However, an increased risk of potentially fatal aplastic anemia and/or liver failure limit the drug's usage to severe refractory epilepsy.

[11] Therefore, the importance of the effects of felbamate on NMDA receptors to its therapeutic action in epilepsy is uncertain.

Adverse reactions include decreased appetite, vomiting, insomnia, nausea, dizziness, somnolence, and headache.

[citation needed] Felbamate is an inhibitor of CYP2C19 - an enzyme involved in the metabolism of several commonly used medications.

[14] Felbamate interacts with several other AEDs, including phenytoin, valproate, and carbamazepine; dosage adjustments may be necessary to avoid adverse effects.