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Lacosamide
Lacosamide is an anticonvulsant medication used primarily in the treatment of partial-onset seizures in adults and children with epilepsy. It is also utilized as an adjunctive therapy for patients with refractory seizures. Lacosamide helps to stabilize neuronal membranes and inhibit excessive neuronal firing.
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Frequently Asked Questions
How long does it take for lacosamide to start working?
Lacosamide typically begins to take effect within a few days, but it may take longer to assess the full benefits in seizure control
Can I take lacosamide with other medications?
Always consult your healthcare provider before combining lacosamide with other medications, especially other anticonvulsants or CNS depressants.
What should I do if I miss a dose of lacosamide?
If you miss a dose, take it as soon as you remember. If it’s close to the time for your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Is it safe to use lacosamide during pregnancy?
Lacosamide should be used during pregnancy only if clearly needed, and the risks and benefits should be discussed with a healthcare provider.
Can lacosamide cause weight gain?
Weight gain is not commonly reported with lacosamide; however, any significant changes in weight should be discussed with a healthcare provider.
Comprehensive Drug Guide
How Does Lacosamide Work?
Lacosamide works by selectively enhancing the slow inactivation of voltage-gated sodium channels, stabilizing hyperexcitable neuronal membranes and inhibiting repetitive neuronal firing, which contributes to its anticonvulsant effects.
Common Dosages
Lacosamide is typically available in the following formulations:
- Tablets: Common dosages include 50 mg, 100 mg, 150 mg, and 200 mg.
- Oral solution: 10 mg/mL.
- Injectable form: For hospital use or when oral administration is not possible.
Typical Dosing
- The usual starting dose for adults is 50 mg taken orally twice daily. The dosage may be gradually increased based on individual response, with a maximum recommended dose of 400 mg per day.
Typical Dosing
FDA Approved Indications
- Treatment of partial-onset seizures in adults and pediatric patients aged 4 years and older.
Who Shouldn't Take Lacosamide?
- Known hypersensitivity to lacosamide or any components of the formulation
- Certain types of heart block (e.g., second- or third-degree AV block) without a pacemaker
Advice From The Pharmacist
- Patients should be advised to take lacosamide exactly as prescribed and to avoid missing doses to maintain consistent blood levels.
- Inform patients about potential side effects, including dizziness and fatigue, and to avoid activities requiring alertness until they know how the medication affects them.
- Encourage regular follow-ups to assess seizure control and adjust the dosage if necessary.
Side Effects of Lacosamide
Common Side Effects
- Dizziness
- Drowsiness
- Fatigue
- Nausea
- Coordination problems
Uncommon/Severe Side Effects
- Severe allergic reactions (anaphylaxis)
- Suicidal thoughts or behaviors
- Heart rhythm problems
Risks and Warnings of Lacosamide
- Cardiovascular Risks: Monitor patients with a history of cardiac arrhythmias or conduction problems.
- Mood Changes: Assess for mood changes, especially during the initial treatment phase.
Interactions with Lacosamide
Common Drug Interactions
- Other Antiepileptic Drugs: Caution is advised when combining lacosamide with other antiepileptic medications, as drug interactions may affect efficacy or increase side effects.
- CNS Depressants: Use caution when taken with other medications that may cause sedation or respiratory depression.
Alternatives to Lacosamide
- Other Anticonvulsants: Such as levetiracetam or lamotrigine for managing seizures.
- Non-pharmacological Treatments: Such as ketogenic diet or neuromodulation therapies for epilepsy management.
