Lacosamide Medication: Uses, Dosage, Side Effects & Interactions

Summary of Key Points

Lacosamide is a prescription medication primarily used to treat certain types of seizures in adults, including partial-onset and generalized tonic-clonic seizures. It works by stabilizing abnormal electrical activity in the brain. Additionally, Lacosamide is sometimes prescribed to manage neuropathic pain, such as that caused by diabetic neuropathy. Always follow your healthcare provider’s instructions when taking this medication, and consult them before making any changes to your dosage.

Names of Medication

US Brand Name: Vimpat

Generic Name: Lacosamide

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. The generic name is typically listed in parentheses.

Pharmacologic Category

Anticonvulsant

Antiepileptic

Lacosamide Dosage

Epilepsy (Partial-Onset Seizures): The usual starting dose is 50 mg twice daily. Your doctor may increase the dose by 100 mg per week, up to a maximum of 400 mg per day, depending on your response and tolerance.

Generalized Tonic-Clonic Seizures: The typical starting dose is 100 mg twice daily. Your doctor may adjust the dose based on your needs, up to a maximum of 400 mg per day.

Lennox-Gastaut Syndrome: Lacosamide may be used as an adjunctive therapy. The dosage is individualized based on the patient’s specific needs and response to treatment.

Status Epilepticus: In emergency situations, Lacosamide can be administered intravenously (IV). The dosage is determined by the healthcare provider in a hospital setting.

Neuropathic Pain (Diabetic Neuropathy): The typical dose is 100 mg twice daily, which may be increased to 200 mg twice daily based on your response and tolerance.

Postherpetic Neuralgia: The usual dose is 100 mg twice daily, with adjustments made by your healthcare provider as needed.

Fibromyalgia: Lacosamide is sometimes used off-label for fibromyalgia. The dosage is tailored to the patient’s symptoms and response to treatment.

Multiple Sclerosis (Neuropathic Pain): Lacosamide may be prescribed to manage neuropathic pain associated with multiple sclerosis. The typical dose is 100 mg twice daily, with adjustments as necessary.

Always consult your healthcare provider before making any changes to your dosage. If you have questions about your treatment plan, consider scheduling a telemedicine appointment with one of our providers.

Dosage Forms and Strengths

Tablets: 50 mg, 100 mg, 150 mg, 200 mg

Oral Solution: 10 mg/mL

Intravenous (IV) Solution: 200 mg/20 mL

Administration Instructions for Lacosamide

Lacosamide can be taken with or without food. Swallow the tablet whole with water; do not crush or chew it. If using the oral solution, measure the dose carefully using a dosing syringe or cup. For intravenous use, this medication is administered by a healthcare provider in a hospital setting. If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Do not double up on doses.

Lacosamide Side Effects and Adverse Reactions

Dizziness: Feeling lightheaded or unsteady is a common side effect. This usually improves as your body adjusts to the medication.

Headache: Some patients may experience headaches while taking Lacosamide.

Nausea: Mild nausea may occur, especially when starting the medication.

Fatigue: Feeling unusually tired or sleepy is a common side effect.

Double Vision: Some patients report experiencing double or blurred vision.

Serious Side Effects: In rare cases, Lacosamide may cause heart rhythm problems or severe allergic reactions. Seek immediate medical attention if you experience chest pain, difficulty breathing, or swelling of the face or throat.

Contraindications for Lacosamide

A contraindication is a specific condition in which a medication should not be used because it may be harmful. If you have any of the following conditions, Lacosamide may not be safe for you. Always consult your healthcare provider before starting any new medication, and if you have any of these conditions, be sure to discuss them with one of our providers through telemedicine.

Severe heart problems: Lacosamide can affect the electrical activity of the heart, which may worsen conditions like second- or third-degree atrioventricular (AV) block or other serious heart rhythm disorders. This can lead to dangerous heart rhythms.

Hypersensitivity to Lacosamide: If you have had an allergic reaction to Lacosamide or any of its components, you should not take this medication. Allergic reactions can cause symptoms such as rash, itching, swelling, or difficulty breathing.

Severe liver impairment: Lacosamide is processed by the liver, and if your liver is not functioning properly, the drug may accumulate in your system, leading to toxicity.

Severe kidney impairment: Similarly, if your kidneys are not functioning well, Lacosamide may not be cleared from your body efficiently, increasing the risk of side effects.

Lacosamide Drug Interactions

Lacosamide can interact with other medications, which may increase the risk of side effects or reduce the effectiveness of either Lacosamide or the other drugs. Be sure to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Lacosamide:

1. Antiarrhythmics (e.g., amiodarone, quinidine): These medications affect heart rhythm, and taking them with Lacosamide may increase the risk of abnormal heart rhythms.
2. Beta-blockers (e.g., propranolol, metoprolol): These drugs also affect heart rate and rhythm, and combining them with Lacosamide could lead to bradycardia (slow heart rate) or other heart issues.
3. Calcium channel blockers (e.g., verapamil, diltiazem): These medications may increase the risk of heart rhythm problems when taken with Lacosamide.
4. Central nervous system depressants (e.g., benzodiazepines, opioids): Combining these with Lacosamide may increase the risk of drowsiness, dizziness, or difficulty concentrating.
5. Other antiepileptic drugs (e.g., carbamazepine, phenytoin): These drugs may alter the effectiveness of Lacosamide or increase the risk of side effects.

Lacosamide in Pregnancy

Is it safe to take Lacosamide when pregnant?

Information on the safety of Lacosamide during pregnancy is limited. While animal studies suggest some risk to the fetus, there are no well-controlled studies in pregnant women. If you are pregnant or planning to become pregnant, it is essential to discuss the potential risks and benefits of continuing Lacosamide with your healthcare provider. Maintaining seizure control during pregnancy is important, but the potential risks to your baby must also be carefully considered. Our telemedicine providers are available to help you assess these risks and determine the most appropriate course of action for your situation.

Lacosamide while Breastfeeding

Is it safe to take Lacosamide while breastfeeding?

It is not yet clear whether Lacosamide passes into breast milk. Due to the possibility of serious side effects in a nursing infant, it is important to weigh the risks and benefits of breastfeeding while taking Lacosamide with your healthcare provider. In some cases, an alternative medication or feeding method may be recommended. If you are breastfeeding or planning to breastfeed, consult with one of our telemedicine providers to explore the best options for both you and your baby.

Estimated Cost of Lacosamide Medication

The cost of a 30-day supply of Lacosamide without insurance can vary depending on the dosage and the pharmacy. With a GoodRx coupon, the estimated price for a 30-day supply of Lacosamide (100 mg tablets) typically ranges from $200 to $300. Prices may fluctuate, so it is advisable to check with your local pharmacy or use a discount service like GoodRx to find the most affordable option.

Possible Alternatives to Lacosamide

If Lacosamide is not suitable for you or if you are experiencing side effects, there are alternative treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to assist you in exploring these alternatives.

Epilepsy Treatment Options

Other antiepileptic medications, such as levetiracetam (Keppra), valproate (Depakote), or lamotrigine (Lamictal), may be considered. Additionally, lifestyle modifications like stress management, maintaining a regular sleep schedule, and avoiding known seizure triggers can be beneficial.

Partial-Onset Seizures

Alternatives include medications like oxcarbazepine (Trileptal) or topiramate (Topamax). In some cases, dietary changes, such as adopting a ketogenic diet, may help reduce the frequency of seizures.

Generalized Tonic-Clonic Seizures

Medications such as valproate (Depakote) or phenytoin (Dilantin) may be effective. Lifestyle adjustments, including maintaining consistent sleep patterns and avoiding alcohol, can also play a role in managing seizures.

Lennox-Gastaut Syndrome

Other treatment options include medications like clobazam (Onfi) or rufinamide (Banzel). In some cases, a ketogenic diet may also be recommended to help manage symptoms.

Status Epilepticus

Emergency treatments often involve medications like lorazepam (Ativan) or diazepam (Valium). For long-term management, drugs such as levetiracetam (Keppra) or phenytoin (Dilantin) may be prescribed.

Neuropathic Pain

Alternatives for managing neuropathic pain include medications like gabapentin (Neurontin) or pregabalin (Lyrica). Physical therapy and lifestyle changes, such as regular exercise, may also help alleviate symptoms.

Diabetic Neuropathy

Medications like duloxetine (Cymbalta) or pregabalin (Lyrica) may be effective in managing diabetic neuropathy. Additionally, controlling blood sugar levels through diet and exercise is crucial for preventing further nerve damage.

Postherpetic Neuralgia

Treatment options include medications like gabapentin (Neurontin) or topical treatments such as lidocaine patches. Pain management strategies, including acupuncture, may also provide relief for some individuals.

Fibromyalgia

Medications like duloxetine (Cymbalta) or milnacipran (Savella) may help manage fibromyalgia symptoms. Lifestyle changes, including regular exercise, stress management, and ensuring adequate sleep, are also important for symptom control.

Multiple Sclerosis

Medications such as baclofen or tizanidine may help manage muscle spasms associated with multiple sclerosis. Physical therapy and regular exercise can also improve mobility and reduce symptoms.

Recent Updates on Lacosamide Research

Recent studies have focused on the long-term safety and effectiveness of Lacosamide, particularly in patients with drug-resistant epilepsy. A 2022 study published in the journal Epilepsia found that Lacosamide significantly reduced seizure frequency in patients with partial-onset seizures who had not responded to other treatments. Ongoing research is also exploring Lacosamide’s potential in treating other types of neuropathic pain and its role in combination therapies for epilepsy. As more data becomes available, it may offer new insights into the broader applications of Lacosamide in managing neurological conditions.

James Kingsley

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