Lacoset 200 Tablet
Lacosamide
200mg
Sun Pharmaceutical Industries Ltd.
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Available as:
Indications
Lacoset 200 Tablet is used for:
Partial seizures
Adult Dose
Adult : PO/IV
Monotherapy/adjunctive therapy: Initial: 50 mg bid (100 mg bid may also be given as monotherapy), w/ increments of 50 mg bid/wk based on response and tolerability.
Max: 300 mg bid (monotherapy); 200 mg bid (as adjunct).
Hepatic impairment
Mild-to-moderate: No dose adjustment required
Severe: Not recommended
Coadministration with strong CYP3A4 or CYP2C9 inhibitors: Lacosamide systemic exposure may increase; consider dose reduction
Child Dose
Child: 16-18 yr PO/IV
Monotherapy/adjunctive therapy: Initial: 50 mg bid (100 mg bid may also be given as monotherapy), w/ increments of 50 mg bid/wk based on response and tolerability.
Max: 300 mg bid (monotherapy); 200 mg bid (as adjunct).
Hepatic impairment
Mild-to-moderate: No dose adjustment required
Severe: Not recommended
Coadministration with strong CYP3A4 or CYP2C9 inhibitors: Lacosamide systemic exposure may increase; consider dose reduction
Renal Dose
Renal impairment
Mild-to-moderate: no dose adjustment required
Severe (CrCl <30 mL/min) or ESRD: Reduce maximum dosage by 25%
Hemodialysis: Consider supplementing with up to 50% of dose after 4-hr dialysis session
Coadministration with strong CYP3A4 or CYP2C9 inhibitors: Lacosamide systemic exposure may increase; consider dose reduction
Administration
May be taken with or without food.
IV Preparation
May be administered without dilution or diluted in compatible solutions; (see IV Compatibility)
Visually inspect for particulate matter and discoloration prior to administration, whenever solution and container permit
Product with particulate matter or discoloration should not be used
Vials is for single-dose only; discard any unused portion of lacosamide injection
IV Administration
Infuse IV over 15-60 min; 30-60 min preferable, and should be used when a 15 min administration is not required
IV lacosamide may cause bradycardia or AV bock in patients with underlying cardiac disease
Monitor infusion closely patients with known cardiac conduction problems, on concomitant medications that prolong PR interval, or with severe cardiac disease (eg, myocardial ischemia, heart failure)
Contra Indications
2nd- or 3rd-degree AV block (w/o pacemaker). Severe hepatic impairment.
Precautions
Patient w/ severe cardiac disease (e.g. MI, heart failure), conduction problems (e.g. marked 1st degree AV block or sick sinus syndrome w/o pacemaker), Na channelopathies (e.g. Brugada syndrome), structural heart disease. Childn. Hepatic and renal impairment. Pregnancy and lactation.
Pregnancy-Lactation
Interactions
Increased systemic exposure w/ strong inhibitors of CYP2C9 (e.g. fluconazole) and CYP3A4 (e.g. ketoconazole, itraconazole, clarithromycin, ritonavir) enzymes. Reduced systemic exposure w/ rifampicin, phenobarbital, phenytoin, carbamazepine. Risk of PR prolongation w/ class I antiarrhythmics, lamotrigine, pregabalin, carbamazepine, eslicarbazepine.
Adverse Effects
Side effects of Lacosamide :
>10%
Tablets and oral solution
Dizziness (16-53%)
Diplopia (6-16%)
Blurred vision (2-16%)
Nausea (7-17%)
Vomiting (6-16%)
Fatigue (7-15%)
Ataxia (11-14%)
Nystagmus (2-10%)
IV
Fatigue (20-63%)
Somnolence (26-34%)
Headache (4-16%)
Diplopia (4-20%)
Nausea (14-24%)
Dry mouth (6-12%)
Vomiting (4-12%)
Fatigue (12-18%)
Chest pain (3-12%)
1-10%
Tablets and oral solution
Nystagmus (2-10%)
Memory impairment (1-6%)
Balance disorder (1-6%)
Diarrhea (3-5%)
Gait disturbance (<1-4%)
Asthenia (1-3%)
Vertigo (1-4%)
Pruritus (2-3%)
Depression (2%)
IV
Oral paresthesia (4-8%)
Oral hypoesthesia (5-8%)
Diarrhea (4-8%)
Paresthesia (4-8%)
Gait disturbance (2-8%)
Hyperhidrosis (2-8%)
Tremor (4-6%)
Abnormal coordination (3-6%)
Pruritus (4-6%)
Mechanism of Action
Lacosamide is a functionalised amino acid structurally related to serine. Its precise mechanism of action is unknown, however in vitro studies suggest that it selectively enhances the slow inactivation of Na channels w/o affecting fast inactivation. This results in stabilisation of hyperexcitable neuronal membranes and inhibition of repetitive neuronal firing. Additionally, it may affect collapsin response mediator protein-2 (CRMP-2), a protein involved in neuronal differentiation and axonal growth.
Note
Lacoset 200 200mg Tablet manufactured by Sun Pharmaceutical Industries Ltd.. Its generic name is Lacosamide. Lacoset 200 is availble in Nepal.
Farmaco Nepal drug index information on Lacoset 200 Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.