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Dalfampridine Brand Name-Ampyra
What is Dalfampridine
Dalfampridine, also known as 4-aminopyridine, is an oral potassium channel blocker indicated to improve walking in patients with multiple sclerosis (MS).
Among patients with MS who could walk 25 feet in 8 to 45 seconds, more patients responded to dalfampridine than to placebo.
Responders were defined as those with a faster walking speed at least 3 out of 4 times during dalfampridine receipt than the maximum value 5 times without dalfampridine.
In a trial, 34.8% of dalfampridine recipients were responders as compared with 8.3% of placebo recipients. In a separate trial, the respective numbers were 42.9% and 9.3%. Walking speed (feet/second) was measured by the timed 25-foot walks.
The percentage of dalfampridine recipients with at least a 10%, 20%, or 30% increase in walking speed from baseline was significantly higher vs. placebo.
Most patients in clinical trials were receiving immunomodulatory agents for MS, and the results were independent of other drug therapies.
The major dose-limiting side effect is seizures, and patients with moderate to severe renal dysfunction cannot receive the drug.
Dalfampridine was approved by the FDA in 2010.
Indications
- multiple sclerosis
For improved walking (i.e., improved walking speed) in patients with multiple sclerosis
Side Effects
- anaphylactoid reactions
- angioedema
- asthenia
- back pain
- confusion
- constipation
- dizziness
- dyspepsia
- headache
- infection
- insomnia
- nausea
- paresthesias
- pharyngitis
- seizures
- urticaria
- vomiting
Monitoring Parameters
- laboratory monitoring not necessary
- neurologic function
Contraindications
- breast-feeding
- children
- geriatric
- history of angioedema
- infants
- pregnancy
- renal failure
- renal impairment
- seizure disorder
- seizures
Interactions
- Amifampridine
- Bupropion
- Bupropion; Naltrexone
- Cimetidine
