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

Lacosamide is an anti-seizure medication that doctors give through an IV (intravenous) line directly into your bloodstream. This medicine helps control seizures when you can't take pills by mouth, such as during a hospital stay or medical emergency.

The IV form works quickly to get the medication into your system when immediate seizure control is needed. Your healthcare team will monitor you closely while you receive this treatment to ensure it's working safely and effectively.

What is Lacosamide?

Lacosamide is an antiepileptic drug (AED) that belongs to a newer class of seizure medications. It works differently from older anti-seizure drugs by targeting specific sodium channels in your brain cells.

The intravenous form contains the same active ingredient as the oral tablets, but it's specially formulated to be given directly into your bloodstream. This allows the medication to reach your brain faster than pills, which is especially important during seizure emergencies.

Doctors typically use IV lacosamide when you're in the hospital and need immediate seizure control. It's considered a moderately strong anti-seizure medication that can be quite effective for certain types of seizures.

What is Lacosamide Used For?

IV lacosamide is primarily used to treat partial-onset seizures (also called focal seizures) in adults and children 17 years and older. These seizures start in one specific area of your brain and may or may not spread to other parts.

Your doctor might choose the IV form when you're unable to swallow pills due to illness, surgery, or ongoing seizures. It's also used when you need to transition from oral medication to IV treatment while maintaining steady levels of the drug in your system.

Sometimes doctors use IV lacosamide as an add-on treatment alongside other seizure medications when one drug alone isn't controlling your seizures effectively. This combination approach can help achieve better seizure control while potentially reducing side effects.

How Does Lacosamide Work?

Lacosamide works by affecting sodium channels in your brain cells, which are like tiny gates that control electrical activity. When these channels don't work properly, they can trigger seizures.

The medication helps stabilize these channels, making it harder for abnormal electrical activity to spread through your brain. Think of it as helping to calm down overexcited brain cells that might otherwise cause a seizure.

This is a moderately strong anti-seizure medication that typically takes effect within 30 minutes to 2 hours when given intravenously. The IV form ensures consistent blood levels, which is crucial for preventing breakthrough seizures.

How Should I Take Lacosamide?

You won't actually "take" IV lacosamide yourself - your healthcare team will administer it through an IV line in your arm or hand. The medication is given as a slow infusion over 30 to 60 minutes.

Your nurse will monitor you closely during the infusion and for several hours afterward. They'll watch for any signs of side effects or allergic reactions, and check your heart rhythm since lacosamide can affect heart function.

You don't need to worry about food interactions with the IV form since it goes directly into your bloodstream. However, let your healthcare team know about any medications or supplements you're taking, as these can interact with lacosamide.

The infusion rate and total dose will be carefully calculated based on your weight, medical condition, and response to treatment. Never try to adjust the IV drip rate yourself - always ask your nurse if you have concerns.

How Long Should I Take Lacosamide For?

The length of IV lacosamide treatment depends on your specific medical situation and how well you're responding to the medication. Some people receive it for just a few days, while others might need it for several weeks.

Your doctor will typically transition you to oral lacosamide tablets once you're able to swallow pills again. This helps maintain consistent medication levels in your system without interruption.

For long-term seizure control, you might continue taking lacosamide in pill form for months or even years. Your doctor will regularly review your treatment plan and may adjust your medication based on how well your seizures are controlled and any side effects you experience.

Never stop taking lacosamide suddenly, whether IV or oral, as this can trigger dangerous seizures. Your doctor will create a gradual tapering schedule if you need to discontinue the medication.

What Are the Side Effects of Lacosamide?

Like all medications, IV lacosamide can cause side effects, though not everyone experiences them. The most common side effects are usually mild and often improve as your body adjusts to the medication.

Here are the most frequently reported side effects you might experience:

• Dizziness or feeling unsteady
• Headache
• Nausea or vomiting
• Double vision or blurred vision
• Fatigue or drowsiness
• Coordination problems
• Tremor or shaking

These common side effects typically occur within the first few days of treatment and often lessen as your body gets used to the medication. Your healthcare team will monitor you closely and can adjust your treatment if needed.

There are also some less common but more serious side effects that require immediate medical attention:

• Heart rhythm changes (irregular heartbeat)
• Severe allergic reactions (rash, swelling, difficulty breathing)
• Mood changes or thoughts of self-harm
• Severe dizziness or fainting
• Unusual bleeding or bruising
• Signs of liver problems (yellowing skin or eyes)

Your medical team will continuously monitor your heart rhythm and other vital signs while you're receiving IV lacosamide. If you notice any concerning symptoms, don't hesitate to call your nurse immediately.

Who Should Not Take Lacosamide?

Certain people should not receive IV lacosamide due to increased risks of serious complications. Your doctor will carefully review your medical history before prescribing this medication.

You should not receive lacosamide if you have a known allergy to this medication or any of its ingredients. Signs of an allergic reaction include rash, swelling, difficulty breathing, or severe dizziness.

People with certain heart conditions need special consideration, as lacosamide can affect heart rhythm. Your doctor will be especially cautious if you have:

• Heart rhythm disorders (arrhythmias)
• Heart block or other conduction problems
• Severe heart disease
• A history of fainting spells

Your healthcare team will perform an electrocardiogram (EKG) before starting treatment and monitor your heart rhythm throughout the infusion. This helps ensure your heart tolerates the medication safely.

Special caution is also needed for people with kidney or liver problems, as these organs help process the medication. Your doctor may need to adjust your dose or monitor you more closely if you have these conditions.

Lacosamide Brand Names

The brand name for lacosamide is Vimpat, which is available in both IV and oral forms. This is the most commonly prescribed brand in the United States and many other countries.

Generic versions of lacosamide are also available and contain the same active ingredient as the brand name version. Your doctor or pharmacist can help you understand which version you're receiving.

Whether you receive brand name or generic lacosamide, the medication works the same way and has similar effectiveness. The choice often depends on your insurance coverage and hospital formulary preferences.

Lacosamide Alternatives

Several other IV anti-seizure medications are available if lacosamide isn't suitable for you. Your doctor will choose the best alternative based on your specific type of seizures and medical condition.

Common IV alternatives include phenytoin (Dilantin), levetiracetam (Keppra), and valproic acid (Depacon). Each of these medications works differently and has its own set of benefits and potential side effects.

For some people, a combination of medications works better than a single drug. Your doctor might recommend adding or switching to a different medication if your seizures aren't well-controlled with lacosamide alone.

The choice of alternative depends on factors like your age, other medical conditions, potential drug interactions, and how well you've responded to other seizure medications in the past.

Is Lacosamide Better Than Levetiracetam?

Both lacosamide and levetiracetam (Keppra) are effective anti-seizure medications, but they work in different ways and may be better suited for different people. Neither is universally "better" than the other.

Lacosamide tends to cause fewer mood-related side effects compared to levetiracetam, which can sometimes cause irritability or mood changes. However, lacosamide has more potential heart-related effects that require monitoring.

Levetiracetam is often preferred for people with heart conditions because it doesn't affect heart rhythm. It's also approved for more types of seizures and different age groups than lacosamide.

Your doctor will consider your specific seizure type, medical history, other medications, and potential side effects when choosing between these options. What works best can vary significantly from person to person.