lacosamide at a glance
Medicine class
Antiseizure treatment that affects voltage-gated sodium channels.
Main uses
Focal-onset seizures and, as add-on treatment, primary generalised tonic-clonic seizures.
Food
Tablets and syrup may be taken with or without food.
Common effects
Dizziness, headache, nausea and double vision.
What is lacosamide used for?
Selected UK products are licensed for:
Use alone for focal-onset seizures, with or without spread to both sides of the brain, in adults and eligible children. Selected tablet and infusion products include children from 2 years; the selected syrup includes children from 4 years.
Add-on treatment for focal-onset seizures in adults and eligible children.
Add-on treatment for primary generalised tonic-clonic seizures in idiopathic generalised epilepsy from 4 years of age.
How does lacosamide work?
Lacosamide enhances the slow inactivation of voltage-gated sodium channels. This helps stabilise overactive nerve-cell membranes and reduce abnormal electrical firing, although its precise antiseizure mechanism in humans is not fully established.
lacosamide preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 10 mg/mL
Syrup
Route: Oral
Strengths: 10 mg/mL
Tablet
Route: Oral
Strengths: 50 mg, 100 mg, 150 mg, 200 mg
How to take lacosamide
Follow the product and prescriber instructions. Do not change or stop treatment without clinical advice.
Tablets and syrup may be taken with or without food.
Shake the syrup well and measure the prescribed volume using the supplied device, not a kitchen spoon.
The infusion is administered by healthcare professionals when oral treatment is temporarily unsuitable.
lacosamide side effects
Common or expected effects
- Dizziness or headache
- Nausea or vomiting
- Double or blurred vision
- Sleepiness, fatigue or impaired concentration
- Balance or coordination problems
Get urgent medical advice
- Slow, fast or irregular heartbeat, palpitations, breathlessness or fainting
- Facial or throat swelling, breathing difficulty or another severe allergic reaction
- Painful, blistering or peeling rash, especially with fever or mouth or eye sores
- New or worsening suicidal thoughts or behaviour
- New or worsening myoclonic jerks or seizures
lacosamide in pregnancy
Information from human pregnancies is limited, so risk cannot be confirmed or excluded. Lacosamide may be used when a specialist considers the benefits greater than the potential risks. Seek early specialist review when planning pregnancy or after becoming pregnant, and do not stop epilepsy treatment suddenly. Folic acid may also be prescribed.
lacosamide while breastfeeding
Lacosamide passes into human breast milk, and effects on a breastfed baby cannot be excluded. The selected UK product information recommends stopping breastfeeding during treatment; discuss treatment and feeding options with the specialist or prescriber.
lacosamide interactions
Clinically important combinations include:
Antiarrhythmics and medicines that prolong PR interval
May add to cardiac-conduction effects; clinical review and ECG monitoring may be appropriate.
Sodium-channel-blocking antiseizure medicines
Combined effects on cardiac conduction are possible.
Fluconazole, itraconazole, ketoconazole, ritonavir or clarithromycin
May increase lacosamide exposure, particularly when clearance is impaired.
Common questions about lacosamide
Answers are fully visible for fast scanning and source review.
What types of seizures does lacosamide treat?
It treats focal-onset seizures and may be used as add-on treatment for primary generalised tonic-clonic seizures in idiopathic generalised epilepsy.
Can lacosamide be taken with food?
Yes. The tablets and syrup may be taken with or without food.
How should lacosamide syrup be measured?
Shake the bottle well and use the measuring device supplied with that product.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.