LACOSAMIDE:
It is an antiseizure drugs used to reduce the frequency of seizures.
What is Lacosamide used for?
- Partial onset seizures
- Primary generalized tonic- clonic seizure
- Status epilepticus
What is Lacosamide available as?
- Tablet.
- Syrup.
- Injection.
How does Lacosamide act (mechanism of action)?
It works by stabilizing electrical activity in the brain and thereby reduces the frequency of seizures.
How much time does Lacosamide take to act?
Lacosamide begins to take effect quickly when taken orally, reaching peak blood levels within 1 to 4 hours and when given as an injection, lacosamide typically starts to take effect within 10 to 30 minutes
However, it may take several days or weeks to notice improvements in seizure control, depending on dosage, frequency, and individual response.
Why is Lacosamide important for you/your child’s treatment?
It is important that you/your child takes Lacosamide regularly to decrease the number of seizures or have no Seizures at all.
Do not stop taking Lacosamide suddenly, as it may lead to increase in number of seizures
What is the ideal time to take Lacosamide?
Twice a day; morning and evening. Ideally, 10-12 hours apart.
For example, anytime between 7 to 8 am and right after 12 hours between 7 to 8 pm. You can adjust the time slot according to your schedule.
However, there are some exceptions when your doctor may advise to give it thrice a day. Please follow your doctor’s instructions in such case.
It should ideally be given at the same time every day to establish a routine as it minimizes the chances of missing a dose.
NEVER GIVE A DOUBLE DOSE OF LACOSAMIDE.
If your child vomits the contents of medicine within 30 minutes of taking a dose, then you can give the dose again; but if your child vomits after 30 minutes of taking the dose, then leave him be and do not give it again.
How should I give Lacosamide?
Tablets: A whole tablet must be swallowed with a glass of water, juice or milk. You may give it by crushing and mixing it in water.
Liquid or syrup: Use an oral syringe or a medicine spoon to measure the accurate quantity. You can easily get these from any pharmacy nearby.
Do not use a kitchen teaspoon as it will not give the accurate amount of the drug.
When Should I take Lacosamide?
Lacosamide can be taken either before or after food, as food does not significantly affect its absorption. However, it is important to follow the specific instructions provided by your healthcare provider
Could this medication have any side effects?
Every medication has both positive and potential negative effects. Fortunately, adverse effects are not common for everyone, but it’s essential to be aware of them. Understanding possible side effects allows us to act quickly and effectively if they occur, ensuring that we can address any concerns promptly while continuing to benefit from the intended effects of medications.
Even though it may be rare, few people sometimes may have serious side effects when taking a drug. Consult your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect.
ADVERSE EFFECTS
>10%: common
Gastrointestinal: Nausea
Nervous system: Dizziness, drowsiness, headache
1% to 10%: less common
- Skin-related: Itching.
- Stomach and digestion issues: Loose motions (diarrhoea) and throwing up (vomiting).
- At the injection site: Pain and irritation where the injection was given.
- Nervous system problems: Difficulty walking, feeling very tired, poor coordination, trouble balancing, feeling low or sad (depression), sudden jerky movements (myoclonic seizures), trembling, and dizziness or feeling like the world is spinning.
- Eyes: Blurry vision, seeing double, or quick, jerky eye movements.
<1%: rare
- Heart-related: Slow heartbeat and a mild delay in the heart’s electrical signals (first-degree heart block).
- Liver-related: Unusual liver test results and swelling or inflammation of the liver.
- Kidney-related: Swelling or inflammation of the kidneys.
Frequency not defined:
- Stomach and digestion issues: Difficulty passing stools (constipation), reduced feeling in the mouth, and dryness in the mouth.
- Blood-related: Low red blood cell count (anaemia).
- Nervous system problems: Trouble speaking clearly, feeling overly excited or overly happy (euphoria), worsening of epilepsy (including severe seizures), and reduced or no sensation in parts of the body.
- Muscles and bones: Muscle cramps or spasms.
- Ear-related: Hearing sounds like ringing or buzzing that aren’t actually there (tinnitus).
If you/your child’s health deteriorates and falls sick every few hours, suffers from stomach ache, skin and eyes are pale yellow in colour, feels lethargic and sleepy or increased number of seizures take them to your doctor straight away.
Can other common medicines be taken during the course of Lacosamide?
Common medications such as ibuprofen, paracetamol, antibiotics, or other over-the-counter drugs can generally be taken alongside lacosamide, as long as they are not contraindicated by your doctor.
Always consult your healthcare provider before administering any additional medicines to your child, including herbal or complementary treatments.
Some other epilepsy medications may interfere with how well cannabidiol works or cause side effects.
If your child experiences an increase in seizures or any other adverse reactions after taking other medications, contact your doctor immediately.
What foods should I avoid while taking Lacosamide?
- Alcohol: Drinking alcohol while taking lacosamide may increase the risk of dizziness and drowsiness.
- Foods that contain stimulants, like caffeine in coffee, tea, energy drinks, soft drinks, or chocolate, can interfere with epilepsy medications and potentially trigger seizures.
- Carbohydrates: Increased sugar levels in the blood can increase the risk of seizure
- A high-salt diet: This can raise sodium levels in the body, causing an electrolyte imbalance that may disrupt the brain’s electrical signals and potentially trigger a seizure.
PREGNANCY AND LACTATION:
- Lacosamide is generally considered safe to use during pregnancy.
- Studies have found no major or minor congenital malformations in newborns of mothers who took lacosamide during pregnancy
Is there any risk if I conceive while taking Lacosamide?
Conceiving while taking lacosamide may carry certain risks. It may have potential risks, but the benefits may outweigh the risks in some cases. Your doctor may recommend adjusting your medication or monitoring you more closely during pregnancy to ensure the best outcome for both you and your child.
Where should I store Lacosamide?
- Keep the medicine in a cupboard, secured away from heat and direct sunlight. It is not a must to keep the medicine in the refrigerator though.
- Make sure the medicine is out of your child’s reach.
- Store the medication in the same box it was packed in.
For complete information please see the manufacturer’s information leaflet.
MONITORING PARAMETERS:
- It is mandatory to monitor liver enzymes regularly.
- Patients with conduction disease problems, sodium channelopathies or any other cardiac disease should undergo ECG tracing prior to start of the therapy.
How to cope up with side effects of Lacosamide?
- Dizziness: use support while walking, a wall or furniture for support which can help you avoid falls. Avoid machinery works and driving.
- Fatigue: Engaging in physical activity, even a brief walk, can help increase your energy levels. Additionally, short naps during the day can be effective in combating fatigue.
- Vision changes: If you notice any changes in your vision, take extra care to move slowly and cautiously to prevent falls.
- Heart rhythm changes and severe allergic reactions: If you experience changes in your heartbeat, along with chest pain, difficulty breathing, or light-headedness, get medical attention immediately.
- Suicidal thoughts: If you experience any changes in your mood or thoughts while on lacosamide, contact your healthcare provider.
However, if any symptoms are preventing you from participating in regular activities or you’re also feeling depressed, it’s important to consult with your healthcare provider.
Author:
1. Dr. Ramya. R, Pharm D, Clinical pharmacologist, Aster Hospitals, Bengaluru
2. Dr Praveen Kumar, B. Pharm, Pharm D(PB), Head Clinical Pharmacologist, Aster Hospitals, Bengaluru
3. Dr C P Ravi Kumar, Consultant Paediatric Neurologist, Aster CMI Hospital.