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Lacosamide (la KOE sa mide) has been approved by the FDA to treat focal-onset seizures in patients 4 years of age and older and for use with other anti-seizure medications for patients 4 years and older with primary generalized tonic-clonic seizures.

Your epilepsy treatment should always be discussed with your healthcare provider before use. Based on their judgment and knowledge, a drug may be prescribed for other epilepsy types not included in the indications. For more information, please see the prescribing information.

How can you take lacosamide? (Available formulations)

Lacosamide is available in a few different formulations to take by mouth with or without food. You can take lacosamide as a tablet or as a solution (liquid). Lacosamide is also available through intravenous injection.

Who should not take lacosamide?

If you have phenylketonuria (an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that lacosamide oral solution contains aspartame that forms phenylalanine.

Other considerations may influence whether you should take lacosamide. Tell your healthcare provider if you:

  • have or have had depression, mood problems, or suicidal thoughts or behavior.
  • have heart problems.
  • have kidney problems.
  • have liver problems.
  • have or have had an irregular heartbeat, a heart attack, a pacemaker, heart failure, or other heart problems.
  • have diabetic neuropathy (nerve damage caused by diabetes)
  • have abused prescription medicines, street drugs, or alcohol in the past.
  • are pregnant or plan to become pregnant.
  • are breastfeeding or plan to breastfeed.

What is important to know about taking lacosamide?

Do not stop taking lacosamide suddenly unless directed to do so by your healthcare provider.

As with all antiseizure medications, lacosamide should be withdrawn gradually to minimize the risk of causing or worsening seizures or status epilepticus. You should not stop using lacosamide suddenly unless your healthcare provider tells you to stop the medicine because of a serious side effect.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Taking lacosamide with certain other medicines may cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider. Especially tell your healthcare provider if you take: beta-blockers or calcium channel blockers.

Women or those who are/plan to become pregnant
Use in pregnancy

At this time, there is not enough evidence regarding developmental risks associated with the use of lacosamide in pregnant people. In animal studies, there were instances of developmental issues at clinically relevant doses. However, having a seizure during pregnancy could harm both the pregnant person and the baby. Tell your healthcare provider right away if you become pregnant. Do not start or stop taking seizure medication during pregnancy without your healthcare provider’s advice.

If you become pregnant while taking lacosamide, talk to your healthcare provider about registering with the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The purpose of this registry is to collect information about the safety of antiseizure medicine during pregnancy. You can enroll in this registry by calling 1-888-233-2334.

Use during breastfeeding

It is not known if lacosamide is present in breast milk. It is unknown whether there are effects on the breastfed infant, or if lacosamide impacts milk production. Talk to your healthcare provider about the risks. Your healthcare provider will consider the developmental and health benefits of breastfeeding along with your need for lacosamide and the potential effect on the infant from lacosamide or from your epilepsy.

What are the side effects of lacosamide?

Lacosamide is approved by the FDA because it is safe and effective for most people who take it. However, there are risks associated with all medicines. Some side effects caused by lacosamide can be very serious, and even life-threatening. It is important to be informed about these serious reactions and to be aware of their symptoms.

Common side effects

The most common side effects that were reported in studies of lacosamide are double vision, headache, dizziness, nausea, sleepiness.

Rare, but serious side effects
Dizziness and ataxia

Lacosamide may make you dizzy or drowsy and may cause blurred vision or problems with coordination, balance, or walking. Do not drive a car, operate machinery, or participate in activities requiring alertness or coordination until you know how this medication affects you.

Serious reactions, including serious blood or liver problems

Rare but life-threatening reactions involving the immune system or multi-organ hypersensitivity, which can cause serious blood or liver problems have been reported with lacosamide use. You may or may not have a rash with these types of reactions. Call your healthcare provider right away if you experience fever, frequent infections, severe muscle pain, swelling of your face, eyes, lips, or tongue, swollen lymph glands, unusual bruising or bleeding, weakness, fatigue, yellowing of your skin, or the white part of your eyes, dark urine, trouble walking or seeing, seizures happening more often, or pain/tenderness in the area toward the top of your stomach (enlarged liver/spleen).

Cardiac rhythm and conduction abnormalities

Lacosamide is associated with electrocardiographic changes that may cause you to have an irregular heartbeat and syncope (fainting). This risk is increased in patients who have cardiovascular disease, with heart conduction problems or are taking other medications that affect the heart. The symptoms may occur especially when you get up too quickly from a lying position. In rare cases, cardiac arrest has been reported. Call your healthcare provider right away if you: have a fast, slow, or pounding heartbeat, feel your heart skip a beat, have shortness of breath, have chest pain, feel lightheaded, have chest pain, or fainted or if you feel like you are going to faint. If you have fainted or feel like you are going to faint you should lay down with your legs raised until you feel better.

Suicidal thoughts or behaviors

Studies have found that people who take antiseizure medications including lacosamide may have suicidal thoughts or behaviors, which occur in approximately 1 in 500 patients. If you experience any thoughts or impulses to hurt yourself, you should contact your healthcare provider immediately.