Lacosamide is indicated for the treatment of partial-onset seizures in patients 1 month of age and older.
Lacosamide is indicated for adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients 4 years of age and older.

It is proposed that lacosamide's inhibition of sodium channels is responsible for its anticonvulsant and analgesic effects. Lacosamide may be selective for inhibiting depolarized neurons rather than neurons with normal resting potentials. Pain and nociceptor hyperexcitability are associated with neural membrane depolarization. Lacosamide binds to collapsin response mediator protein-2 (CRMP-2), a phosphoprotein expressed primarily in the nervous system that is involved in neuronal differentiation and control of axonal outgrowth. The role of CRMP-2 binding in seizure control has not yet been elucidated.

The precise mechanism by which lacosamide exerts its anti-epileptic effects in humans remains to be fully elucidated. In vitro electrophysiological studies have shown that lacosamide selectively enhances the slow inactivation of voltage-gated sodium channels, resulting in stabilization of hyperexcitable neuronal membranes and inhibition of repetitive neuronal firing.

Recommended Dosages for Partial-Onset Seizures (Monotherapy or Adjunctive Therapy) in Patients 1 Month and Older, and for Primary Generalized Tonic-Clonic Seizures (Adjunctive Therapy) in Patients 4 Years of Age and Older.

Lacosamide tablets and oral solution may be taken with or without food.

Dose reduction of Lacosamide may be necessary in patients with renal or hepatic impairment who are taking strong inhibitors of CYP3A4 and CYP2C9. Lacosamide should be used with caution in patients who are on concomitant medications that affect cardiac conduction (sodium channel blockers, beta-blockers, calcium channel blockers, potassium channel blockers), including those that prolong the PR interval (sodium channel blocking AEDs).

Lacosamide is contraindicated in patients with a known hypersensitivity to either Lacosamide or to any excipients in Lacosamide.

The most common adverse reactions of Lacosamide are dizziness, headache, somnolence, ataxia, tremor, nausea, vomiting, fatigue, diplopia, blurred vision, and others.

Pregnancy: There are no adequate and well-controlled studies in pregnant women, and Lacosamide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Lactation: Lacosamide is excreted in human breast milk. The known benefits of breastfeeding should be weighed against the unknown risks of infant exposure to Lacosamide.

Monitor patients for suicidal behavior, dizziness, ataxia, PR interval prolongation, atrioventricular block, ventricular tachyarrhythmia, atrial fibrillation, atrial flutter, syncope, phenylketonuria, multi-organ hypersensitivity, and others when Lacosamide is prescribed.

Pediatric use: Safety and effectiveness of Lacosamide have not been established in pediatric patients below 1 month of age for partial-onset seizures, and below 4 years of age for primary generalized tonic-clonic seizures.

Geriatric use: Start at the lower end of the dosing range.

Renal impairment: No dose adjustment is necessary in patients with mild to moderate renal impairment. In patients with severe renal impairment and end-stage renal disease, a reduction of 25% of the maximum dosage is recommended.

Hepatic impairment: In patients with mild to moderate hepatic impairment, a reduction of 25% of the maximum dosage is recommended. Lacosamide use is not recommended in patients with severe hepatic impairment.

There is no specific antidote for overdose with Lacosamide. If overdose occurs, general supportive and symptomatic measures should be employed.

Atypical anti-depressant drugs

Do not store above 30°C. Keep away from light and out of the reach of children.