This guideline outlines the general management of anti-epileptic drugs (AEDs) in nil by mouth (NBM) adult patients with a history of epilepsy/seizures. Patients who present with seizures should be discussed with the on-call neurologist (seek advice via Queen Elizabeth University Hospital (QEUH) switchboard). Please note that routine switching between different manufacturers of anti-epileptic drugs should be avoided, however the following advice in the link below is preferable to missed doses. With all changes to AEDs, close monitoring of the patient is needed.
It is preferable to pass a nasogastric tube in NBM patients with a history of epilepsy/seizures to avoid missed doses of medication and thus minimise the risks of loss of seizure control. The alteration of medications for use via enteral feeding tubes generally results in the medication being unlicensed (see Section 9(b) of the Code of Practice for Medicines Governance [link only active if accessing via NHS network] for further information). The advice provided in the link below applies to all types of enteral feeding tube unless otherwise stated. Use 30ml of distilled water to flush the tube before and after drug administration. If more than one medication is to be given, flush with 10ml distilled water between each one.
| Guideline reviewed | February 2023 |
| Page updated | November 2024 |