Lacosamide
Anti-epileptic · Sodium channel inactivator
Indications
As adjunctive therapy in the treatment of partial-onset seizures in patients 17 years of age and older with epilepsy.
Dosage
Adults: Initially 50 mg twice daily, increased weekly by 50 mg twice daily; max 200 mg twice daily. Children: Above 17 yr, same as adult dose. Below 17 yr, not recommended.
Adverse Effects
Nausea, vomiting, constipation, flatulence, dizziness, headache, impaired coordination, cognitive disorder, drowsiness, tremor, depression, fatigue, abnormal gait, blurred vision, nystagmus, pruritus, dyspepsia, dry mouth, first degree AV block, bradycardia, PR-interval prolongation, confusion, hypoesthesia, dysarthria, irritability, muscle spasm, tinnitus, rash, suicidal ideation, insomnia, impaired balance, memory loss, somnolence, paraesthesia, diplopia, vertigo, tinnitus.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Second- or third-degree AV block. Precautions: Risk of PR-interval prolongation (including conduction problems, severe cardiac disease and concomitant use of drugs that prolong PR interval), elderly. Renal or hepatic impairment. Warns patients to report symptoms of AV block, atrial fibrillation or flutter. Monitor patients for suicidal thoughts or behaviour. Risk of dizziness. Withdraw gradually.
Interactions
Drugs associated with PR prolongation (e.g., carbamazepine, lamotrigine, pregabalin), class I antiarrhythmics, rifampicin, St. John's wart, phenytoin, phenobarbital, fluconazole, itraconazole, ketoconazole, ritonavir, clarithromycin.
Advice to Patient
Take with or without meals. Carry identification card mentioning you have epilepsy and names of all medications you take. On start of therapy or change of dosage, patient must be watched for suicidal tendency by caretaker.
Pharmacokinetics
Absorption: Oral: Completely. Metabolism: Hepatic. Bioavailability: Approx. 100%. Half-life elimination: Children =4 yrs and Adolescents: Mean weight 11 kg: 7.4 hrs. Mean weight 28.9 kg: 10.6 hrs. Mean weight 70 kg: 14.8 hrs. Adults: Approx. 13 hrs. Time to peak, plasma: Oral: 1-4 hrs. Excretion: Urine (95%). Faeces (<0.5%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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