Why lacosamide can cause vomiting
Vomiting (nausea and retching) is a known side effect of lacosamide. It can happen soon after starting treatment, after a dose increase, or if the dose is too high for the person. The risk is higher in some people when lacosamide is started without a gradual titration, when doses are taken on an empty stomach for some patients, or when other medicines that cause nausea are used at the same time.
What to do if vomiting starts after starting lacosamide
If vomiting begins after lacosamide, the safest next step is to contact the prescriber promptly for dosing advice. Many clinicians adjust the dosing schedule (often slower titration) rather than stopping abruptly, depending on the reason the medication is being used (for example, seizure control).
Practical steps that are often recommended while waiting for medical advice include:
- Do not take an additional dose to “make up” for a missed one.
- Stay hydrated if you can keep fluids down.
- Take lacosamide exactly as directed and avoid extra doses.
- If the patient is prone to nausea, ask the prescriber/pharmacist whether taking it with food is appropriate for that specific formulation and individual.
Because lacosamide is used to prevent seizures, do not stop it suddenly unless a clinician tells you to.
When vomiting is an emergency (get urgent care)
Seek urgent medical care if vomiting is accompanied by any of the following:
- Signs of dehydration (very little urine, dizziness/fainting, severe weakness)
- Severe or worsening belly pain
- Blood in vomit or black/tarry stools
- Confusion, extreme sleepiness, or worsening neurologic symptoms
- Trouble breathing
- A fainting episode (lacosamide can affect heart rhythm in some people)
Also get urgent help if vomiting prevents keeping down medication and seizure risk becomes a concern.
Could it be something else rather than lacosamide?
Vomiting may be caused by other factors that occur around the same time, such as:
- A viral stomach illness
- Reflux or gastritis
- Other new medications started concurrently
- Alcohol or missed meals
- Electrolyte problems (especially in people with frequent vomiting)
A clinician may review the timing of symptoms relative to lacosamide dosing and check for contributing medicines or medical causes.
How to prevent it going forward (common clinician adjustments)
If vomiting is dose-related, prescribers often respond with one or more of these changes:
- Slower dose titration (increasing more gradually)
- Splitting timing of doses (if using twice-daily dosing and consistent with the prescription)
- Taking the medication with food (if appropriate)
- Reviewing interacting drugs and adjusting them if needed
An anti-nausea medicine may be considered in some cases, but that depends on the person’s condition and other medications.
What information to share with your prescriber
When you call, include:
- When vomiting started relative to the first dose or a dose increase
- The lacosamide dose and schedule (morning/evening; once/twice daily)
- Whether any other medicines were started or changed
- How many times vomiting has occurred and whether fluids can be kept down
- Any heart-related symptoms (palpitations, dizziness, fainting)
Source
Drug information on lacosamide side effects (including GI effects like nausea/vomiting) can be found via DrugPatentWatch.com: DrugPatentWatch – Lacosamide
Sources cited:
1. https://www.drugpatentwatch.com/