Brief Answer:
Medication schedule is ok.Orcerin may have caused gastric trouble.

Detailed Answer:
Hi mr.XXXX,
Thanks for being here on HCM. I am Dr.Ajay,a neurologist, and I'd surely like to help you with your query.

Let's take your medicines ,step by step, as per your schedule.
1)Morning empty stomach- you are taking Thyronorm 125 mcg and Pantocid-domperidone sustained release combination(Pantocid-DSR).Both of the medicines are to be taken empty stomach to ensure better absorption, as you are already taking.Only thing to stress here is that please take Thyronorm about 30 minutes in advance of the Pantocid-DSR ,as several clinical studies have shown that pantoprazole inhibits absorption of thyroxine thus reducing it's effectiveness,although some studies even proved it wrong and the issue is debatable.So,its better to maintain this time gap to be on safer side.Taking thyronorm in the early hours of the day around 6:00 a.m goes well with the biological clock and has shown better effectiveness.

2)After breakfast: Amlopress 5 + Chymoral Plus

Amlodipine can be taken with or without food.Food does not affect its absorption and thus effectiveness.However,in clinical practice,we usually ask patients to take it early on in the morning ,a little after patient rises from the bed,be it empty stomach only.This is done so as to prevent the early morning rise of blood pressure,which again has its mechanisms lying with the circadian rhythm of the human body.This practice of taking antihypertensive medicines after the breakfast sometimes costs patient a lot because it is the early morning that most people suffer strokes due to the malignant rise of blood pressure.So,better start taking it early morning without waiting for breakfast.Chymoral plus is ok to take after breakfast.

After lunch: Chymoral Plus + Orcerin

Again Chymoral Plus is ok to take after lunch and so is orcerin.Diacerin(Orcerin) infact should be taken with or immediately after at least, moderate amount of food(not just a single biscuit will do),because it has a high tendency to cause epigastric (pain or burning sensation), vomiting or nausea if not taken with food or taken with a very little amount of food.
And probably it was some error here while taking orcerin,probably your father ate too less and took this drug or he kept a gap between food and taking this drug.Pantocid-DSR will ease him up and you can sometimes repeat Pantocid-DSR twice a day,if your father has stomach symptoms ,just keeping in mind to give it at a time,when your father has eaten at least 3 to 4 hours back.

After dinner: Chymoral Plus + Orcerin + Cartigen Duo + Frisium 5

All these drugs after dinner don't have any interaction and can well be taken together.
I hope I have answered your question.If you need any further clarifications,you can send follow up questions,and I shall be glad to help you.

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Brief Answer:
Levipil should be preferred instead of Frisium.Rest,both are same.

Detailed Answer:
Hi XXXXXXX
Thanks for appreciation.
Firstly,your father had a cavernoma with chronic bleed in the inferior frontal lobe.It's fine that your father did not have any seizure episode, but he has a definite risk.I say 'a definite risk' because a cavernoma in itself has a propensity to cause seizures and when it has resulted in a chronic bleed,chances of having a seizure increase more.The physiological basis is - when there is blood lying for a long time in the brain parenchyma,red blood cells degenerate and release iron from hemoglobin.This iron interacts with surrounding brain tissue,causing irritation of the brain cells,thus resulting in abnormal electrical activity causing seizures.In your father's case,the cavernoma has been diagnosed incidentally but what happens mostly in clinical practice is that, a patient is brought to hospital due to first ever episode of seizure in his life,and when he gets a brain imaging(like CT scan or MRI) done,he is found to have a cavernoma lying in the brain.In other words,a cavernoma mostly manifests with a seizure.Hence,since we already know the risk in your father's case,it becomes wiser to put him up on an antiepileptic drug like Levetiracetam.

Secondly,Let us analyse your father's treatment according to two different prescriptions:
Prescription 1:

Tab Levipil 500 MG Twice daily after meal
Tab RABICIP 400 MG once daily before breakfast
Tab Amlopress 2.5 MG once daily 8 am after breakfast
Tab Thyronorm for his hypothyroidism.

Prescription 2:

Thyronorm in morning (before breakfast)
Tab Pantocid DSR 1 * OD (BBF) 08 AM
Tab Amlopress 5 mg 1*OD (09 AM)
Tab Frisium 5 mg 1*HS (09 PM)
Thyronorm and amlopress are same in both and timings as we already discussed are ok.
Differences:
1)Rabeprazole(Rabicip) and Pantoprazole-
There are a few studies which have shown that during the initial 8-10 hours of taking the tablet,rabeprazole is more effective in reducing gastric acidity,but after that for the rest of the time duration left to complete 24 hours(24-10=14 hours),effect of both the drugs is same.That means,if your father took it in the morning around 8:00 am,then till 6:00 pm,he will feel better if he took rabeprazole instead of pantoprazole but after that till next day morning,effect will be like same for both drugs.But as I said, there are a few clinical studies which say like that while the practicing physicians believe there is no difference between the two except that rabeprazole is costlier.And so,the most conventional physicians and the older ones, you will find prescribing pantoprazole.
2)Levetiracetam(Levipil) vs Clobazam(Frisium):
Time schedule is ok for both drugs as Levipil is given on twice a day schedule(with or without food) and Clobazam at the time of sleep.While considering this age specific subgroup of elderly persons,there are considerable differences between the two:
Points against Frisium:
1)Levipil is a first line antiepileptic drug while Frisium is usually an add-on drug(to be added if seizures are not controlled on a single 1st line drug).So,why give Frisium when we are just starting with an antiepileptic.
2)Frisium is a sedative drug,whose sedative effect can result in falls in elderly(though 5 mg dose is not that much).
3)Frisium if abruptly withdrawn,can cause severe withdrawl symptoms in elderly(even in case of forgotten or missed doses sometimes)
Points against Levipil:
1)Most importantly,Levipil can cause behavioural abnormalities,suicidal tendencies,insomnia or lack of sleep,depression(about 1 in 300 risk)-it has to be reported to the treating physician if attendants observe any change in behaviour of the patient.
2)Frisium has no interactions with other drugs,plasma proteins or enzymes while Levipil may have some(No such drug to cause interation with Levipil in your case).
3)Levipil dose has to be reduced if blood urea or serum creatinine are raised(or kidney is not functioning properly,which is slightly more frequent in elderly).

So based on above points,my suggestion is to take Levipil(a 1st line antiepileptic with minor risks) instead of Frisium(an add-on antileptic with a sedative effect and risk of withdrawl symptoms which may be dangerous sometimes).

Hope,I have cleared all your doubts.If you have still some,you are most welcome else you may close the thread and rate it.Wish your father a good health.If you have some,you can send queries, even directly to me on HCM.

Dr.Ajay Panwar

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Brief Answer:
It's not a seizure.Bleed is chronic(old).No definite reason for Frisium.

Detailed Answer:
Hi dear XXXXXXX
Thanks again.
Taking your questions:
1)Headache and heaviness in extreme rarity only,can be a manifestation of seizure and it is not suspected to be epileptic unless,it is episodic, like migraine not responding to anti-migraine medicines at all.But,as I say,it's extremely rare.In this cae,it doesn't seems to be one.
2)It was not a fresh bleed here rather chronic(>14 days old) as MRI signal intensities in a fresh bleed would have been different.
3)I don't see any definite reason why your treating doctor suggested Frisium over Levipil(referencing all the above Frisium vs Levipil discussion),except one situation where you people would have complaint to him that 'my father doesn't sleep well in night' and he might have given it thinking that it will act as a sedative on top of an antiepileptic.Even if that's the reason and If I would have been in his place,I would have given Levipil instead of Frisium and would have added another drug meant for that purpose only.
4)Seizures can rarely be dangerous,when a patient aspirates(food material or salive getting into wind pipe) during a seizure.

Your father have a lesion in frontal lobe and can have a few seizure patterns-
1) Most common and most risky one-involuntary jerky movements of the limbs,turning of neck, uprolling of eyeballs, clinching of teeth which may cause tongue bite,frothing from mouth(all this simultaneously)-followed by loss of consciousness for a few minutes.First aid or preventive aspect here-make your father lay in left lateral or right lateral position(to prevent aspiration) and insert a piece of cloth between teeth to prevent tongue injury.
2)Another pattern-sudden motionless staring look and not following commands for a few minutes.This may be associated with automatic movements like facial twitching,lip smacking or picking movements of fingers.
3)Rarely-If you see a sudden change in behaviour for no explained reasons like sudden he becomes aggressive,it can be a frontal lobe seizure.
If any of these ,please visit a hospital immediately besides doing the first aid or preventive aspects ,I already told.

I hope I have, made my clarifications. If you have any further doubt,I shall be glad to help you.

Dr.Ajay Panwar

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