LACOSAMIDE
(Vimpat)Standard Prescription
Lacosamide __mg (__ mg/kg/dose) PO {frequency}
Lacosamide __ mg (__ mg/kg/dose) IV loading dose.
Dosages
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
Refractory Status Epilepticus:* Loading dose: 5-10 mg/kg/dose IV (max 200 mg/dose)
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)
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.
Forms Supplied
tablet: 50 mg, 100 mg, 200 mg
injection: 10 mg/mL
injection: 10 mg/mL
Comments
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.
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.
References
44, 417, 418, 419
Last Edited
2022-07-04 19:04:25