2026 Volume 52 Issue 5 Pages 293-298
Ketogenic diet therapy is an effective treatment for drug-resistant epilepsy in children, and careful consideration of medication formulations is required to maintain dietary restrictions. Although such cases are rarely encountered in community pharmacy settings, pharmacists must be adequately prepared with the necessary knowledge to manage them. We present the case of an infant with West syndrome who was managed on ketogenic diet therapy in a community pharmacy setting. Ketogenic diet therapy was initiated following hospitalization for seizures and a subsequent tracheostomy. At the discharge conference, physicians informed the pharmacists that the patient was receiving ketogenic diet therapy, required medications with minimal lactose excipients, and was dependent on tube feeding. To reduce the waiting time at the community pharmacy, the pharmacists requested and obtained approval to change the prescription from crushed perampanel tablets to perampanel granules after presenting information about the lactose content of each formulation. During subsequent home care visits, the parents expressed concerns regarding the increased medication volume and the risk of potential tube obstruction associated with the granule formulation. Following parental preference, the medication was changed to crushed tablets. This case demonstrates the importance of pharmacists’ knowledge acquisition beyond conventional drug therapy, particularly with respect to excipients in ketogenic diet therapy, interprofessional collaboration, and ongoing patient follow-up by community pharmacists.
