Lacosamide (Oral)

Overview

Lacosamide can be used alone or in conjunction with other medications to help control partial seizures or convulsions. It is used in patients who are suffering from seizures caused by epilepsy. Lacosamide acts on the central nervous system n the patient to reduce the occurrence of seizures and to reduce their severity.

Lacosamide is not a cure for epilepsy and will be effective in preventing seizures only for as long as the treatment is taken. Patients who are taking this treatment should not cease use without discussing this with their doctor first. The dose of medication may need to be reduced gradually to prevent unwanted and severe symptoms returning.

Lacosamide is available only when prescribed by a doctor and is available as vimpat tablets or solution. The medication can also be administered intravenously for different treatment methods.

Condition treated

  • Seizures, from epilepsy

Type Of Medicine

  • Central nervous system inhibitor

Side Effects

As well as preventing and reducing the number and severity of seizures through epilepsy, Lacosamide can also have other unwanted side effects that may impact on the patient. While not all side effects will occur, when they do the patient may be required to seek immediate medical attention. Other side effects may also occur that are less serious.

If you experience the following side effects from use then you should seek medical attention immediately:

Occurring more commonly:

  • Dizziness without cause
  • Shakiness
  • Sleepiness
  • Trembling or other problems with control of muscles or coordination
  • Trembling or shaking of the hands and/or feet
  • Unsteadiness when walking
  • Unusual drowsiness
  • Unusual or surreal sense of wellbeing

Occurring less commonly:

  • Discouragement or loss of confidence
  • Feelings of sadness or emptiness
  • Forgetfulness
  • Irritability or quickness to annoyance
  • Itching of the skin
  • Loss of appetite
  • Loss of control of balance
  • Loss of interest
  • Loss of pleasure
  • Mental changes
  • Mood changes
  • Tearing or breaking of the skin
  • Tiredness
  • Trouble with concentrating
  • Trouble with sleeping
  • Trouble with walking

The frequency of incidence not known:

  • Abnormal touch sensation
  • Black stools with a tarry appearance
  • Burning, crawling, tingling, itching, numbness or prickling of the skin
  • Changes to or irregularity of heartbeat or pulse
  • Changes to the pattern and/or rhythm of speech
  • Chills
  • Continued ringing or buzzing sounds heard
  • Coughing
  • Decreased touch sensation
  • Feeling drunkenness
  • Feverishness
  • Hearing loss
  • Lower back pain
  • Pain or difficulty experienced during urination
  • Paleness of the skin
  • Pins and needles
  • Shortness of breath
  • Side pains
  • Slurring of speech
  • Soreness of the throat
  • Trouble in performing routine tasks
  • Trouble with maintaining balance
  • Trouble with speaking
  • Troubled breathing when exerting oneself
  • Ulcers or sores appearing in the mouth
  • Unexplained noise in the ears
  • Unusual bleeding
  • Unusual bruising
  • Unusual tiredness
  • Unusual weakness
  • White spots on mouth

Certain side effects may also occur that do not require that you seek medical attention. The following side effects will usually be mild, will abate over time and do not usually indicate any wider medical complications. If these side effects do become bothersome or are ongoing, however, then you can consult your healthcare professional to determine how best to alleviate them:

Occurring more commonly:

  • Blurring of vision
  • Doubling of vision
  • Headaches
  • Nausea
  • Vomiting

Occurring less commonly:

  • Diarrhea
  • Feeling that self or surroundings are constantly moving
  • Lack of strength
  • Loss of strength
  • Spinning sensation
  • Uncontrolled movements of the eye

The frequency of incidence not known:

  • Acid stomach
  • Belching or burping
  • Difficulty in passing a bowel movement
  • Dryness of the mouth
  • Heartburn
  • Indigestion
  • Muscle spasms
  • Sourness of the stomach
  • Stomach discomfort
  • Stomach pain
  • Stomach upset

Other side effects that have not been listed herein may also occur when using Lacosamide. If you experience any other side effects then you should inform your doctor straight away. If you are worried about your immediate health, however, then you should always seek emergency medical attention.

Dosage

You should use Lacosamide only as you have been directed by your doctor. The dose will be carefully calculated to help you as much as possible. You should not take more or less of it than prescribed and should follow the dosing schedule exactly. Do not take this medication for longer than ordered. Taking increased doses will increase the chance of side effects occurring.

This medication will be provided with a medication guide. You should read the medication guide carefully before use and should discuss any questions that you have with your doctor.

You can take these tablets with or without food. If they upset your stomach then take them with food to reduce this unless you have been ordered otherwise by your doctor.

You should use a marked measuring device to measure the oral liquid solution. Standard kitchenware may not be the correct dose and you will risk taking too much or too little of the treatment.

Lacosamide may be used in conjunction with other medications in some circumstances. When you are prescribed with Lacosamide you should inform your doctor of all treatments that you are taking and should not stop taking any other medications unless you are directed to by the doctor.

The dose of this medication given will differ from patient to patient. You should take the medication exactly as directed by your doctor and should not share your treatment with anyone else. The following dosing information is to be used as a guideline only and should not be used to adjust your dosing:

When using only Lacosamide:

  • Adults and teenagers aged 17+ should be treated with an initial dose of 100mg taken twice daily. Your doctor may increase this dose with tolerance up to 400mg daily.
  • Below the age of 17, any treatment must be decided in each case by the prescribing doctor.

When changing from other medications to Lacosamide:

  • Adults and teenagers aged 17+ will start with a dose of 150-200mg taken twice daily.
  • Below the age of 17, use of this medication should be determined by a doctor.

When taking Lacosamide in conjunction with other seizure medications:

  • Adults and teenagers aged 17+ will begin with 50mg taken twice daily. This may be increased to a maximum dose of 400mg with tolerance.
  • Below the age of 17, patients will have their dose determined in each case by the prescribing doctor.

If you miss a dose of this medication then you should take it as soon as possible. If it is then close to your next dose being due, however, then you need to skip the dose and return to your normal schedule. You should not ever take a double dose of this medication.

Interactions

Lacosamide can interact with a wide range of medications in the body. Drug interactions can be very dangerous and should be avoided. In the most serious cases, medications can have life-threatening effects when used together. In other cases, medications may prevent one another from working or may increase the risk of side effects occurring. To avoid drug interactions you must inform your doctor of all medications and substances that you are taking before you begin use of this treatment.

Use of Lacosamide in conjunction with the following medications is not usually recommended, but it may be required in some cases. When both treatments are needed the doctor may adjust the dose or frequency of use of one or more medication:

  • Verapamil
  • Timolol
  • Sotalol
  • Saquinavir
  • Ritonavir
  • Quinine
  • Propranolol
  • Practolol
  • Pindolol
  • Penbutolol
  • Oxprenolol
  • Orlistat
  • Nisoldipine
  • Nimodipine
  • Nifedipine
  • Nicardipine
  • Nebivolol
  • Nadolol
  • Metoprolol
  • Metipranolol
  • Lopinavir
  • Levobunolol
  • Labetalol
  • Isradipine
  • Felodipine
  • Esmolol
  • Eslicarbazepine Acetate
  • Dolasetron
  • Diltiazem
  • Clevidipine
  • Cinnarizine
  • Chlordiazepoxide
  • Celiprolol
  • Carvedilol
  • Carteolol
  • Calcifediol
  • Bisoprolol
  • Betaxolol
  • Atenolol
  • Atazanavir
  • Amlodipine
  • Amitriptyline
  • Acebutolol

Other drug interactions with Lacosamide can also occur. To avoid unwanted effects from drug interactions from occurring you must inform your doctor of all treatments you are using before beginning this treatment.

Other medical conditions can also impact on the use of this medication. Some conditions can prohibit the use of this treatment and others may increase the risk of side effects occurring. You should inform your doctor of your full medical history before you begin treatment with Lacosamide. This is particularly important in the following cases:

  • Brugada syndrome
  • History of depression
  • History of drug abuse or dependency
  • Heart attack
  • Heart block
  • Heart disease
  • Heart rhythm problems
  • History of mental illness
  • Sick sinus syndrome
  • Diabetic neuropathy
  • Heart or blood vessel disease
  • Severe kidney disease
  • Mild to moderate liver disease
  • Severe liver disease
  • Phenylketonuria

Other medical conditions not listed herein can also impact on the use of Lacosamide. You must inform your doctor of your full medical history before use.

Warnings

Before you begin treatment with this medication you should consider the benefits in relation to the risks of use. You will make this decision with your doctor and should ensure that you have considered all of the following together:

Allergies ' You must inform your doctor if you have ever reacted badly to any medication in the past. This is particularly important if you have ever had a bad reaction to a central nervous system suppressant in the past. You should also inform your doctor of any other allergies that you suffer from. Certain allergies may prohibit the use of Lacosamide.

Pediatric'The safety and efficiency of this medication in patients below the age of 17. You should discuss the use of this medication below this age carefully with your doctor.

Geriatric' Studies performed to date have not shown any limitations in the use of this medication in elderly patients. Elderly patients are, however, more likely to suffer from heart, kidney, liver and blood vessel problems that may limit the use of this medication. Caution should be used when treating the elderly with Lacosamide.

Pregnancy ' Category C risk. Patients must inform their doctor if they are pregnant before beginning use. If you become pregnant during use or believe that you have become pregnant during use then you must inform your doctor immediately. If you become pregnant then you may be asked to join the North American Antiepileptic Drug Pregnancy Registry so that more can be learned about the use of this medication when pregnant.

Breastfeeding 'The risks of breastfeeding during use of this treatment are unknown. You should discuss the risks in relation to the benefits with your doctor.

It is important that you have a regular visitation with your doctor during your use of this treatment. You will need to be checked to ensure that the medication is working properly and to check for any unwanted side effects that may be occurring.

This medication can cause changes in behavior that is intensified in patients who have suffered depression. If you begin to develop any unusual thoughts or feel as though you are drunk then you need to inform your doctor immediately. You may become confused, depressed, excitable and nervous. You may also begin to have suicidal thoughts and hallucinations. If you notice any of these occurring then you should contact your doctor immediately.

This medication can affect your ability to see and may cause you to lose coordination. If these side effects occur, then you will not be safe to drive or operate machinery. Remember that it is your legal responsibility to ensure that you are safe to carry out such tasks before doing so. To operate a vehicle or machinery could put you and others at risk and should not be carried out.

Changes in heart rhythm may also occur that can cause fainting and lightheadedness to occur. If you notice any change in your heart rate then you should contact your doctor immediately before fainting occurs. If you are alone then you should contact the emergency services immediately.

Lacosamide can cause serious allergic reactions to occur that will affect your kidney and liver as well as other organs. If you experience any of the following symptoms then you must seek emergency medical attention and inform them that you took Lacosamide:

  • Darkened urine
  • Feverishness
  • Headaches
  • Rash
  • Stomach pain
  • Swelling, pain or tenderness of the lymph nodes
  • Unusual tiredness
  • Yellowing of eyes and/or skin

You should not take any other medications in conjunction with this treatment unless you have been directed to by a doctor. To do so may put you at risk of serious medical complications. Only take this medication as prescribed and do not ever take a larger dose of Lacosamide than you have been ordered to.

Storage

This medication should be stored in a sealed container at room temperature. Keep it away from moisture, light and heat. Prevent the medication from freezing. Dispose of any unwanted or unused medication safely. You should ask your healthcare professional how to dispose of any medication that is not used.

Always keep this and all other medications out of reach of children. Any opened oral solution needs to be used within seven weeks and disposed of after this time.

Summary

Lacosamide is used in the treatment and control of seizures that are caused by epilepsy. The medication is a central nervous system suppressant that can effectively reduce the frequency and severity of epileptic fits.

Epilepsy is not cured by the use of Lacosamide tablets, but the condition can be controlled and the fits can be reduced in frequency and severity. If the medication is ceased to be used, then the seizures will return. Patients may need to have their dose gradually reduced to prevent a worsening of condition from occurring.

Lacosamide is only recommended for use in patients aged 17+ and must be prescribed by a doctor. The dose of this medication will be calculated personally for you and you should not ever take more of it than you have been prescribed. To do so will put you at greater risk of side effects occurring.

Lacosamide can cause a range of unwanted side effects. Patients should be aware of the potential risks of use before beginning use of this treatment. There will be a medication guide provided with the treatment. The patient should be sure to read this thoroughly and check any questions that they have with their doctor.

Changes in mood and unusual thoughts may also occur from the use of this treatment. When taking Lacosamide it is important that any unusual thoughts or changed outlooks are shared with the doctor as soon as possible. In some cases, this medication may trigger suicidal thoughts that may require that changes are made to the medication.

Patients should avoid becoming pregnant during the use of this treatment. If you do become pregnant, however, then you may be asked to join a registry of patients who are receiving antiepileptic medications during pregnancy.