Comprehensive medication guide to Xcopri including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$20–$50/month with commercial copay card; Medicare Extra Help patients pay <$15/prescription
Estimated Cash Pricing
$1,100–$1,650/month without insurance; free 28-day trial pack available for new patients
Medfinder Findability Score
68/100
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Xcopri (cenobamate) is a prescription anticonvulsant FDA-approved in November 2019 for the treatment of partial-onset (focal) seizures in adults. It is manufactured by SK Life Science, a subsidiary of SK Biopharmaceuticals.
Xcopri has generated significant interest in the epilepsy community because clinical trials showed that up to 21% of patients achieved seizure freedom at the 400 mg dose — a remarkably high rate for add-on therapy in drug-resistant epilepsy. Many of these patients had previously failed multiple other anticonvulsants.
Xcopri is classified as a Schedule V controlled substance due to a small abuse potential observed in clinical studies, though this is considered minimal compared to other controlled substances.
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Cenobamate has a dual mechanism of action that distinguishes it from most other anticonvulsants. It works by enhancing inhibitory neurotransmission and reducing excitatory neurotransmission through two complementary pathways:
This dual mechanism may explain why Xcopri shows efficacy in patients who have not responded to other anticonvulsants that work through only one of these pathways. Effects on seizure frequency are typically seen within the first few weeks of reaching therapeutic doses.
12.5 mg (starting dose, weeks 1
2)
25 mg (weeks 3
4)
50 mg (weeks 5
6)
100 mg (weeks 7
8)
150 mg (weeks 9
10)
200 mg (maintenance, week 11+)
Xcopri (cenobamate) is a newer anticonvulsant for partial-onset seizures in adults, and we've assigned a findability score of 68 out of 100. While there is no FDA-listed shortage, the medication's brand-only status, high cost, and specialty distribution create meaningful access barriers.
Xcopri is a brand-name only medication with no generic available — and none expected until at least 2032 based on current patent protections. The retail price exceeds $1,100/month, which means many pharmacies do not routinely stock it. Independent pharmacies in particular may need to special-order it.
Many insurance plans require prior authorization and may require patients to have tried and failed other anticonvulsants before approving Xcopri. This adds time before a patient can even attempt to fill the prescription.
The manufacturer, SK Life Science, offers a patient support program called SK Life Science Navigator that can help locate pharmacies with stock and connect patients with specialty pharmacies that offer home delivery.
Patients are unlikely to face stockout issues once they have an established supply chain — but the initial process of getting insurance approval, finding a stocking pharmacy, and managing cost can take 1–2 weeks. Specialty pharmacies with home delivery are often the most reliable access point.
Medfinder can help you find pharmacies that carry Xcopri near you.
Xcopri is a Schedule V controlled substance. Neurologists and epileptologists are the primary prescribers. PCPs may prescribe it in some cases, though most initiate under specialist supervision due to the critical slow titration requirement and monitoring needs.
Because of prior authorization requirements from most insurers, getting started on Xcopri typically requires documentation of previous anticonvulsant failures.
Medfinder helps you find pharmacies with Xcopri in stock.
Yes, Xcopri is classified as a Schedule V controlled substance, the lowest level of control. In abuse potential studies, cenobamate showed mild euphoric effects at supratherapeutic doses. In practice, this classification has minimal impact on prescribing or filling — refills are straightforward, and there are no special prescription requirements beyond standard controlled substance rules.
The more significant barrier to access is insurance prior authorization and the medication's high cost without insurance.
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CYP3A4 substrates
moderateCenobamate is a moderate CYP3A4 inducer and can reduce levels of hormonal contraceptives, making them less effective.
CYP2C19 substrates
moderateCenobamate inhibits CYP2C19, potentially increasing levels of clobazam, omeprazole, and other 2C19 substrates.
Phenytoin and phenobarbital
moderateDose adjustments required when co-administered.
Hormonal contraceptives
moderateMay be less effective. Additional or alternative contraception recommended.
Other CNS depressants
moderateAdditive sedation with benzodiazepines, opioids, alcohol.
Xcopri has emerged as one of the most effective add-on anticonvulsants for drug-resistant focal epilepsy, with seizure-freedom rates that exceed those seen with most other newer AEDs. Its dual mechanism of action offers hope for patients who have not responded to other treatments.
The main barriers to access are cost (over $1,100/month without insurance), prior authorization requirements, and limited pharmacy stocking. The manufacturer's trial program offers a free 28-day titration pack, and copay assistance programs can reduce costs to $20/month for commercially insured patients.
Medfinder helps you find pharmacies with Xcopri in stock. Search for availability near you.
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