What is Dalfampridine: Uses, Dosage, Side Effects and More

Dalfampridine is a medication specifically designed to help people with multiple sclerosis (MS) walk better and move more easily. It's the first and only FDA-approved treatment that can improve walking ability in people living with MS, offering hope for those who struggle with mobility challenges.

This medication works by strengthening the electrical signals in damaged nerve fibers, helping your brain communicate more effectively with your muscles. Think of it as helping to restore some of the communication pathways that MS has disrupted in your nervous system.

What is Dalfampridine?

Dalfampridine is an oral medication that belongs to a class of drugs called potassium channel blockers. It's designed specifically for people with multiple sclerosis who experience walking difficulties due to their condition.

The medication comes as an extended-release tablet that you take twice daily. It's important to understand that dalfampridine doesn't cure MS or stop the progression of the disease. Instead, it focuses on improving one specific symptom that many people with MS face - difficulty walking.

You might also hear this medication referred to by its brand name, Ampyra. Both names refer to the same medication, so don't worry if you see either one on your prescription or in medical discussions.

What is Dalfampridine Used For?

Dalfampridine is specifically approved to improve walking ability in adults with multiple sclerosis. If you have MS and find that walking has become more challenging, slower, or requires more effort than it used to, this medication might help.

The medication can be helpful for people with any type of MS - whether you have relapsing-remitting, secondary progressive, or primary progressive forms of the condition. What matters most is that you're experiencing walking difficulties related to your MS.

It's worth noting that not everyone with MS will benefit from dalfampridine. Studies show that about 35-40% of people who take it experience meaningful improvement in their walking speed and ability. Your doctor can help determine if you're a good candidate for this treatment.

How Does Dalfampridine Work?

Dalfampridine works by blocking potassium channels in your nerve fibers, which helps strengthen the electrical signals traveling through damaged nerves. In MS, the protective covering around nerve fibers (called myelin) becomes damaged, making it harder for electrical signals to travel properly.

When you take dalfampridine, it helps these weakened electrical signals travel more efficiently from your brain to your muscles. This improved communication can translate into better walking ability, increased walking speed, and improved muscle strength in your legs.

The medication is considered moderately effective rather than a strong treatment. While it can provide meaningful benefits for those who respond to it, the improvements are typically modest but still significant enough to make a real difference in daily life.

How Should I Take Dalfampridine?

Dalfampridine should be taken exactly as prescribed by your doctor, typically twice daily about 12 hours apart. The standard dose is 10 mg twice daily, and it's crucial not to exceed this amount as higher doses can increase the risk of seizures.

You can take dalfampridine with or without food, but try to be consistent with your approach. If you choose to take it with food, do so every time, and if you prefer taking it on an empty stomach, stick with that routine.

Always swallow the tablets whole - never crush, chew, or break them. The extended-release formulation is designed to release the medication slowly throughout the day, and breaking the tablet can cause too much medication to be released at once.

Take your doses at roughly the same times each day to maintain steady levels of the medication in your system. Many people find it helpful to set reminders or take their doses with other daily activities like breakfast and dinner.

How Long Should I Take Dalfampridine For?

The duration of dalfampridine treatment varies from person to person and depends on how well you respond to the medication. Your doctor will typically have you try the medication for about 2-4 weeks to see if you notice any improvement in your walking ability.

If you experience meaningful benefits, you may continue taking dalfampridine for as long as it remains helpful and you don't experience troublesome side effects. Some people take it for months or even years as part of their ongoing MS management.

However, if you don't notice any improvement in your walking after several weeks of treatment, your doctor will likely recommend discontinuing the medication. There's no benefit to continuing dalfampridine if it's not helping your symptoms.

Regular follow-up appointments with your doctor are important to monitor your response to the medication and check for any side effects. Your doctor may also periodically assess whether the medication is still providing benefits.

What Are the Side Effects of Dalfampridine?

Like all medications, dalfampridine can cause side effects, though not everyone experiences them. The most common side effects are generally mild and manageable, but it's important to be aware of what to watch for.

The most frequently reported side effects include urinary tract infections, trouble sleeping, dizziness, headache, nausea, weakness, back pain, and problems with balance. These symptoms are usually mild and may improve as your body adjusts to the medication.

Here are the common side effects you might experience:

• Urinary tract infections
• Difficulty sleeping or insomnia
• Dizziness or feeling lightheaded
• Headaches
• Nausea or upset stomach
• Feeling weak or tired
• Back pain
• Balance problems

Most people find these side effects manageable, and they often become less noticeable over time as your body adapts to the medication.

There are also some less common but more serious side effects that require immediate medical attention. The most concerning is the risk of seizures, which is why it's absolutely critical never to exceed the prescribed dose.

Contact your doctor immediately if you experience any of these serious side effects:

• Seizures or convulsions
• Severe dizziness or fainting
• Difficulty breathing
• Severe allergic reactions (rash, swelling, difficulty breathing)
• Severe confusion or disorientation

These serious side effects are rare when the medication is taken as prescribed, but it's important to seek medical help right away if they occur.

Who Should Not Take Dalfampridine?

Dalfampridine isn't safe for everyone, and there are certain conditions and situations where this medication should not be used. Your doctor will carefully review your medical history before prescribing this medication.

You should not take dalfampridine if you have moderate to severe kidney problems, as your kidneys need to be able to process and eliminate the medication properly. People with a history of seizures should also avoid this medication due to the increased seizure risk.

Here are the main conditions that make dalfampridine unsuitable:

• Moderate to severe kidney disease
• History of seizures or epilepsy
• Allergy to dalfampridine or any of its ingredients
• Severe liver problems
• Currently taking other medications that contain dalfampridine

Your doctor will also be cautious about prescribing dalfampridine if you're elderly, as older adults may be more sensitive to the medication's effects.

Pregnancy and breastfeeding considerations are also important. While there isn't enough research to definitively say whether dalfampridine is safe during pregnancy, your doctor will weigh the potential benefits against any possible risks if you're pregnant or planning to become pregnant.

Dalfampridine Brand Names

Dalfampridine is most commonly known by its brand name Ampyra in the United States. This is the original brand name under which the medication was first approved by the FDA.

In other countries, you might see dalfampridine sold under different brand names, but the active ingredient remains the same. Some generic versions of dalfampridine may also be available, though they must meet the same strict standards as the brand-name version.

Whether you receive brand-name Ampyra or a generic version of dalfampridine, the medication should work the same way. Your pharmacist can help clarify which version you're receiving and answer any questions about differences between brand and generic options.

Dalfampridine Alternatives

Currently, dalfampridine is the only FDA-approved medication specifically designed to improve walking ability in people with MS. This makes it unique among MS treatments, as most other medications focus on preventing relapses or slowing disease progression.

However, there are other approaches that can help with walking difficulties in MS. Physical therapy is often recommended alongside or instead of medication, as it can help improve strength, balance, and coordination through targeted exercises.

Your healthcare team might also suggest mobility aids like walking sticks, walkers, or braces to help with walking challenges. Occupational therapy can provide strategies for conserving energy and moving more efficiently throughout your day.

Some people find benefit from complementary approaches like aquatic therapy, yoga adapted for people with MS, or specific exercise programs designed for neurological conditions. These aren't direct alternatives to dalfampridine, but they can be valuable additions to your overall treatment plan.

Is Dalfampridine Better Than Other MS Medications?

Dalfampridine serves a different purpose than most other MS medications, so it's not really a matter of being "better" but rather addressing different aspects of the condition. Most MS medications focus on preventing relapses or slowing disease progression, while dalfampridine specifically targets walking difficulties.

You might take dalfampridine alongside other MS treatments like disease-modifying therapies (DMTs) such as interferon beta, glatiramer acetate, or newer oral medications. These work together rather than competing with each other.

The advantage of dalfampridine is that it's the only medication specifically proven to improve walking ability in MS. If walking difficulties are significantly impacting your quality of life, dalfampridine offers a targeted approach that other medications don't provide.

Your doctor will help you understand how dalfampridine might fit into your overall MS treatment plan and whether it makes sense alongside your other medications.