Lacosamide

DEA Class;  Rx

Common Brand Names; Horizant

None

Tablets and oral solution

• Dizziness (16-53%)

• Diplopia (6-16%)

• Blurred vision (2-16%)

• Nausea (7-17%)

• Vomiting (6-16%)

• Fatigue (7-15%)

• Ataxia (11-14%)

• Nystagmus (2-10%)

IV

• Fatigue (20-63%)

• Somnolence (26-34%)

• Headache (4-16%)

• Diplopia (4-20%)

• Nausea (14-24%)

• Dry mouth (6-12%)

• Vomiting (4-12%)

• Fatigue (12-18%)

• Chest pain (3-12%)

Increase the risk of suicidal thoughts or behavior; monitor for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior

Dizziness and ataxia reported; may impair ability to perform hazardous tasks

Blurred vision and diplopia may occur during therapy; consider increased monitoring in patients with preexisting ocular conditions or vision-related issues

Oral solution contains aspartame, a source of phenylalanine; 200 mg dose (20 mL) contains 0.32 mg of phenylalanine

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), also known as multi-organ hypersensitivity, reported with antiepileptic drugs; some of these events have been fatal or life- threatening; monitor for signs and symptoms of possible disparate manifestations associated with lymphatic hepatic, renal, and/or hematologic organ systems; may require gradual discontinuation and conversion to alternate therapy

Use caution in renal and hepatic impairment; dosage adjustments may be required

Withdraw gradually over 1 week; do not discontinue abruptly because of risk for increased frequency of seizures

There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antiepileptic drugs (AEDs)

Data from published literature indicate that lacosamide is present in human milk; there are reports of increased sleepiness in breastfed infants exposed to lacosamide; there is no information on effects of lacosamide on milk production