COSAMIDE TABLETS
Lacosamide
What it does
Lacosamide is a medication used to help control seizures in people with epilepsy.
Commonly used for: epilepsy, seizure disorders
Read more in plain English ↓Plain-language summary for general understanding - not medical advice. Always follow your pharmacist/doctor.
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Answers come only from this medicine's registration record, BNF monograph and interaction data - not medical advice.
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Sourcing - Kenya onlyRegistration & product details
Source: Food and Drugs Authority · fetched 2026-04-18 08:33:04 · updated 2026-09-18 04:00:08
Drug Interactions
65Severe (7)
Antiepileptics - decreases absorption
Iron chelators (dexrazoxane) might decrease the absorption of antiepileptics (fosphenytoin, phenytoin). Avoid.
Antiepileptics - decreases exposure
Lumacaftor is predicted to decrease the exposure to antiepileptics (carbamazepine, fosphenytoin, phenobarbital, phenytoin, primidone). Avoid.
Antiepileptics - decreases concentration
St John’s wort is predicted to decrease the concentration of antiepileptics (fosphenytoin, phenobarbital, phenytoin, primidone). Avoid.
Antiepileptics - increases risk of overheating and dehydration
Hydroxyzine potentially increases the risk of overheating and dehydration when given with antiepileptics (zonisamide). Avoid in children.
Antiepileptics - increases risk of overheating and dehydration
Haloperidol potentially increases the risk of overheating and dehydration when given with antiepileptics (zonisamide). Avoid in children.
Antiepileptics - decreases absorption
Dexrazoxane might decrease the absorption of antiepileptics (fosphenytoin, phenytoin). Avoid.
Antiepileptics - increases risk of overheating and dehydration
Oxybutynin potentially increases the risk of overheating and dehydration when given with antiepileptics (zonisamide). Avoid in children.
Moderate (25)
Antiepileptics - increases concentration
Intravenous chloramphenicol increases the concentration of antiepileptics (fosphenytoin, phenytoin) and antiepileptics (fosphenytoin, phenytoin) affect the concentration of intravenous chloramphenicol
Antiepileptics - decreases concentration
Diazoxide decreases the concentration of antiepileptics (fosphenytoin, phenytoin) and antiepileptics (fosphenytoin, phenytoin) are predicted to decrease the effects of diazoxide. Monitor concentration
Antiepileptics - increases concentration
Disulfiramincreasestheconcentrationofantiepileptics (fosphenytoin,phenytoin).Monitorconcentrationandadjust dose.rStudy →AlsoseeTABLE12p.1520
Antiepileptics - increases concentration
Fluorouracilincreasestheconcentrationofantiepileptics (fosphenytoin,phenytoin).Monitorconcentrationandadjust dose.rAnecdotal 1xidneppA|snoitcaretnI A1 https://www.facebook.c (Books-Courses-Medic
Antiepileptics - decreases concentration
Folates are predicted to decrease the concentration of antiepileptics (fosphenytoin, phenobarbital, phenytoin, primidone). Monitor concentration and adjust dose.
Unknown (33)
Antiepileptics - increases risk of overheating and dehydration
Acetazolamide potentially increases the risk of overheating and dehydration when given with antiepileptics (zonisamide). Avoid in children.
Antiepileptics - increases risk of visual disturbances
Alcohol potentially increases the risk of visual disturbances when given with antiepileptics (retigabine).
Antiepileptics - decreases exposure
Enzalutamide is predicted to slightly decrease the exposure to antiepileptics (brivaracetam).
Antiepileptics - decreases exposure
Apalutamidepotentiallydecreasestheexposureto antiepileptics(valproate).nTheoretical
Antiepileptics - increases concentration
Capecitabine increases the concentration of antiepileptics (fosphenytoin, phenytoin).
Data from BNF 85 (British National Formulary). This is not a substitute for professional medical advice. Matched via: class
About this medicine
Lacosamide is a medication used to help control seizures in people with epilepsy.
What it treats
- epilepsy
- seizure disorders
How it works
Lacosamide works by stabilizing electrical activity in the brain to prevent seizures.
Who it's for
This medication is for individuals who experience seizures due to epilepsy.
Drug class
Antiepileptics
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: Lacosamide
BNF-referencedLacosamide is an antiepileptic drug primarily used in the management of epilepsy and other seizure disorders. It is known for its ability to stabilize hyperexcitable neuronal membranes and inhibit repetitive neuronal firing. Lacosamide is an amino acid derivative with a unique mechanism of action that selectively enhances the slow inactivation of voltage-gated sodium channels, which plays a crucial role in the pathophysiology of seizures. The drug is often prescribed for patients who have not achieved adequate control with conventional antiepileptic medications.
Indications
- Epilepsy
- Generalized tonic-clonic seizures
- Partial-onset seizures
- Neuropathic pain (off-label use)
Dosage
Children: In pediatric patients aged 4 years and older, initial dosing typically starts at 2
Adults: For adult patients, the usual starting dose of lacosamide is 50 mg twice daily, which may be increased by 100 mg weekly based on clinical response, up to a maximum dose of 400 mg per day.
Mechanism of action
Lacosamide selectively enhances the slow inactivation of voltage-gated sodium channels, shifting the slow inactivation curve to more hyperpolarized potentials. This increases the fraction of sodium channels in the slow inactivated state, resulting in stabilization of hyperexcitable neuronal membranes, and inhibition of repetitive neuronal firing. Unlike traditional sodium channel blockers, lacosamide does not affect the fast component of sodium currents.
Pharmacodynamics
Lacosamide is a highly potent antiepileptic with stereoselectivity and anticonvulsant properties. It also exhibits analgesic activity by blocking sensory neuronal voltage-gated sodium channels that mediate neuropathic pain responses. The drug is characterized as a chiral functionalized amino acid, where the S-stereoisomer does not have antiepileptic activity.
Pharmacokinetics
Lacosamide is well absorbed after oral administration with a bioavailability of approximately 100%. It is metabolized predominantly by hydrolysis and is not significantly affected by cytochrome P450 enzymes. The elimination half-life is approximately 13 hours, allowing for twice-daily dosing. The drug is primarily excreted in the urine, with less than 5% of the dose excreted unchanged. Dose adjustments may be necessary in patients with renal impairment.
Contra-indications
- Hypersensitivity to lacosamide or any of its excipients
- History of severe hypersensitivity reactions, including anaphylaxis
- Severe cardiac conduction disorders, including second or third degree atrioventricular block
Adverse effects
- Dizziness
- Fatigue
- Nausea
- Headache
- Diplopia
- Ataxia
- Somnolence
- Euphoria
- Palpitations
- Agranulocytosis
- Psychotic disorders
- Suicidal tendencies
- Angioedema
- Rhabdomyolysis
Interactions
- May enhance the effects of other CNS depressants
- Caution with concomitant use of drugs affecting cardiac conduction
- Potential for increased plasma levels when used with strong CYP3A4 inhibitors
Precautions
- Monitor for signs of hypersensitivity reactions
- Caution in patients with a history of drug abuse
- Use with caution in patients with cardiac conduction problems
- Assess renal function prior to use and adjust dose accordingly
- Gradual withdrawal is advised to prevent seizure exacerbation
Pregnancy
Limited data available; use only if the potential benefit justifies the potential risk to the fetus. Animal studies suggest potential risks.
Breast-feeding
Present in breast milk; use only if potential benefit outweighs risk.
Storage
Store at room temperature, protected from moisture and light. Keep out of reach of children.
Formulations
- Tablets (100 mg, 150 mg, 200 mg, 300 mg, 400 mg)
- Oral solution (10 mg/mL)
- Injection (20 mg/mL)
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Molecular reference: Lacosamide
PubChem CID 219078Molecular formula: C13H18N2O3
Mechanism of action
Caused by neuronal hyperexcitability, seizures in epilepsy involve sustained firing of sodium-dependent action potentials. The slow inactivation process, intrinsic to voltage-gated sodium channel functioning, has been implicated in the paroxysmal depolarizing shifts associated with epileptic activity. The exact mechanism of action of lacosamide is not fully known; however, in vitro electrophysiological studies have shown that lacosamide selectively enhances the slow inactivation of voltage-gated sodium channels, shifting the slow inactivation curve to more hyperpolarized potentials and augmenting the maximal fraction of channels in the slow inactivated state. This results in the stabilization of hyperexcitable neuronal membranes and inhibition of repetitive neuronal firing. Lacosamide does not affect the fast component of voltage-gated sodium currents, unlike traditional sodium channel blockers.
Pharmacodynamics
Lacosamide is an antiepileptic drug with high oral potency, stereoselectivity, and anticonvulsant effects. By blocking sensory neuronal voltage-gated sodium channels that mediate neuropathic pain responses, lacosamide was shown to possess analgesic activity. Lacosamide is a chiral functionalized amino acid. The S-stereoisomer does not exhibit antiepileptic activity.
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
This drug in other countries
The same active ingredient registered across other registries we cover - including different brands.
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