patients pay $0–$25/month through the UCB ONWARD Copay Assistance Program. Medicaid patients average $4.95–$9.85/month. Medicare costs vary by plan and coverage phase. Prior authorization is required by most payers.
Estimated Cash Pricing
Fintepla is a brand-name specialty drug with no generic equivalent; it is not available through standard retail pharmacies. Cash price without insurance would be very high. Most patients access it through insurance with the UCB ONWARD Copay Assistance Program capping costs at $0–$25/month.
Medfinder Findability Score
55/100
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Fintepla (fenfluramine) is a prescription antiseizure medication approved by the FDA for the treatment of seizures associated with Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) in patients 2 years of age and older. It is a cherry-flavored oral solution containing 2.2 mg/mL fenfluramine.
Fintepla was first approved by the FDA for Dravet syndrome on June 25, 2020, and received a second approval for Lennox-Gastaut syndrome on March 28, 2022. It is manufactured and marketed by UCB, a global biopharmaceutical company that acquired it from Zogenix in 2022. Fintepla was granted Orphan Drug Designation and pediatric exclusivity by the FDA.
Fintepla is a Schedule IV controlled substance (CIV) and is available exclusively through the FINTEPLA REMS (Risk Evaluation and Mitigation Strategy) program — a federal safety program requiring cardiac monitoring. It can only be dispensed by REMS-certified specialty pharmacies, and only prescribed by REMS-certified providers.
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The exact mechanisms by which Fintepla reduces seizures are not fully understood. Unlike most antiseizure medications that work by blocking sodium channels or enhancing GABA inhibition, Fintepla primarily works through the serotonin system. It acts as a serotonin-releasing agent — causing neurons to release stored serotonin, which then activates inhibitory serotonin receptors (particularly 5-HT2C) that help calm overactive brain circuits.
Fintepla also activates sigma-1 receptors, which are intracellular proteins that help regulate neuronal excitability. This dual serotonergic and sigma-1 receptor mechanism gives Fintepla a complementary profile to other Dravet syndrome medications like stiripentol (GABA-mediated) and cannabidiol (calcium channel/TRP channel effects). Its metabolite norfenfluramine is also pharmacologically active.
In patients with Dravet syndrome — where SCN1A gene mutations impair inhibitory interneurons — Fintepla's serotonergic actions appear to compensate for the loss of inhibitory function, helping reduce seizure frequency and severity. In clinical trials for Dravet syndrome and LGS, fenfluramine demonstrated significant reductions in monthly seizure frequency compared to placebo, with effects sustained over years of treatment.
Starting dose: 0.1 mg/kg — oral solution (2.2 mg/mL)
Taken twice daily; titrate weekly based on response and tolerability
Maximum 26 mg/day — oral solution (2.2 mg/mL)
Without stiripentol: max 0.35 mg/kg twice daily (26 mg/day total)
Maximum 17 mg/day — oral solution (2.2 mg/mL)
With stiripentol + clobazam: max 0.2 mg/kg twice daily (17 mg/day total)
Maximum 20 mg/day — oral solution (2.2 mg/mL)
With strong CYP1A2 or CYP2D6 inhibitors: max 20 mg/day
Fintepla is not on the FDA's Drug Shortage Database — it is not in a traditional drug shortage. However, finding it is not straightforward. Fintepla is exclusively dispensed through REMS-certified specialty pharmacies, meaning it cannot be filled at standard retail pharmacy chains. Most local pharmacies — even large chains — simply cannot dispense it.
The most common access barriers are: REMS enrollment requirements for both prescriber and pharmacy (takes 1-2 weeks), insurance prior authorization (30-45 days for standard review), baseline echocardiogram requirement before first dose, and specialty-only mail delivery. These logistics can make it feel like a shortage even when supply exists.
To quickly identify which REMS-certified specialty pharmacies can fill your Fintepla prescription, use medfinder — a service that contacts pharmacies on your behalf and texts you the results.
Fintepla is a Schedule IV controlled substance available exclusively through the FINTEPLA REMS program. Any licensed prescriber can become REMS-certified, but in practice, Fintepla is almost exclusively prescribed by specialists in epilepsy and pediatric neurology. Prescribers must enroll at FinteplaREMS.com before writing their first prescription.
Pediatric neurologists (most common prescribers)
Epileptologists (subspecialists in epilepsy)
Child neurologists
Adult neurologists (for adult patients transitioning from pediatric care)
Nurse practitioners and physician assistants with prescribing authority (if REMS-certified)
Telehealth prescribing of Fintepla is possible for REMS-certified providers, but the mandatory baseline echocardiogram typically requires at least one in-person visit before treatment can begin. Many academic epilepsy centers offer co-management arrangements for patients in rural areas.
Yes. Fintepla (fenfluramine) is a Schedule IV controlled substance (CIV) under the DEA's Controlled Substances Act. Schedule IV drugs have a recognized medical use but also a potential for dependence, though this potential is considered relatively low. Other Schedule IV drugs include benzodiazepines like alprazolam (Xanax), diazepam (Valium), and clonazepam (Klonopin).
As a CIV controlled substance, Fintepla prescriptions are subject to federal and state controlled substance regulations. Prescribers must be licensed to prescribe Schedule IV medications. Refill rules vary by state but typically allow a limited number of refills per prescription. Fintepla's controlled substance status, combined with its REMS requirements, means it goes through additional verification steps at specialty pharmacies before dispensing.
The controlled substance classification reflects fenfluramine's historical context (it was previously misused for weight loss at high doses) and does not change its legitimate, evidence-based use for epilepsy treatment at therapeutic doses under strict medical supervision.
In Dravet syndrome clinical trials, the most common side effects (≥10% and more frequent than placebo) were:
Decreased appetite (37% of patients)
Somnolence, sedation, or lethargy
Diarrhea
Constipation
Fatigue, malaise, or weakness
Ataxia, balance disorder, or gait disturbance
Blood pressure increase
Drooling / increased salivation
Fever (pyrexia)
Upper respiratory tract infection
Vomiting
Decreased weight
Valvular heart disease / pulmonary arterial hypertension (boxed warning — requires echocardiogram monitoring)
Serotonin syndrome (life-threatening; risk highest with concomitant serotonergic drugs)
Hypertension (can occur even without prior BP history; hypertensive crisis reported rarely)
Angle closure glaucoma (watch for eye pain, vision changes, nausea)
Suicidal behavior or ideation (class warning for all antiseizure drugs)
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Diacomit (stiripentol)
Second-line add-on for Dravet syndrome; often used in combination with Fintepla and clobazam. A 2024 meta-analysis found it at least as effective as Fintepla for DS seizure control.
Epidiolex (cannabidiol)
Third-line add-on for Dravet syndrome and LGS; FDA-approved pharmaceutical CBD. Schedule V, no REMS required, generally easier to access than Fintepla.
Onfi (clobazam)
Benzodiazepine approved for LGS add-on therapy; widely used in Dravet syndrome and LGS; Schedule IV.
Depakote/Depakene (valproate/valproic acid)
First-line treatment for Dravet syndrome; widely available in generic form; broad-spectrum antiseizure medication.
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MAOIs (phenelzine, tranylcypromine, isocarboxazid, linezolid)
majorAbsolutely contraindicated — risk of acute hypertensive episode and serotonin syndrome. Do not use within 14 days of MAOIs.
SSRIs (fluoxetine, sertraline, escitalopram)
majorIncreased risk of serotonin syndrome due to additive serotonergic effects. Use with caution; monitor for serotonin syndrome symptoms.
SNRIs (venlafaxine, duloxetine)
majorIncreased risk of serotonin syndrome. Use with caution under close medical supervision.
Fluvoxamine (CYP1A2 inhibitor)
moderateIncreases fenfluramine exposure by 102%. Maximum Fintepla dose is 20 mg/day when co-administered.
Paroxetine (CYP2D6 inhibitor)
moderateIncreases fenfluramine exposure by 81%. Maximum Fintepla dose is 20 mg/day when co-administered.
Rifampin (CYP inducer)
moderateDecreases fenfluramine exposure by 58%. Avoid coadministration; if necessary monitor for reduced seizure control.
Stiripentol (Diacomit)
moderateRequires dose reduction of Fintepla to max 17 mg/day when combined with stiripentol and clobazam.
St. John's Wort
moderateHerbal CYP3A4 inducer that reduces Fintepla levels AND has serotonergic activity. Avoid.
TCAs (amitriptyline, nortriptyline)
majorIncreased serotonin syndrome risk. Avoid or use alternate drug; complex sympathomimetic interaction.
Fintepla (fenfluramine) represents an important treatment advance for two of the most difficult-to-treat epilepsy syndromes. For patients with Dravet syndrome and Lennox-Gastaut syndrome who continue to have seizures despite first-line therapy, Fintepla offers a complementary mechanism of action that can significantly reduce seizure burden. Long-term safety data published in 2025 confirmed sustained efficacy over years of treatment with no cases of the cardiac side effects seen historically with fenfluramine at weight-loss doses.
The primary challenge with Fintepla is access — not supply. The REMS program, insurance prior authorization, and specialty-only dispensing create a complex pathway that can delay treatment by weeks to months. Families who understand this system — and know which resources to contact (REMS program, UCB ONWARD, specialty pharmacies) — are better positioned to navigate it successfully.
If you or your child has been prescribed Fintepla and you're having trouble finding a pharmacy that can fill it, medfinder contacts certified specialty pharmacies on your behalf to identify which ones can fill your prescription and texts you the results — saving hours of phone calls and stress.
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