What are the dosages for lacosamide?

Initial Epilepsy Treatment Dosages

For adults with epilepsy, lacosamide is typically started at a dose of 50 mg twice daily [1]. The dose can be increased by 50 mg increments twice daily as needed to a maximum dose of 200 mg twice daily [1].

Maintenance Treatment Dosages

For adults with epilepsy who are already receiving carbamazepine, phenytoin, phenobarbital, primidone, valproate, or estrogen, lacosamide should be initiated at a dose of 50 mg twice daily [2]. The dose can be increased by 25 mg increments twice daily as needed to a maximum dose of 200 mg twice daily [2].

Dose Adjustments for Concomitant Use with Enzyme-Inducing Antiepileptic Medications

For adults who are using an enzyme-inducing antiepileptic medication concomitantly, a reduced dose of lacosamide may be necessary [3]. Specifically, patients taking carbamazepine, phenytoin, or phenobarbital should start with 25 mg twice daily and not exceed a daily maintenance dose of 150 mg, while those taking valproate should start with 25 mg twice daily and not exceed a daily maintenance dose of 100 mg [3].

Dosage in Pediatric Patients

In pediatric patients aged 17 years and older, the recommended starting dose is 50 mg twice daily, which may be increased as needed up to a maximum daily dose of 400 mg [4]. For pediatric patients aged 4-16 years, the recommended starting dose is 25 mg twice daily, which may be increased as needed up to a maximum daily dose of 300 mg [4].

References

[1] Vimpat (lacosamide) [package insert]. UCB Inc.

[2] Vimpat (lacosamide) [package insert]. UCB Inc.

[3] Vimpat (lacosamide) [package insert]. UCB Inc.

[4] Vimpat (lacosamide) [package insert]. UCB Inc.

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