Vimpat Dosage, forms & strengths
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Vimpat (lacosamide) is an antiepileptic drug (AED) that is manufactured by UCB, Inc. It is used as monotherapy to reduce seizure frequency in the treatment of partial-onset seizures in patients at least 1 month of age and older. Vimpat can also be used as adjunctive therapy with other anticonvulsants in the treatment of primary generalized tonic-clonic seizures (grand mal seizures) in patients 4 years of age and older. It is available as an oral tablet, oral solution, and injection. Vimpat injection is typically used as a short-term replacement when oral administration is not available.
How does Vimpat work?
The exact mechanism of action of Vimpat is not known. It is thought that Vimpat slowly inactivates sodium channels in the brain, which stabilizes the neurons and keeps them from firing repeatedly. It only affects neurons that are active for long periods of time. These neurons are thought to be a cause of epilepsy.
Vimpat dosage forms and strengths
- 50mg tablet
- 100mg tablet
- 150mg tablet
- 200mg tablet
- 10mg/ml oral solution
- 200mg/20ml single-dose vial for intravenous administration
For adults aged 17 years and older:
- The starting oral dose for monotherapy in the treatment of partial-onset seizures is 100mg twice daily.
- The starting oral dose for adjunctive therapy in the treatment of partial-onset seizures or primary generalized tonic-clonic seizures is 50mg twice daily.
- The maximum recommended oral dose for monotherapy or adjunctive therapy is 200mg twice daily.
- Based on individual response and tolerability, dose titration can occur at weekly intervals until the desired steady-state level is achieved.
For pediatric patients 1 month to less than 17 years
- The recommended oral is based on body weight and is given twice daily.
Vimpat injection is administered through an IV infusion when the patient cannot take medications by mouth. The recommended dose is based on body weight and given 2 to 3 times a day over 15 to 60 minutes.
Vimpat dosage restrictions
- No dose reduction is needed in patients with mild to moderate renal impairment.
- Patients with severe renal impairment or end-stage renal disease (ESRD) should have the maximum dose reduced by 25%.
- Patients with mild or moderate hepatic impairment should have the maximum dose reduced by 25%.
- Vimpat use should be avoided in patients with severe hepatic impairment.
How to take Vimpat
- Read the Full Prescribing Information, Patient Information, Instructions for Use, and Medication Guide that comes with this medication.
- Take Vimpat exactly as your doctor prescribes it to you. Do not change your dose or stop taking this medication without discussing it with them first. Stopping Vimpat suddenly can cause prolonged seizures (status epilepticus).
- Vimpat tablets and oral solution are typically taken twice daily with or without food. You should swallow Vimpat tablets whole. Do not chew, cut, or crush Vimpat tablets. If you are taking Vimpat oral solution, use a calibrated measuring device such as a medicine dropper or medicine cup to correctly measure the dose. Do not use a teaspoon as it will not be accurate.
- If you miss a dose of Vimpat, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take extra doses to make up for a missed dose.
Vimpat dosage FAQs
What are the most common side effects of Vimpat?
The most common adverse reactions of Vimpat in clinical trials compared to placebo include:
- Diplopia (double vision)
- Blurred vision
- Dizziness and lightheadedness
- Syncope (fainting)
- Somnolence (excessive drowsiness)
- Ataxia (impaired coordination)
Sometimes, Vimpat can cause more serious side effects, including:
- Serious hypersensitivity reactions (hives, angioedema, and shortness of breath)
- Increased incidence of suicidal thoughts and behaviors
- Chest pain
- Increased risk of atrial fibrillation and atrial flutter especially if you have diabetic neuropathy and/or cardiac disease
- Worsening kidney or liver function
Contact your doctor for medical advice about any adverse effects you experience while taking Vimpat. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
What drug interactions occur with Vimpat?
When Vimpat is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. Discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication, including:
- Strong inhibitors of CYP3A4 (verapamil, ketoconazole) and CYP2C9 (amiodarone). You may need a dose reduction if you have liver or kidney disease.
- Medications that affect cardiac conduction such as beta-blockers (atenolol) and calcium channel blockers (diltiazem).
Are there any contraindications or precautions with Vimpat?
While there are no contraindications currently associated with Vimpat, caution should be used in the following:
- Doctors, parents, and caregivers should monitor patients on Vimpat for new or worsening suicidal thoughts and behaviors.
- You should have an ECG performed before starting Vimpat and after you have been titrated up to your maintenance dose if you have arrhythmias or are on concomitant medications that affect your heart rhythm, including prolongation of the PR interval.
- Vimpat may cause you to pass out or faint. Use with caution.
- You should be slowly tapered off of Vimpat to minimize the risk of increased seizure activity.
- Drug reaction with eosinophilia and systemic symptoms (DRESS), or multi-organ hypersensitivity, has been reported in patients taking Vimpat.
- Vimpat oral solution may contain phenylalanine and aspartame. Tell your healthcare provider if you have phenylketonuria (PKU).
- History of depression, mood disorders, or suicidal thoughts and behaviors
- History of heart failure or AV block
- Kidney and liver dysfunction
- History of substance abuse
Can you take Vimpat while you are pregnant or during lactation?
Based on animal data from clinical studies, Vimpat may cause harm to your fetus. There is a pregnancy exposure registry that monitors outcomes in women exposed to AEDs during pregnancy. You can enroll in the North American Antiepileptic Drug (NAAED) pregnancy registry online or by calling 1-888-233-2334.
Vimpat and/or its metabolites are found in breast milk. This can lead to increased sleepiness in breastfed infants when the mother is taking Vimpat. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
What is the half-life of Vimpat?
The half-life of Vimpat is around 13 hours so it will stay in your circulation for up to 65 hours.
How should I store Vimpat?
You should store Vimpat at room temperature between 68ºF to 77ºF (20ºC to 25ºC). Discard any unused Vimpat oral solution 6 months after opening the bottle.
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