Lacosamide

✔️ Uses:

• Used as an adjunctive treatment of partial onset seizures in patients above 17 years of age

✔️ How does Lacosamide work?

Lacosamide works slowly by inactivating the sodium-gated channels, which decreases the abnormal and excessive activity of the nerve cells in the brain and controls seizures or fits.

✔️ Side Effects of Lacosamide

Common adverse reactions include diplopia, headache, dizziness, and nausea.

✔️ Quick Suggestions:

• Take your medication regularly as directed by your doctor as missing doses can trigger seizures.
• Do not change the brand of your medicine and make sure that you have a sufficient amount of medicine present with you.
• Some healthy tips to prevent seizures:
  
  • Practice yoga every day.
  • Get enough sleep at nighttime.
  • Limit the use of screen time such as mobile/laptop.
  • Take your medication on time.
• It may cause dizziness and sleepiness. Do not drive or do anything that requires mental focus until you know how it affects you.
• Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
• Talk to your doctor if you have a heart problem that affects your heartbeat.
• Do not stop taking the medication suddenly without talking to your doctor as it may increase the seizure frequency.

✔️ Indications:

Lacosamide is prescribed for the treatment of partial-onset seizures in patients aged 4 years and older. However, the safety of Lacosamide injection has not been established in pediatric patients. Lacosamide injection is indicated for the treatment of partial-onset seizures in adult patients aged 17 years and older.

✔️ Pharmacology

Lacosamide is believed to provide analgesia by inhibiting sodium channels, primarily affecting depolarized neurons associated with pain and nociceptor hyperexcitability. It also binds to collapsin response mediator protein-2 (CRMP-2), a nervous system phosphoprotein involved in neuronal differentiation and axonal outgrowth. Its role in seizure control is not yet fully understood.

✔️ Dosage & Administration of Lacosamide

Adults (17 years and older):

• The initial dosage for monotherapy is 100 mg twice daily.
• The initial dosage for adjunctive therapy is 50 mg twice daily.
• The maximum recommended dosage for both monotherapy and adjunctive therapy is 200 mg twice daily.

Pediatric Patients (4 years to less than 17 years):

• The recommended dosage is based on body weight and is administered orally twice daily.
• Dosage may be increased based on clinical response and tolerability, but no more frequently than once per week.

Injection:

• For intravenous and adult use only when oral administration is temporarily not feasible.
• Administer over 15 to 60 minutes.
• Obtaining an ECG before initiation is recommended in certain patients.

✔️ Interaction

Strong CYP3A4 or CYP2C9 Inhibitors: Patients with renal or hepatic impairment taking strong inhibitors of CYP3A4 and CYP2C9 may have increased exposure to Lacosamide, potentially requiring dose reduction.

Concomitant Medications that Prolong PR Interval: Lacosamide should be used with caution in patients taking medications that prolong PR interval, such as beta-blockers and calcium channel blockers, due to the risk of AV block or bradycardia.

✔️ Contraindications

None specified.

✔️ Pregnancy & Lactation

Based on animal data, Lacosamide may cause fetal harm during pregnancy.

✔️ Precautions & Warnings

• Monitor patients for suicidal behavior and ideation.
• Lacosamide may cause dizziness and ataxia.
• Cardiac Rhythm and Conduction Abnormalities: Obtain ECG before and after titration in patients with known cardiac conduction issues or taking drugs known to induce PR interval prolongation.
• Lacosamide may cause syncope.
• Gradually withdraw Lacosamide to minimize the potential for increased seizure frequency.
• Discontinue if Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Multi-Organ Hypersensitivity is suspected.
• Use with caution and consider dose adjustment in patients with renal or hepatic impairment.

✔️ Storage Conditions

Store at 20°C to 25°C.