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It is approved in the US for treating seizures associated with Dravet syndrome (DS) and Lennox\u2013Gastaut syndrome (LGS) in patients \u22652\u2009years old and as add\u2010on therapy for seizures associated with DS and LGS in the EU, UK, and Japan in similarly aged patients. Consensus guidelines for treatment of DS have recommended FFA to be an early\u2010line ASM, and it has also shown efficacy in managing seizures associated with LGS. DS and LGS are DEEs associated with a range of seizure types, developmental impairments, and multiple comorbidities. Here we provide case vignettes describing 4 patients (3 DS and 1 LGS) aged 4\u201329\u2009years old in whom up to 14 ASMs had previously failed, to illustrate real\u2010world practice issues encountered by neurologists. This review provides guidance on the use of FFA in the context of ASM polytherapy and drug\u2013drug interactions (DDIs), behavioral issues, dose titration, and adverse events. Along with data from the clinical trial program, these case vignettes emphasize the low risk of DDIs, a generally well\u2010tolerated safety profile, and other seizure and nonseizure benefits (eg, improved cognition and sleep) associated with the use of FFA in DS or LGS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>Fenfluramine is used to treat seizures in individuals with Dravet syndrome and Lennox\u2013Gastaut syndrome, but there are a range of issues that clinicians may face when treating patients. This review highlights four patients from the authors\u2019 everyday clinical work and offers guidance and practical considerations by neurologists with expertise in managing these complex conditions related to drug interactions, dosing, and side effects associated with fenfluramine.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12998","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T10:00:06Z","timestamp":1720087206000},"page":"1643-1657","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Practical considerations for the use of fenfluramine to manage patients with Dravet syndrome or Lennox\u2013Gastaut syndrome in clinical practice"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3015-8282","authenticated-orcid":false,"given":"Elaine C.","family":"Wirrell","sequence":"first","affiliation":[{"name":"Divisions of Child and Adolescent Neurology and Epilepsy, Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7118-0139","authenticated-orcid":false,"given":"Lieven","family":"Lagae","sequence":"additional","affiliation":[{"name":"Member of the European Reference Network EpiCARE, Department of Pediatric Neurology University of Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2311-2174","authenticated-orcid":false,"given":"Ingrid E.","family":"Scheffer","sequence":"additional","affiliation":[{"name":"Austin Hospital and Royal Children\u2019's Hospital, Florey and Murdoch Children's Research Institutes University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7345-4829","authenticated-orcid":false,"given":"J. 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