Brief Overview:

Everolimus (Afinitor®) is not a traditional anti-seizure drug, but exhibits modest effectiveness in the treatment of seizures associated with Tuberous Sclerosis Complex (TSC), and may be effective in the treatment of seizures associated with other causes of infantile spasms, including cortical dysplasia. Everolimus acts via modulation of an important cell proliferation pathway known as the MTOR (mammalian target of rapamycin) pathway. In the setting of TSC, everolimus also exhibits effectiveness in the treatment of a variety of tumors/growths, especially a particular brain tumors known as a subependymal giant-cell astrocytoma (SEGA). The effectiveness of everolimus in the specific management of infantile spasms, with or without TSC, is uncertain.


A typical dosage of everolimus is 4.5 mg/m2/day in a single daily dose. Modest adjustment of dose may be necessary and is guided by blood level (goal 5-10 ng/mL) and effectiveness. The medication is manufactured as a tablet, or dispesible tablet. Everolimus interacts with several anti-seizure drugs, especially carbamazepine, oxcarbazepine, eslicarbazeipine, and felbamate.

Side Effects:

Everolimus commonly produces mouth sores (stomatitis/mucositis) in the first few weeks of treatment, but this most often resolves in the first few months of treatment. Everolimus is also linked to relatively modest suppression of the immune system (likely related to a reduction in white blood cell counts), may impact wound healing, rarely causes a form of lung inflammation called non-infectious pneumonitis, may increase blood cholesterol/lipid levels, and can affect (or even suppress) menstruation. 


This medication should be administered only under the direct supervision of a physician.

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