| DRUG | SUPPLIED | DOSE | COMMENTS |
|---|---|---|---|
| LACOSAMIDE (Paeds) (Vimpat) Mechanism of action: Lacosamide, an anticonvulsant compound, is a functionalized amino acid that produces activity in the maximal electroshock seizure (MES) test. It enhances the slow inactivation of voltage-gated sodium channels. This inactivation prevents the channel from opening, helping end the action potential. Ref: 44, 417, 418, 419 Last update: 2022-07-04 |
tablet: 50 mg, 100 mg, 200 mg injection: 10 mg/mL |
Seizures: Children > 3 years: Initial: 0.5-1 mg/kg/dose PO BID (Maximum: 50 mg/dose) Increment: 0.5 mg/kg/dose PO BID every 7 days Maintenance: 2-5 mg/kg/dose PO BID Maximum: 7.5 mg/kg/dose PO BID or 200 mg/dose PO Adolescents > 17 years: Initial: 50 mg/dose PO BID Increment: 50 mg/dose PO BID every 7 days Maintenance: 100-200 mg/dose PO BID Maximum: 200 mg/dose PO BID Refractory Status Epilepticus:* Loading dose: 5-10 mg/kg/dose IV (max 200 mg/dose) |
IV and PO dosing is equivalent. May adjust PO dose according to tablet increments. Dosage adjustment required in hepatic/renal impairment. Adverse effects: ataxia, sedation, blurred vision (especially if combined with another sodium channel blocker). May prolong PR interval/precipitate arrhythmias; use with caution in patients with cardiac conduction problems. Obtain ECG prior to starting lacosamide if there are cardiac concerns. Drug Interactions: carbamazepine, phenobarbital, phenytoin. *Note: dosing in pediatric refractory status epilepticus is not well established. Standard Prescription: Lacosamide __mg (__ mg/kg/dose) PO {frequency} Lacosamide __ mg (__ mg/kg/dose) IV loading dose. |