How does this medication work? What will it do for me?
Lacosamide belongs to the class of medications called antiepileptics. This medication is used alone or with other medications to treat partial-onset seizures for adults with epilepsy. Lacosamide works in the brain to stop the spread of seizure activity. The exact way that lacosamide works to treat partial-onset seizures is not known.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each pink, oval, film-coated tablet engraved with "SP" on one side and "50" on the other, contains 50 mg of lacosamide. Nonmedicinal ingredients: colloidal silicon dioxide, crospovidone, hydroxypropylcellulose, hypromellose, lecithin, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, talc, titanium dioxide, red iron oxide, black iron oxide, and FD&C Blue No. 2/Indigo Carmine Aluminum Lake.
Each dark yellow, oval, film-coated tablet, engraved with "SP" on one side and "100" on the other, contains 100 mg of lacosamide. Nonmedicinal ingredients: colloidal silicon dioxide, crospovidone, hydroxypropylcellulose, hypromellose, lecithin, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, talc, titanium dioxide, and yellow iron oxide.
Each salmon, oval, film-coated tablet, engraved with "SP" on one side and "150" on the other, contains 150 mg of lacosamide. Nonmedicinal ingredients: colloidal silicon dioxide, crospovidone, hydroxypropylcellulose, hypromellose, lecithin, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, talc, titanium dioxide, yellow iron oxide, red iron oxide, and black iron oxide.
Each blue, oval, film-coated tablet engraved with "SP" on one side and "200" on the other, contains 200 mg of lacosamide. Nonmedicinal ingredients: colloidal silicon dioxide, crospovidone, hydroxypropylcellulose, hypromellose, lecithin, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, talc, titanium dioxide, and FD&C Blue No. 2/Indigo Carmine Aluminum Lake.
How should I use this medication?
If lacosamide is the only medication being used to treat seizures, the recommended starting dose is 100 mg taken by mouth, twice a day. The dose may then be increased gradually by your doctor to a maximum of 300 mg taken twice a day, depending on how well the medication is working for you and how well it is tolerated.
When lacosamide is being used in addition to other seizure medications, the recommended starting dose is 50 mg twice a day for 1 week. The dose is then increased to 100 mg twice a day during the second week. Depending on your response, your doctor may increase the dose of the medication to 150 mg twice a day during the third week, and 200 mg twice a day during the fourth week. Do not stop taking this medication or any other seizure medications unless your health care provider advises you to.
This medication can be taken with plenty of water, with or without food. Swallow the tablets whole - do not crush or chew the tablets.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Lacosamide should not be taken by anyone who:
- is allergic to lacosamide or to any of the ingredients of the medication
- has or has had second- or third-degree AV block (types of heart rhythm disorder)
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- poor muscle coordination
- tremor or shaking
Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
- symptoms of irregular heartbeat (e.g., chest pain; dizziness; fast, slow or pounding heartbeat; shortness of breath)
- vision changes, such as blurred vision, double vision
Stop taking the medication and seek immediate medical attention if any of the following occur:
- suicidal thoughts or behaviour
- symptoms of an allergic reaction (e.g., swelling of the face, tongue, mouth, or throat; difficulty breathing or swallowing; itching; rash)
- signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Behaviour changes and suicidal thoughts: Some people taking medications to treat epilepsy and seizure have experienced depression, including thoughts of suicide. If you experience any behaviour changes or symptoms such as sad mood, hopelessness, feelings of guilt, loss of pleasure or interest in activities, changes in sleep pattern, irritability, or restlessness while taking this medication, contact your doctor immediately. Family members or caregivers of people who are taking this medication should contact the person's doctor immediately if they notice unusual behaviour changes.
Dizziness/blurred vision: Lacosamide may cause dizziness or blurred vision, affecting your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how you are affected by this medication.
Heart problems: People with heart disease, heart rhythm problems, heart failure, or heart block, or people who are taking medications that may cause abnormal ECG (electrocardiogram) such as propranolol, metoprolol, carbamazepine, pregabalin, or lamotrigine, should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is need. Your doctor may advise you to get an ECG done before starting this medication and after starting this medication. If you experience symptoms of an irregular heartbeat, such as a fast, slow, or pounding heartbeat; shortness of breath; lightheadedness; or fainting, contact your doctor as soon as possible.
Hypersensitivity syndrome: A severe allergic reaction called hypersensitivity syndrome has occurred for some people who take lacosamide. Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.
Injury or falls: This medication may cause dizziness and a decrease in muscle coordination, which can lead to accidental injury or falls. While taking this medication, do not drive a car, operate a complex machine, or perform hazardous tasks until you know how much this medication affects your ability to perform these tasks.
Kidney function: Kidney disease or decreased kidney function may cause this medication to build up in the body, causing increased side effects. If you have decreased kidney function discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.
Lacosamide may rarely cause decreased liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Stopping treatment: Lacosamide should be stopped gradually over a period of at least 1 week, as directed by your doctor. Do not suddenly stop taking this medication as this can increase the risk of seizures. Do not stop this medication without talking to your doctor.
Vision changes: People taking lacosamide should immediately report blurred vision or double vision to their doctor.
Pregnancy: This medication should not be used during pregnancy unless the benefits clearly outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if lacosamide passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
Seniors: People over the age of 65 may be more at risk of developing side effects from this medication, particularly falls.
What other drugs could interact with this medication?
There may be an interaction between lacosamide and any of the following:
- alpha-agonists (e.g., clonidine, methyldopa)
- antiarrhythmics (e.g., amiodarone, disopyramide, dronedarone, procainamide, quinidine)
- beta-adrenergic blockers (e.g., atenolol, bisoprolol, propranolol, sotalol)
- seizure medications (e.g., carbamazepine, lamotrigine, phenobarbital, phenytoin, topiramate)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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