Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
ONLS
АТХ:N.03.A.X Other antiepileptic drugs
N.03.A.X.18 Lacosamide
Pharmacodynamics:Selectively enhances inactivation of voltage-dependent sodium channels, neuronal hyperexcitability stabilizing shell.
Associated phosphoprotein with CRMP-2 - mediator kollapsina-2, which ekspessiruetsya in the nervous system and is involved in the process of differentiation and control of axonal growth.
Pharmacokinetics:After oral administration, it is completely absorbed from the gastrointestinal tract. The maximum concentration in the plasma is reached after 0.5-4 hours. It binds to blood plasma proteins in 15%.
The half-life is 13 hours.
The elimination of the urine in an unmodified form is 40%, about 30% - as an inactive metabolite O-desmetilnogo, less than 0.5% excreted in feces.
Indications:It is used in the complex therapy of partial epileptic seizures in patients from 16 years of age and older.
Contraindications:Atrioventricular block II-III degree.
Individual intolerance.
Carefully:For patients with severe renal insufficiency (creatinine clearance less than 30 ml / min), a maximum dose of no more than 300 mg per day is required. Patients who are on hemodialysis should increase the dose by 50% immediately after the end of the procedure, since lacosamide is removed during hemodialysis.
Pregnancy and lactation:Recommendations for FDA - not defined. During pregnancy and lactation, the drug is contraindicated.
Dosing and Administration:Inside, regardless of the meal. The starting dose is 50 mg 2 times a day. After a week, the dose increases to 100 mg twice a day with good drug tolerance and high efficacy, possibly increasing the dose to 400 mg per day, 200 mg 2 times a day.
The drug is withdrawn gradually, with a decrease of 200 mg per week.
The highest daily dose: 400 mg.
The highest single dose: 200 mg.
Side effects:Central nervous system: dizziness, irritability, depression, cognitive impairment, movement coordination disorders, tremor, dysarthria, nystagmus.
Gastrointestinal tract: nausea, vomiting, dyspepsia, dry mouth.
Musculoskeletal system: muscle spasms.
Sense organs: diplopia, blurred vision, tinnitus.
Allergic reactions.
Overdose:Increased side effects.
Treatment is symptomatic, hemodialysis.
Interaction:Combines with all antiepileptic drugs.
Simultaneous use of inducers of microsomal liver enzymes (carbamazepine, pregabalinum, lamotrigine) with lacosamide causes a decrease in the systemic concentration of lacosamide.
Rifampicin and St. John's wort (Hypericum perforatum) also cause a decrease in the concentration of lacosamide.
Special instructions:Lacosamides are often accompanied by dizziness, which can lead to falls and injuries. Patients should be careful.
Persons caring for patients receiving lacosamide, should be warned about the possibility of patients appearing suicidal thoughts and attempts.