Lacosamide Brand Name– Vimpat
What is Lacosamide
Lacosamide a functionalized amino acid, is an anticonvulsant indicated for the treatment of partial seizures.
Psychological dependence may be possible as euphoria-type reactions similar to the benzodiazepine alprazolam have been reported and a high rate of euphoria was reported compared to placebo during premarketing evaluation of the drug.
Both oral and injectable forms are available; the injectable form can be used in adult and adolescent patients 17 years of age and older when oral administration is temporarily not feasible.
The clinical study experience of intravenous lacosamide is limited to 5 days of consecutive treatment
Indications
- partial seizures
General Dosing Information
- Oral lacosamide is indicated for the treatment of partial-onset seizures in patients 4 years of age and older; lacosamide injection is indicated in patients 17 years of age and older.
- For patients converting to lacosamide monotherapy from another single anticonvulsant, do not withdraw the concomitant anticonvulsant until the therapeutic dose of lacosamide has been maintained for at least 3 days. A gradual withdrawal of the concomitant anticonvulsant over at least 6 weeks is recommended.
- Lacosamide injection can be administered with the same dosing regimens as oral dosing, including the loading dose. The clinical study experience of intravenous lacosamide is limited to 5 days of consecutive treatment.
Side Effects
- acute cerebellar syndrome
- agitation
- agranulocytosis
- anemia
- angioedema
- asthenia
- ataxia
- atrial fibrillation
- atrial flutter
- AV block
- blurred vision
- bradycardia
- confusion
- constipation
- depression
- diarrhea
- diplopia
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysarthria
- dyspepsia
- elevated hepatic enzymes
- erythema
- euphoria
- fatigue
- fever
- hallucinations
- headache
- hepatitis
- hypoesthesia
- injection site reaction
- insomnia
- irritability
- muscle cramps
- myocarditis
- nausea
- neutropenia
- nystagmus
- orthostatic hypotension
- palpitations
- paresthesias
- PR prolongation
- proteinuria
- pruritus
- psychological dependence
- psychosis
- rash
- seizures
- suicidal ideation
- syncope
- tinnitus
- tremor
- urticaria
- vertigo
- vomiting
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- abrupt discontinuation
- acute myocardial infarction
- atrial fibrillation
- atrial flutter
- AV block
- bradycardia
- breast-feeding
- Brugada syndrome
- cardiac disease
- dehydration
- depression
- dialysis
- driving or operating machinery
- geriatric
- heart failure
- hepatic disease
- hypovolemia
- labor
- myocardial infarction
- orthostatic hypotension
- phenylketonuria
- pregnancy
- renal disease
- renal failure
- renal impairment
- sick sinus syndrome
- substance abuse
- suicidal ideation
- syncope
Interactions
- Acebutolol
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Alprazolam
- Amiodarone
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amphetamines
- Atazanavir
- Atazanavir; Cobicistat
- Atenolol
- Atenolol; Chlorthalidone
- Bendroflumethiazide; Nadolol
- Beta-adrenergic blockers
- Betaxolol
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Boceprevir
- Bretylium
- Brimonidine; Timolol
- Bupivacaine; Lidocaine
- Bupropion
- Bupropion; Naltrexone
- Calcium-channel blockers
- Carbamazepine
- Carteolol
- Carvedilol
- Class IA Antiarrhythmics
- Class IB Antiarrhthmics
- Class IC Antiarrhythmics
- Class III Antiarrhythmics
- Clevidipine
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Dextromethorphan; Quinidine
- Digoxin
- Diltiazem
- Disopyramide
- Dofetilide
- Dorzolamide; Timolol
- Dronedarone
- Enalapril; Felodipine
- Encainide
- Eslicarbazepine
- Esmolol
- Felbamate
- Felodipine
- Fenofibric Acid
- Flecainide
- Fluconazole
- Fosphenytoin
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydroxychloroquine
- Ibutilide
- Indinavir
- Isradipine
- Itraconazole
- Ketoconazole
- Labetalol
- Lamotrigine
- Letermovir
- Levobetaxolol
- Levobunolol
- Lidocaine
- Lidocaine; Prilocaine
- Lopinavir; Ritonavir
- Luliconazole
- Maprotiline
- Mefloquine
- Metoprolol
- Mexiletine
- Molindone
- Moricizine
- Nadolol
- Nebivolol
- Nebivolol; Valsartan
- Nicardipine
- Nifedipine
- Nimodipine
- Nisoldipine
- Ombitasvir; Paritaprevir; Ritonavir
- Oritavancin
- Oxcarbazepine
- Pemoline
- Penbutolol
- Perindopril; Amlodipine
- Phentermine; Topiramate
- Phenytoin
- Pindolol
- Procainamide
- Prochlorperazine
- Propafenone
- Propranolol
- Quinidine
- Ritonavir
- Rufinamide
- Sotalol
- Telaprevir
- Telithromycin
- Timolol
- Tipranavir
- Tocainide
- Topiramate
- Trandolapril; Verapamil
- Tricyclic antidepressants
- Valproic Acid, Divalproex Sodium
- Verapamil
- Zonisamide
