Rufinamide

A triazole anticonvulsant, FDA-approved as add-on treatment for seizures of Lennox-Gastaut syndrome in adults and children 1 year and older.

psilodex.org/m/rufinamide · data v2026.10.05

Clinical contraindication: None listed; No label contraindication covering psilocybin was found. This is not a finding that the combination has been shown to be without risk.
Psilocybin evidence: No psilocybin data
Half-life: 6–10 h; Approximate, in adults. Source under Interaction below.

Named in state rules?

Not namedColorado Condition rules (3)

Not namedOregon

PendingNew Mexico

Cite asPsilodex, “Rufinamide”, v2026.10.05. psilodex.org/m/rufinamide

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

What it is used for

FDA status

FDA-approved

FDA-approved for

Seizures of Lennox-Gastaut syndrome (add-on treatment, age 1 and older)

Sources [1]

Other safety

Contraindicated in familial short QT syndrome; the label reports dose-related shortening of the QT interval.

About the medication itself, separate from any interaction with psilocybin.

Sources [1]

01 Interaction with psilocybin

Not studied with psilocybin; it weakly speeds drug breakdown, so slightly lower psilocybin levels are possible. Stopping it suddenly after regular use can cause seizures.

Detail No psilocybin data exist. Its label describes it as a weak CYP3A4 inducer (enzyme speeder). CYP3A4 metabolized psilocin (psilocybin's active form) in lab studies, so psilocin levels may fall slightly (untested). Also, its label lists sleepiness, dizziness and coordination problems, and QT shortening (a heart-rhythm change). It also carries the antiepileptic class warning for suicidality and lists seizure risk on abrupt withdrawal. Sources [1][2]

Human data with psilocybin: No psilocybin data; based on how it works and its label
Half-life: 6–10 h (FDA label, checked 2026-10-04)

Evidence types on this record

No psilocybin dataNo psilocybin data: no human data with psilocybin or another classic psychedelic; the text draws on the medication's own pharmacology and its label or reference facts

02 Pharmacology relevant to psilocybin

4 listed (1 possible) · counted on reports

Sedating or CNS depressant: Slows the central nervous system: drowsiness, slower reactions and impaired coordination, and slowed breathing at high doses. Effects add with other sedating substances. Sources [1]
Withdrawal or rebound if stopped abruptly: Stopping suddenly can cause withdrawal or a rebound of symptoms. Sources [1]
Speeds up drug metabolismPossible: Increases the liver enzymes that break down many medicines, lowering their levels. When it is stopped, levels of other medicines can rise over the following weeks.Possible: The source describes the effect as small, seen only in laboratory or animal studies, or theoretical. Sources [1]
Psychiatric reactions: The label or source warns of psychiatric effects such as psychosis, mania, hallucinations, suicidal thoughts or severe mood or behavior changes. Psilocybin can also bring up strong emotions, so these warnings are relevant to screening. Sources [1]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not namedCondition rules (3)

No provision names this medication or its class.

Colorado · checked 2026-10-04

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-10-04

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-10-04

04 Conditions to ask about

Screening items in state rules

This medication is usually taken for a condition. State rules screen for some conditions directly, so the medication is a prompt to ask about them. Confirm with the participant; never assume a condition from the medication.

Seizure disorder (usual indication)
- CO 2.5(A)(2) · Clinical Facilitator licensees
- CO 6.16(F)(2)(a) · Facilitators without a clinical facilitator license
- CO 6.16(F)(1) · All licensees

05 Sources

BANZEL (rufinamide) tablet and oral suspension · FDA label (DailyMed) — revised 2024-11 | Psychiatric reactions: 5.1 Suicidal Behavior and Ideation "Antiepileptic drugs (AEDs), including BANZEL, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication." | Sedating or CNS depressant: 5.2 Central Nervous System Reactions "The most significant of these can be classified into two general categories: 1) somnolence or fatigue, and 2) coordination abnormalities, dizziness, gait disturbances, and ataxia." | Withdrawal or rebound if stopped abruptly: 5.5 Withdrawal of AEDs "to minimize the risk of precipitating seizures, seizure exacerbation, or status epilepticus" | Speeds up drug metabolism: 12.3 Pharmacokinetics "rufinamide is a weak inducer of the CYP 3A4 enzyme and can decrease exposure of drugs that are substrates of CYP 3A4." | 4 Contraindications "BANZEL is contraindicated in patients with Familial Short QT syndrome" | 12.3 Pharmacokinetics "The plasma elimination half-life is approximately 6-10 hours in healthy subjects and patients with epilepsy."
Thomann J, Kolaczynska KE, Stoeckmann OV, et al. In vitro and in vivo metabolism of psilocybin’s active metabolite psilocin. Front Pharmacol 2024;15:1391689. — Lab studies: MAO-A, CYP2D6 and CYP3A4 metabolized psilocin; glucuronidation and conversion to 4-HIAA are the main routes.

Record history

v2026.10.02First published.
2026-10-04Last reviewed against its sources.

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