LACOSAMIDE
Background and Date of Approval
Lacosamide (Vimpat) received initial approval from the U.S. Food and Drug Administration (FDA) on 28 October 2008.
Uses
It is an anticonvulsant medication used to treat partial-onset seizures (seizures that involve only one part of the brain) in adults and children 1 month of age and older. It is also combined with other medications to control primary generalized tonic-clonic seizures (formerly known as a grand mal seizure, a seizure that involves the entire body) in adults and children 4 years and older.
How is it administered?
The drug is given via intravenous (IV) injection, offering flexibility in dosing and administration. The recommended dosage and administration of lacosamide depend on the patient's age, weight, medical condition, and response to other medications. Patients must follow their healthcare provider's instructions carefully and attend regular check-ups to monitor the drug's effectiveness.
Side Effects
Lacosamide, an antiepileptic medication, can entail common side effects like dizziness, headache, nausea, and vomiting. It might also cause blurred vision, tremors, or coordination issues. Potentially serious effects include allergic reactions, suicidal thoughts, mood changes, cardiac effects, and hypersensitivity reactions. Visual changes, Stevens-Johnson syndrome, and multi-organ hypersensitivity syndrome are rare but severe possibilities. Patients should be monitored for worsening seizures upon abrupt discontinuation.
Warnings
Lacosamide carries important warnings, including an increased risk of suicidal thoughts or behavior, necessitating vigilant monitoring for mood changes. Its potential to affect cardiac conduction requires caution in patients with heart conditions. Central nervous system-related effects such as dizziness and coordination difficulties may impact activities requiring alertness. Abrupt discontinuation can lead to increased seizure frequency. Hypersensitivity reactions, including severe skin conditions, are possible.
Precautions
Patients should be cautious about photosensitivity, and potential interactions with other medications or alcohol should be discussed with healthcare providers. Pregnant and breastfeeding individuals should seek medical advice before use, and patients with impaired kidney or liver function should have dosages adjusted. Regular communication with healthcare professionals is essential to navigate these warnings effectively.
Word of Advice
Patients with a history of allergic reactions to lacosamide or its components should avoid use. Caution is advised for patients with pre-existing cardiac conditions or those taking medications that affect heart rhythm due to potential cardiac effects. Pregnant and breastfeeding patients should consult their healthcare provider due to uncertain safety. Kidney function should be assessed before initiating treatment.
References
UCB Pharma Limited, Electronic medicines compendium (EMC), [Revised on Dec 2021] [ Accessed on 5th August 2023], https://www.medicines.org.uk/emc/files/pil.2286.pdf UCB, Inc, US Food and Drug Administration, [Revised on Oct 2008] [Accessed on 5th August 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/022253lbl.pdf Sheridan M Hoy; Lacosamide: A Review in Focal-Onset Seizures in Patients with Epilepsy; CNS Drugs; Published on May 2018; [Accessed on 5/08/2023]; https://pubmed.ncbi.nlm.nih.gov/29785508/
Frequently Asked Questions
Can lacosamide be used in children?
Lacosamide is approved for use in children aged 4 years and older with epilepsy. Its safety and efficacy in younger children have not been well established.
Can lacosamide cause changes in mood or behavior?
Yes, lacosamide has been associated with changes in mood, including an increased risk of suicidal thoughts and behaviors. Patients, caregivers, and healthcare providers should monitor for any unusual behaviors or mood changes.
Should I be cautious about photosensitivity while taking lacosamide?
Yes, lacosamide has been associated with increased sensitivity to light (photosensitivity). Patients should take precautions to protect their skin from excessive sun exposure.
What are the common side effects of lacosamide?
Common side effects of lacosamide may include dizziness, headache, nausea, and vomiting. Patients may also experience changes in mood, cognitive function, or coordination.
Can lacosamide cause changes in blood pressure?
Lacosamide can potentially cause changes in blood pressure, including both increases and decreases. Blood pressure should be monitored regularly, especially in patients with preexisting cardiovascular conditions.
Can lacosamide affect hormonal contraceptives?
Lacosamide has not been shown to impact hormonal contraceptives like birth control pills significantly, but it's advisable to discuss this with your healthcare provider.