LACOSAMIDE

Indications & Dose:

Adjunctive treatment of focal seizures with or without secondary generalisation

•   BY MOUTH, OR BY INTRAVENOUS INFUSION

Child 16–17 years: Initially 50 mg twice daily, infusion to be administered over 15–60 minutes (for up to 5 days), then increased, if tolerated, in steps of 50 mg twice daily, adjusted according to response, dose to be increased in weekly intervals; maintenance 100 mg twice daily (max. per dose 200 mg twice daily) Adult: Initially 50 mg twice daily, infusion to be administered over 15–60 minutes (for up to 5 days), then increased, if tolerated, in steps of 50 mg twice daily, adjusted according to response, dose to be increased in weekly intervals; maintenance 100 mg twice daily (max. per dose 200 mg twice daily)

Adjunctive treatment of focal seizures with or without secondary generalisation (alternative loading dose regimen when it is necessary to rapidly attain therapeutic plasma concentrations) (under close medical supervision)

•  BY MOUTH, OR BY INTRAVENOUS INFUSION

Child 16–17 years: Loading dose 200 mg, infusion to be administered over 15–60 minutes (for up to 5 days), followed by maintenance 100 mg twice daily, to be given 12 hours after initial dose, then increased, if tolerated, in steps of 50 mg twice daily (max. per dose 200 mg twice daily), adjusted according to response, dose to be increased in weekly intervals

Adult: Loading dose 200 mg, infusion to be administered over 15–60 minutes (for up to 5 days), followed by maintenance 100 mg twice daily, to be given 12 hours after initial dose, then increased, if tolerated, in steps of 50 mg twice daily (max. per dose 200 mg twice daily), adjusted according to response,dose to be increased in weekly intervals 

Contraindications:

Second or third degree block.

Side Effects:

Cautions:

Precautions:

Risk of PR interval prolongation (including conduction problems, severe cardiac disease and cocomitant use of drugs that prolong PR interval ) elderly 

Interaction:

DRUGS drugs that may prolong the QT interval: Possibly further QT-interval prolongation 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Asthenia, ataxia, attention deficit, cerebellar syndrome, confusion, depression, dizziness, feeling drunk, fever, headache, hypoaesthesia, impaired balance, irritability, memory impairment, mood alteration, paresthesia, somnolence, suicidal ideation, tremor, vertigo

CV: Palpitations, prolonged QT interval

ENT: Blurred vision, diplopia, dry mouth, nystagmus, oral hypoaesthesia, tinnitus

GI: Constipation, diarrhea, dyspepsia,  nausea, vomiting

HEME: Anemia, neutropenia

MS:Dysarthria, muscle spasms

SKIN: Pruritus, rash

Other :Delayed multi-organ hypersensitivity reaction; injection-site pain, irritation, and eryth

Patient And Carer Advice: