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Lacosamide Dosage

Medically reviewed by Drugs.com. Last updated on Dec 19, 2023.

Applies to the following strengths: 10 mg/mL; 200 mg/20 mL; 50 mg; 100 mg; 150 mg; 200 mg

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Epilepsy

MONOTHERAPY FOR PARTIAL-ONSET SEIZURES:
Initial dose: 100 mg orally twice a day

Maintenance dose: 150 to 200 mg orally twice a day

ADJUNCTIVE THERAPY FOR PARTIAL-ONSET SEIZURES OR GENERALIZED TONIC-CLONIC SEIZURES: :
Initial dose: 50 mg orally twice a day
Maintenance dose: 100 to 200 mg orally twice a day

Alternatively, may initiate therapy with a loading dose:
LOADING DOSE: 200 mg oral/IV once, followed in 12 hours with 100 mg oral/IV every 12 hours for at least 1 week; subsequent dose titrations should be performed as described above

Comments:

Use: As monotherapy for partial-onset seizures or adjunctive therapy for partial-onset seizures or primary generalized tonic-clonic seizures in patients 17 years and older

Usual Adult Dose for Seizures

MONOTHERAPY FOR PARTIAL-ONSET SEIZURES:
Initial dose: 100 mg orally twice a day

Maintenance dose: 150 to 200 mg orally twice a day

ADJUNCTIVE THERAPY FOR PARTIAL-ONSET SEIZURES OR GENERALIZED TONIC-CLONIC SEIZURES: :
Initial dose: 50 mg orally twice a day
Maintenance dose: 100 to 200 mg orally twice a day

Alternatively, may initiate therapy with a loading dose:
LOADING DOSE: 200 mg oral/IV once, followed in 12 hours with 100 mg oral/IV every 12 hours for at least 1 week; subsequent dose titrations should be performed as described above

Comments:

Use: As monotherapy for partial-onset seizures or adjunctive therapy for partial-onset seizures or primary generalized tonic-clonic seizures in patients 17 years and older

Usual Pediatric Dose for Epilepsy

AGE: 1 month or older:
WEIGHT: Less than 6 kg: Monotherapy Only

WEIGHT: 6 to less than 11 kg: Monotherapy Only

AGE: 4 to less than 17 years:
WEIGHT: 11 to less than 30 kg:
WEIGHT: 30 to less than 50 kg:
WEIGHT 50 kg or greater:

17 years and older: See Adult Dosing

Comments:

Uses: For the treatment of partial onset seizures in patients 1 month or older and as adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients 4 years or older.

Usual Pediatric Dose for Seizures

AGE: 1 month or older:
WEIGHT: Less than 6 kg: Monotherapy Only

WEIGHT: 6 to less than 11 kg: Monotherapy Only

AGE: 4 to less than 17 years:
WEIGHT: 11 to less than 30 kg:
WEIGHT: 30 to less than 50 kg:
WEIGHT 50 kg or greater:

17 years and older: See Adult Dosing

Comments:

Uses: For the treatment of partial onset seizures in patients 1 month or older and as adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients 4 years or older.

Renal Dose Adjustments

Mild to moderate renal dysfunction (CrCl greater than 30 mL/min): No adjustment recommended
Severe renal dysfunction (CrCl less than 30 mL/min [adults] or CrCl less than 30 mL/min/1.73 m2 [pediatrics]) and ESRD: Maximum dose should be reduced by 25%

Dose titration should be performed with caution in patients with renal impairment

Liver Dose Adjustments

Mild to moderate hepatic impairment: Maximum dose should be reduced by 25%
Severe hepatic impairment: Not recommended

Dose titration should be performed with caution in patients with hepatic impairment

Dose Adjustments

Elderly: Dose titration should be cautious, usually starting at the lower end of the dosing ranges

Concomitant Use with Strong CYP450 3A4 or CYP450 2C9 Inhibitors:


Therapy Discontinuation:

Precautions

CONTRAINDICATIONS:


Safety and efficacy have not been established in treating partial onset seizures in patients younger than 1 month
Safety and efficacy have not been established in treating primary generalized tonic-clonic seizures in patients younger than 4 years

Consult WARNINGS section for additional precautions.

US Controlled Substance: Schedule V

Dialysis

Following a 4-hour hemodialysis treatment, dosage supplementation of up to 50% should be considered as this drug is effectively removed by hemodialysis

Other Comments

Administration advice:
Oral Tablets:


Oral Solution:

IV formulation

Storage requirements:

General:

Monitoring:

Patient Advice:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.