Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. Motpoly XR
  2. Vimpat

Descriptions


Lacosamide is used to treat partial-onset seizures. It is also used with other medicines to treat primary generalized tonic-clonic seizures. It acts on the central nervous system (CNS) to reduce the number and severity of seizures. However, this medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to take it.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Tablet
  • Solution
  • Capsule, Extended Release

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of Motpoly XR® in children weighing less than 50 kilograms (kg). Safety and efficacy have not been established.

Appropriate studies have not been performed on the relationship of age to the effects of Vimpat® in children younger than 4 years of age to treat primary generalized tonic-clonic seizures and in children younger than 1 month of age to treat partial-onset seizures. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of lacosamide in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving lacosamide.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acebutolol
  • Acecainide
  • Acepromazine
  • Ajmaline
  • Alfentanil
  • Alprazolam
  • Amiodarone
  • Amitriptyline
  • Amlodipine
  • Amobarbital
  • Anileridine
  • Aprindine
  • Aranidipine
  • Aripiprazole
  • Aripiprazole Lauroxil
  • Asenapine
  • Atazanavir
  • Atenolol
  • Baclofen
  • Benperidol
  • Benzhydrocodone
  • Bepridil
  • Betaxolol
  • Bisoprolol
  • Bretylium
  • Bromazepam
  • Buprenorphine
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Calcifediol
  • Calcium Oxybate
  • Cannabidiol
  • Cannabis
  • Carbinoxamine
  • Carisoprodol
  • Carphenazine
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Cetirizine
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorpromazine
  • Chlorzoxazone
  • Cilnidipine
  • Clevidipine
  • Clobazam
  • Clonazepam
  • Clorazepate
  • Clozapine
  • Codeine
  • Cyclobenzaprine
  • Daridorexant
  • Dexmedetomidine
  • Diacetylmorphine
  • Diazepam
  • Dichloralphenazone
  • Difenoxin
  • Dihydrocodeine
  • Diltiazem
  • Diphenhydramine
  • Diphenoxylate
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Doxylamine
  • Dronedarone
  • Droperidol
  • Encainide
  • Enflurane
  • Esketamine
  • Eslicarbazepine Acetate
  • Esmolol
  • Estazolam
  • Eszopiclone
  • Ethchlorvynol
  • Ethopropazine
  • Ethylmorphine
  • Felodipine
  • Fentanyl
  • Flecainide
  • Flibanserin
  • Flunitrazepam
  • Fluphenazine
  • Flurazepam
  • Fluspirilene
  • Fospropofol
  • Gabapentin
  • Gabapentin Enacarbil
  • Halazepam
  • Haloperidol
  • Halothane
  • Hexobarbital
  • Hydrocodone
  • Hydromorphone
  • Hydroquinidine
  • Hydroxyzine
  • Ibutilide
  • Indecainide
  • Isoflurane
  • Isradipine
  • Ketamine
  • Ketazolam
  • Ketobemidone
  • Labetalol
  • Lercanidipine
  • Levobunolol
  • Levocetirizine
  • Levorphanol
  • Lidocaine
  • Lopinavir
  • Lorazepam
  • Loxapine
  • Magnesium Oxybate
  • Manidipine
  • Meclizine
  • Melperone
  • Meperidine
  • Mephobarbital
  • Meprobamate
  • Meptazinol
  • Mesoridazine
  • Metaxalone
  • Methadone
  • Methdilazine
  • Methocarbamol
  • Methohexital
  • Methotrimeprazine
  • Methylene Blue
  • Metipranolol
  • Metoprolol
  • Mexiletine
  • Midazolam
  • Molindone
  • Moricizine
  • Morphine
  • Morphine Sulfate Liposome
  • Nadolol
  • Nalbuphine
  • Nebivolol
  • Nicardipine
  • Nicomorphine
  • Nifedipine
  • Nimodipine
  • Nisoldipine
  • Nitrazepam
  • Nitrendipine
  • Nitrous Oxide
  • Olanzapine
  • Opium
  • Opium Alkaloids
  • Orlistat
  • Orphenadrine
  • Oxazepam
  • Oxprenolol
  • Oxycodone
  • Oxymorphone
  • Papaveretum
  • Paregoric
  • Penbutolol
  • Pentazocine
  • Pentobarbital
  • Perampanel
  • Perazine
  • Periciazine
  • Perphenazine
  • Phenobarbital
  • Pimozide
  • Pindolol
  • Piperacetazine
  • Pipotiazine
  • Piritramide
  • Potassium Oxybate
  • Prajmaline
  • Prazepam
  • Primidone
  • Procainamide
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propafenone
  • Propofol
  • Propranolol
  • Quazepam
  • Quetiapine
  • Quinidine
  • Quinine
  • Ramelteon
  • Remifentanil
  • Remimazolam
  • Remoxipride
  • Ritonavir
  • Saquinavir
  • Secobarbital
  • Sertindole
  • Sodium Oxybate
  • Sotalol
  • Sparteine
  • Sufentanil
  • Sulpiride
  • Suvorexant
  • Tapentadol
  • Tedisamil
  • Temazepam
  • Thiethylperazine
  • Thiopental
  • Thiopropazate
  • Thioridazine
  • Tilidine
  • Timolol
  • Tizanidine
  • Tocainide
  • Tolonium Chloride
  • Topiramate
  • Tramadol
  • Triazolam
  • Trifluoperazine
  • Trifluperidol
  • Triflupromazine
  • Trimeprazine
  • Verapamil
  • Zaleplon
  • Zolpidem
  • Zopiclone
  • Zotepine

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Brugada syndrome (genetic disease) or
  • Depression, history of or
  • Drug or alcohol abuse or dependence, history of or
  • Heart attack or
  • Heart block or
  • Heart disease (eg, heart failure, myocardial ischemia) or
  • Heart rhythm problems (eg, prolonged PR interval) or
  • Mental illness, history of or
  • Sick sinus syndrome (type of abnormal heart rhythm), without pacemaker—Use with caution. May make these conditions worse.
  • Diabetic neuropathy (nerve problem caused by diabetes) or
  • Heart or blood vessel disease—May increase risk for more serious side effects.
  • Kidney disease, severe or
  • Liver disease, mild to moderate—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Liver disease, severe—Should not be used in patients with this condition.
  • Phenylketonuria (PKU)—The oral liquid contains aspartame (a source of phenylalanine), which can make this condition worse.

Proper Use

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

You may take this medicine with or without food.

Swallow the tablet or the extended-release capsule whole with liquid. Do not open, crush, break, or chew it.

Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

The oral liquid may also be given using a nasogastric tube or gastrostomy tube.

Lacosamide may be used together with other seizure medicines. Keep using all of your medicines unless your doctor tells you to stop.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (solution and tablets):
    • For partial-onset seizures or primary generalized tonic-clonic seizures:
      • For patients taking lacosamide alone:
        • Adults and children 17 years of age and older—At first, 100 milligrams (mg) 2 times a day. Some patients may have a starting dose of 200 mg taken as a single dose, followed approximately 12 hours later by 100 mg 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 400 mg per day.
        • Children 4 to 16 years of age—Dose is based on body weight and must be determined by your doctor.
          • Weighing 50 kilograms (kg) or more—At first, 50 milligrams (mg) 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 400 mg per day.
          • Weighing 30 kg to less than 50 kg—At first, 1 milligram per kilogram (mg/kg) body weight 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 8 mg/kg body weight per day.
          • Weighing 6 kg to less than 30 kg—At first, 1 milligram per kilogram (mg/kg) body weight 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 12 mg/kg body weight per day.
          • Weighing less than 6 kg—At first, 1 milligram per kilogram (mg/kg) body weight 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 15 mg/kg body weight per day.
        • Children younger than 4 years of age—Use and dose must be determined by your doctor.
      • For patients switching from other seizure medicines:
        • Adults and children 17 years of age and older—At first, 150 to 200 milligrams (mg) 2 times a day.
        • Children younger than 17 years of age—Use and dose must be determined by your doctor.
      • For patients who are taking lacosamide together with other seizures medicines:
        • Adults and children 17 years of age and older—At first, 50 milligrams (mg) 2 times a day. Some patients may have a starting dose of 200 mg taken as a single dose, followed approximately 12 hours later by 100 mg 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 400 mg per day.
        • Children 4 to 16 years of age and weighs 50 kilograms (kg) or more—Dose is based on body weight and must be determined by your doctor. The usual dose is 100 mg 2 times a day. However, the dose is usually not more than 400 mg per day.
        • Children younger than 4 years of age—Use and dose must be determined by your doctor.
  • For oral dosage forms (extended-release capsules):
    • For partial-onset seizures:
      • For patients taking lacosamide alone:
        • Adults and children 17 years of age and older—200 milligrams (mg) once a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 400 mg per day.
        • Children weighing 50 kilograms (kg) or more—100 mg once a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 400 mg per day.
        • Children weighing less than 50 kg—Use and dose must be determined by your doctor.
      • For patients who are taking lacosamide together with other seizures medicines:
        • Adults and children 17 years of age and older—At first, 100 milligrams (mg) once a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 400 mg per day.
        • Children weighing 50 kilograms (kg) or more—At first, 100 milligrams (mg) once a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 400 mg per day.
        • Children weighing less than 50 kg—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Do not freeze the oral liquid. Throw away any unused medicine after 6 months of first opening the bottle.

Precautions

It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

If you or your child develop any unusual or strange thoughts and behavior while taking lacosamide, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink too much alcohol. Other changes might be confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

This medicine may cause blurred vision, double vision, clumsiness, unsteadiness, dizziness, drowsiness, sleepiness, or trouble with thinking. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. If these side effects are especially bothersome, check with your doctor.

This medicine can cause changes in heart rhythms, including a condition called PR prolongation. It may change the way your heart beats and cause lightheadedness, fainting, or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, including a fast, slow, or irregular heartbeat.

Do not stop taking this medicine without first checking with your doctor. Stopping the medicine suddenly may cause your seizures to return or to occur more often. Your doctor may want you to gradually reduce the amount you are using before stopping it completely.

Lacosamide may cause a condition called drug reaction with eosinophilia and systemic symptoms (DRESS), which is a serious allergic reaction affecting multiple body organs (eg, liver or kidney). Check with your doctor right away if you have fever, dark urine, headache, rash, stomach pain, swollen, painful, or tender lymph glands in the neck, armpit, or groin, unusual tiredness, or yellow eyes or skin.

Breastfeeding during treatment with this medicine may cause your baby to be more sleepy. Talk with your doctor if you have concerns.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Dizziness
  2. false or unusual sense of well-being
  3. shakiness and unsteady walk
  4. sleepiness or unusual drowsiness
  5. trembling or shaking of the hands or feet
  6. unsteadiness, trembling, or other problems with muscle control or coordination

Less common

  1. Being forgetful
  2. discouragement
  3. feeling sad or empty
  4. irritability
  5. itching skin
  6. lack of appetite
  7. loss of balance control
  8. loss of interest or pleasure
  9. mood or mental changes
  10. tearing of the skin
  11. tiredness
  12. trouble concentrating
  13. trouble with sleeping
  14. trouble with walking

Incidence not known

  1. Abnormal or decreased touch sensation
  2. black, tarry stools
  3. burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  4. changes in patterns and rhythms of speech
  5. chills
  6. continuing ringing or buzzing or other unexplained noise in the ears
  7. cough
  8. fast, irregular, pounding, or racing heartbeat or pulse
  9. feeling drunk
  10. fever
  11. hearing loss
  12. lower back or side pain
  13. painful or difficult urination
  14. pale skin
  15. slurred speech
  16. sore throat
  17. trouble breathing
  18. trouble performing routine tasks
  19. trouble with balance
  20. trouble with speaking
  21. ulcers, sores, or white spots in the mouth
  22. unusual bleeding or bruising
  23. unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Blurred vision
  2. double vision
  3. headache
  4. nausea
  5. vomiting

Less common

  1. Diarrhea
  2. feeling of constant movement of self or surroundings
  3. lack or loss of strength
  4. sensation of spinning
  5. uncontrolled eye movements

Incidence not known

  1. Acid or sour stomach
  2. belching
  3. blistering, peeling, loosening of the skin
  4. constipation
  5. difficulty having a bowel movement
  6. dry mouth
  7. heartburn
  8. increased sweating
  9. indigestion
  10. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  11. muscle spasms
  12. stomach discomfort, upset, or pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: Feb. 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/lacosamide-oral-route/description/DRG-20072409