Ver el código de «Lacosamide»

==General==
*Type: [[Anticonvulsant]]<ref>Beydoun A, et al. Lacosamide: pharmacology, mechanisms of action. Expert Rev Neurother. 2009;9(1):33-42. PMID 19102667</ref>
*Dosage Forms: 50, 100, 150, 200 PO/IV; 10/mL sol IV
*Common Trade Names: Vimpat

==Adult Dosing==
*Monotherapy
**100mg PO/IV q12hr initially, THEN, based on response and tolerability, increase dose at weekly intervals by 50mg PO/IV BID; up to a recommended dose of 150-200mg BID
**Alternate loading dose schedule: 200mg PO/IV as a single dose, followed ~12 hr later by starting 100mg PO/IV BID x 1 week, THEN increase dose at weekly intervals by 50mg BID; up to a recommended dose of 150-200mg BID
**In patients already taking an antiepileptic drug (AED), maintain lacosamide at recommended maintenance dose of 150-200mg PO BID for at least 3 days before initiating withdrawal of the previous AED
*Adjunctive therapy
**Initial: 50mg PO/IV q12hr
**Based on response and tolerability, increase dose at weekly intervals by 50mg PO/IV BID; up to a recommended dose of 100-200mg BID
*Max 400mg/day

==Pediatric Dosing==
*Safety not established under age 17
*>17 yo, see adult

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*Lactation: saftey unknown
*Renal Dosing
**Severe (CrCl <30 mL/min): Not to exceed 300mg/day
**Hemodialysis: Supplement with up to 50% of dose after dialysis
*Hepatic Dosing
**Mild to moderate: Not to exceed 300mg/day
**Severe: Not recommended

==Contraindications==
*Allergy to class/drug
*Caution in:
**elderly
**renal impairment
**hepatic impairment
**severe cardiac disease
**cardiac conduction defects
**diabetic neuropathy
**depression

==Adverse Reactions==
===Serious===
*PR prolongation
*AV block
*AFib
*AFlutter
*Syncope
*Suicidality
*Drug Rash with eosinophilia and systemic sx
*Stevens-Johnson
*Toxic epidermal necrolysis
*withdrawal seizures if abrupt discharge
*neutropenia
*agranulocytosis
===Common===
*>10%
**Dizziness (31%)
**Headache (13%)
**Diplopia (11%)
**Nausea (11%)
*1-10%
**Vomiting (9%)
**Ataxia (8%)
**Blurred vision (8%)
**Tremor (7%)
**Nystagmus (5%)
**Balance disorder (4%)
**[[Diarrhea]] (4%)
**Injection site discomfort (2.5%)
**Depression (2%)
**Memory impairment (2%)
**Pruritus (2%)
**Increased ALT (1%)
**Local irritation (1%)

==Pharmacology==
*Half-life: 13h
*Metabolism: liver; CYP450: 2C9, 2C19, 3A4 substrate
*Excretion: urine 95% (40% unchanged), feces <0.5%
*Mechanism of Action: exact mechanism unknown; enhances slow inactivation of voltage-sensitive Na channels, stabilizing neuronal membranes, inhibiting repetitive firing

==Indications by Condition==
''The following table is automatically generated from disease/condition pages across WikEM.''

{{#ask:[[Has DrugName::Lacosamide]]
 |?Has Indication=Indication
 |?Has Dose=Dose
 |?Has Context=Context
 |?Has Route=Route
 |?Has Population=Population
 |format=table
 |headers=plain
 |mainlabel=-
 |sort=Has Indication
 |limit=50
}}

==See Also==
*[[Seizure]]
*[[Anticonvulsants]]
*[[Anticonvulsant levels and reloading]]

==References==
epocrates, medscape

[[Category:Pharmacology]] [[Category:Neurology]]