Missed a Dose of Your Epilepsy Medication? Here's What You Must Do
24 Oct 2025
Missing a dose of your epilepsy medication, also known as anti-seizure medication (ASM) and anti-epileptic drugs (AEDs), is a common, but often stressful experience for people with epilepsy. Knowing the correct, immediate steps to take is crucial for maintaining seizure control.
This guide provides advice on what to do if you realize you’ve missed a dose and strategies to not let that happen again.
The essential first step: Do not panic
First and foremost: do not panic.
However, acknowledge that this is a serious situation. Missing a dose is one of the most common triggers for a breakthrough seizure and can, in rare cases, increase the risk of status epilepticus (a prolonged seizure or back-to-back seizures without recovery).
Always follow the specific instructions provided by your neurologist, epilepsy specialist, or pharmacist regarding your specific medication. If you are unsure, call your healthcare team or pharmacist immediately for personalized advice.
Quick Action Guide: Where to find your next step
Your Regular Schedule | When you realised you missed a dose | What action to take |
|---|---|---|
Once a day | The same day | Check Your Leaflet/Plan: Most medication leaflets advise taking the dose immediately, but you must confirm the specific grace period with your Patient Information Leaflet (PIL). |
The next day | Check Your Leaflet/Plan: Most advice recommends skipping the missed dose and just taking your next scheduled dose at the usual time. Do NOT take a double dose unless it says to do it. | |
Twice a day | Within the grace period (e.g., within 6-8 hours of the scheduled time) | Check Your Leaflet/Plan: If your leaflet allows, you may be advised to take the missed dose and then space out the next one. |
Closer to the next dose (e.g., more than 6-8 hours later) | Check Your Leaflet/Plan: Most advice suggests skipping the missed dose entirely and taking your next scheduled dose at the usual time. Do NOT take a double dose unless the leaflet says to do it. |
Always read the medication box and leaflet before taking medication. Always consult with your healthcare provider first.
The Danger of a Double Dose
Taking a double dose to “catch up” can cause the level of medication in your blood to spike too high, leading to concentration-dependent side effects like:
Dizziness or Lightheadedness
Drowsiness or Extreme Sleepiness
Blurred or Double Vision
Nausea or Vomiting
These side effects can be just as dangerous as a seizure, potentially leading to falls or accidents.
What to Monitor after a Missed Dose of Epilepsy Medication
After you’ve followed the advice in your medication leaflet, it’s vital to be vigilant for the next 24-48 hours:
Watch for Seizure Signs: Pay close attention to any prodromal (pre-seizure) symptoms you typically experience, such as tiredness.
Avoid High-Risk Activities: Refrain from activities where a breakthrough seizure could be dangerous, such as driving, operating heavy machinery, swimming, or bathing alone.
Let Your Support System Know: Let a family member, roommate or trusted friend know that you missed a dose and are monitoring yourself.
Track It: Write down the exact time you missed the dose, the time you took the make-up dose (if advised), and any new symptoms in your seizure diary or tracking app
Missing a dose can be stressful, as it increases the fear of a breakthrough seizure, especially when you are asleep or alone. That’s why continuous, discreet monitoring is an essential part of a comprehensive safety plan.
Long-Term Strategy: Preventing Future Missed Doses
Adherence is key to seizure control. If you are regularly missing doses, it’s a sign that your current regimen needs adjustment.
Tips to Improve Your Adherence:
Use a Weekly Pillbox (Pill Organizer): This simple tool is the single most effective way to visually confirm if a dose has been taken.
Set Alarms/Reminders: Use phone alarms, mobile apps (like a seizure diary app) or even smart-speaker reminders to take your medication on time;
Link to a Daily Routine: Always commit to taking your medicine with a routine daily event, such as brushing your teeth, eating breakfast or before bed.
Keep an Emergency Supply: Always fill your prescription a week early and keep a small emergency supply in your purse, backpack, or office desk in case you’re away from home.
Frequently Asked Questions
Can missing just one dose of my epilepsy medication really cause a seizure?
Yes, it can. Missing a dose, especially for medications with a short half-life, can cause the drug level in your blood to fall below the therapeutic range required to prevent seizures. For many people, a missed dose is one of the top causes of a breakthrough seizure.
What should I do if I am sick (vomiting or diarrhea)?
If you vomit within 30 minutes of taking your pill, you should generally consult your Patient Information Leaflet, as you may be advised to take a replacement dose. If you vomit more than 30 minutes later, the dose was likely absorbed, and you should wait for your next scheduled dose. If you have severe or prolonged vomiting or diarrhea, call your doctor, as this can severely impact drug absorption and cause your blood levels to drop.
What's the best strategy to prevent this from happening again?
The best strategy is using a combination of a pillbox and a phone alarm. Set the alarm to a time that works with your daily routine, and check your pillbox right after the alarm goes off.