Lacosamide(lah koss’ ah mide)
Vimpat
PREGNANCY CATEGORY C
Drug class
Antiepileptic
Therapeutic Actions
Indications
Adjunctive therapy for the treatment of partial-onset seizures in patients 17 yr and older; IV use is indicated for short-term treatment when oral administration is not feasible
Contraindications and Cautions
Contraindicated with hypersensitivity to components of drug, pregnancy, lactation.
Use cautiously with cardiac conduction problems, MI, heart failure, drugs that prolong the PR interval, suicidal ideation, hepatic dysfunction, renal impairment.
Available Forms
Tablets—50, 100, 150, 200 mg; single-use vial—10 mg/mL; solution—10 mg/mL
Dosages
Adults
Initially, 50 mg PO bid; may be increased, if needed and tolerated, at weekly intervals by 100 mg/day given in two divided doses. Usual effective dosage is 200–400 mg/day PO. IV dosage is the same as oral dosage and may be used short-term if oral dosing is not feasible; transfer patient to oral form as soon as feasible.
Pediatric patients younger than 17 yr
Safety and efficacy not established.
Patients with renal impairment
Patients with severe renal impairment (CrCl 30 mL/min or less) should receive a maximum of 300 mg/day.
Patients with hepatic impairment
Increase dosage with caution. Maximum dosage is 300 mg/day with mild to moderate hepatic impairment; not recommended for use with severe hepatic impairment.
Pharmacokinetics
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