Vimpat (Lacosamide) - Oral

What Is Vimpat?

Vimpat has been used in people with epilepsy in the United States, Europe, and Asia. It contains the active drug lacosamide, belonging to a class of drugs called antiepileptics. It acts on the central nervous system (CNS) to decrease abnormal electrical activity in the brain to reduce seizures.

The precise mechanism of action of Vimpat is still unknown. However, studies have shown it reduces excitability in neurons and inhibits repetitive neuronal firing.

Vimpat is a prescription medicine available as oral tablets, oral solutions, and intervenous injections.

Drug Facts

Generic Name: Lacosamide

Brand Name(s): Vimpat

Drug Availability: Prescription

Therapeutic Classification: Antiepileptic/Anticonvulsant drug

Available Generically: Yes

Controlled Substance: Schedule V

Administration Route: Oral and intravenous

Active Ingredient: Lacosamide

Dosage Form(s): Tablets, oral solution, and intravenous injections

What Is Vimpat Used For?

Vimpat is indicated for:

  • Treatment for people with partial-onset seizures aged 1 month and older.
  • Adjunct (add-on) therapy for people with primary generalized tonic-clonic seizures aged 4 years and older. 

Epilepsy is a common neurologic (brain and nervous system) condition. It affects approximately 50 new people per year per 100,000 population. About 1% of the population has epilepsy, and about one-third have refractory epilepsy (seizures not controlled by antiepileptic medications or other therapies). Approximately 75% of epilepsy begins during childhood. This shows that developing brains have a vulnerability to seizures.

How to Take Vimpat

Read the medication guide carefully and ask your healthcare provider or pharmacist. Always follow the manufacturer's medication guidelines on how to take the drug.

  • Vimpat is available as a tablet or solution.
  • Take Vimpat precisely as prescribed. Your healthcare provider will tell you how much Vimpat to take and when to take it and may change your dose if needed.
  • Do not stop taking this medicine without talking to your healthcare provider. Sudden discontinuation (stopping your medication) may cause seizures that will not stop (status epilepticus).
  • Take it with or without food.
  • Swallow the tablets whole with liquid. Do not cut, crush, chew or break the tablets.
  • If taking the oral solution, use a measuring device or medicine cup to help you determine the correct amount of oral solution. Do not use a household spoon.

Your healthcare provider will probably start you on a low dose of Vimpat and gradually increase the dose as required, not more frequently than once a week.

Vimpat will not cure the seizures but will help control the condition. It may take a few weeks or more before you feel the full benefit of this drug.

Storage

Store at room temperature (68 to 77 degrees Fahrenheit). Do not freeze Vimpat oral solution. Discard any unused oral solution remaining after six months of first opening the medicine bottle.

Keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet. Do not store your medicines in your bathroom.

Avoid pouring unused and expired drugs down the drain or in the toilet. Ask your pharmacist or healthcare provider about the best ways to dispose of this medicine. Visit the FDA's website to know where and how to discard all unused and expired drugs. You can also find disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.

If you plan to travel with Vimpat, get familiar with your final destination's regulations. In general, make a copy of your Vimpat prescription. If possible, keep your medication in its original container from your pharmacy with your name on the label. Ask your pharmacist or healthcare provider if you have any questions about traveling with your medicine.

Off-Label Uses

Antiepileptic drugs such as Vimpat may be used for conditions other than approved by FDA. Ask your healthcare provider about the different uses of this drug.

How Long Does Vimpat Take to Work?

The time it takes Vimpat to work may be different for everyone. Ask your healthcare provider or pharmacist any questions you have. The maximum plasma concentration of Vimpat occurs about one to four hours after oral administration. Vimpat's half-life (the time it takes for a medicine's concentration to decrease by half in your body) is 13 hours.

What Are the Side Effects of Vimpat?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The most common side effects of Vimpat include but aren't limited to:

Contact your healthcare provider if the symptoms worsen or do not go away.

Severe Side Effects

Contact your healthcare provider immediately if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Serious side effects of Vimpat and their symptoms include but are not limited to:

  • Suicidal behavior
  • Ataxia (movement disorder)
  • Cardiac rhythm changes and other abnormalities
  • Fainting
  • Multiorgan hypersensitivity reactions
  • Drug withdrawal effects

All of these side effects are precautions for this drug. Keep a close eye on these symptoms. If any of these symptoms occur, seek medical help right away.

Report Side Effects

Vimpat may cause other side effects. Call your healthcare provider if you have unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program online or by phone (800-332-1088).

Dosage: How Much Vimpat Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (solution and tablets):
    • For partial-onset seizures or primary generalized tonic-clonic seizures:
      • For patients taking lacosamide alone:
        • Adults and children 17 years of age and older—At first, 100 milligrams (mg) 2 times a day. Some patients may have a starting dose of 200 mg taken as a single dose, followed approximately 12 hours later by 100 mg 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 400 mg per day.
        • Children 4 to 16 years of age—Dose is based on body weight and must be determined by your doctor.
          • Weighing 50 kilograms (kg) or more—At first, 50 milligrams (mg) 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 400 mg per day.
          • Weighing 30 kg to less than 50 kg—At first, 1 milligram per kilogram (mg/kg) body weight 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 8 mg/kg body weight per day.
          • Weighing 6 kg to less than 30 kg—At first, 1 milligram per kilogram (mg/kg) body weight 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 12 mg/kg body weight per day.
          • Weighing less than 6 kg—At first, 1 milligram per kilogram (mg/kg) body weight 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 15 mg/kg body weight per day.
        • Children younger than 4 years of age—Use and dose must be determined by your doctor.
      • For patients switching from other seizure medicines:
        • Adults and children 17 years of age and older—At first, 150 to 200 milligrams (mg) 2 times a day.
        • Children younger than 17 years of age—Use and dose must be determined by your doctor.
      • For patients who are taking lacosamide together with other seizures medicines:
        • Adults and children 17 years of age and older—At first, 50 milligrams (mg) 2 times a day. Some patients may have a starting dose of 200 mg taken as a single dose, followed approximately 12 hours later by 100 mg 2 times a day. Your doctor will slowly increase your dose as needed and tolerated. However, the dose is usually not more than 400 mg per day.
        • Children 4 to 16 years of age and weighs 50 kilograms (kg) or more—Dose is based on body weight and must be determined by your doctor. The usual dose is 100 mg 2 times a day. However, the dose is usually not more than 400 mg per day.
        • Children younger than 4 years of age—Use and dose must be determined by your doctor.

Modifications

The following modifications should be kept in mind when using Vimpat:

Severe allergic reaction: Avoid using Vimpat if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: In animal studies, Vimpat was found to have developmental toxicity on the fetus in rats. We don't know enough about the safety and effectiveness of Vimpat in pregnant people and their unborn fetuses.

Discuss with your healthcare provider if you plan to become pregnant or are pregnant, and weigh the benefits and risks of taking Vimpat during your pregnancy.

Breastfeeding: We don't know enough about the safety of Vimpat in human breast milk and nursing babies. Talk with your healthcare provider if you plan to breastfeed. Weigh the benefits and risks of taking Vimpat while nursing and the different ways to feed your baby.

Adults over 65 years: Clinical studies haven't included a large enough number of people in this age group to see whether they respond differently from younger adults. No dose adjustment for Vimpat is necessary; however, caution may be advised when used in some people over 65 years.

Children: Safety and effectiveness of Vimpat have not been established in children below 1 month in partial-onset seizures.

The safety and effectiveness of Vimpat have not been established in children below the age of 4 years in primary generalized tonic-clonic seizures.

Kidney problems: No dose adjustment is required in moderate renal impairment (CLCR ≥30 mL/min). In people with severe renal impairment (CLCR <30 milliters/minute) and end-stage renal disease, a 25% dose reduction of the maximum dosage is recommended.

Hepatic (liver) disease: Based on data for people with mild to moderate hepatic impairment, a reduction of 25% of the maximum dosage is recommended. Due to insufficient data, Vimpat is not recommended in people with severe hepatic impairment.

Missed Dose

If you accidentally forgot your Vimpat dose, take it as soon as you remember. If it's already close to your next scheduled dose, skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.

Find ways to help yourself remember to keep your appointments and take your medication. If you miss too many doses, Vimpat might be less effective at treating your condition.

Overdose: What Happens If I Take Too Much Vimpat?

If you think you or someone else may have overdosed on Vimpat, call a healthcare provider or the Poison Control Center (800-222-1222).

The symptoms of a suspected Vimpat overdose may include the following:

  • Dizziness
  • Nausea
  • Confusion
  • Decreased consciousness
  • Seizures (generalized tonic-clonic seizures, status epilepticus)
  • Cardiac conduction disorders (issue with the heart's electrical system that impacts the heart rhythm and rate)
  • Cardiogenic shock
  • Cardiac arrest
  • Coma

What Happens If I Overdose on Vimpat?

If you think you or someone else may have overdosed on Vimpat, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Vimpat, call 911 immediately.

Precautions

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It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

If you or your child develop any unusual or strange thoughts and behavior while taking lacosamide, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink too much alcohol. Other changes might be confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

This medicine may cause blurred vision, double vision, clumsiness, unsteadiness, dizziness, drowsiness, sleepiness, or trouble with thinking. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. If these side effects are especially bothersome, check with your doctor.

This medicine can cause changes in heart rhythms, including a condition called PR prolongation. It may change the way your heart beats and cause lightheadedness, fainting, or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, including a fast, slow, or irregular heartbeat.

Do not stop taking this medicine without first checking with your doctor. Stopping the medicine suddenly may cause your seizures to return or to occur more often. Your doctor may want you to gradually reduce the amount you are using before stopping it completely.

Lacosamide may cause a condition called drug reaction with eosinophilia and systemic symptoms (DRESS), which is a serious allergic reaction affecting multiple body organs (eg, liver or kidney). Check with your doctor right away if you have fever, dark urine, headache, rash, stomach pain, swollen, painful, or tender lymph glands in the neck, armpit, or groin, unusual tiredness, or yellow eyes or skin.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Vimpat?

Avoid using it if you're allergic to Vimpat or any of its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

What Other Medications Interact With Vimpat?

Strong CYP3A4 or CYP2C9 Inhibitors: People with renal or hepatic impairment taking potent inhibitors of CYP3A4 and CYP2C9 may significantly increase their exposure to Vimpat. People taking these medications may need to reduce their dose of Vimpat. These include drugs such as:

Medications that affect heart function: Vimpat may interact with medications that affect cardiac conduction (heart function), including those that prolong the PR interval, because of a risk of AV block, bradycardia (decreased heart rate), or ventricular tachyarrhythmia (abnormal heart rhythm). These drugs include:

Beta-blockers:

Calcium channel blockers:

Medications for irregular heartbeat:

When using these drugs concomitantly with Vimpat, obtaining an ECG and close monitoring is recommended.

This may not be a complete list of drugs that may interact with Vimpat. Talk with your pharmacist or healthcare provider for more detailed information about medication interactions with Vimpat.

And be sure to talk with your healthcare provider about any other medicines you take or plan to take, including over-the-counter, nonprescription products, vitamins, herbs, or plant-based medicines.

What Medications Are Similar?

Antiepileptic drugs (AEDs) have various mechanisms of action. Below is a brief review of some of the other most commonly used AEDs on the market approved by the FDA.

Always use the medicine your healthcare provider prescribes, and never switch between drugs or brand names without asking your healthcare provider.

Frequently Asked Questions

  • What is Vimpat?

    Vimpat is an antiepileptic drug that treats partial-onset seizures in people aged 1 month and older. It is also used as adjunctive therapy in treating primary generalized tonic-clonic seizures in people aged 4 years and older.

  • How does Vimpat work?

    Vimpat acts on the central nervous system (CNS) to decrease abnormal electrical activity in the brain to reduce the frequency and severity of epileptic seizures.

  • What are the side effects of Vimpat?

    Some common side effects of Vimpat include:

    • Diarrhea
    • Headache
    • Dizziness
    • Nausea
    • Double vision
    • Sleepiness
    • Uncontrollable movement
    • Weakness 
    • Itching
    • Cardiac problems
  • What should I avoid while taking Vimpat?

    Like many other antiepileptic drugs, Vimpat can make you feel dizzy and sleepy, reduce your attention levels, and affect your concentration and coordination while doing different activities. It's better not to drive, operate heavy machinery, or do other dangerous activities that require alertness and coordination until you know how this medication affects you. 

  • How do I stop taking Vimpat?

    Do not stop taking Vimpat without asking your healthcare provider. Sudden discontinuation (stopping) of a seizure medicine may lead to severe problems, such as seizures that will not stop (status epilepticus). Your healthcare provider will gradually reduce the dose before stopping the drug altogether.

  • Is Vimpat a controlled drug?

    Vimpat is a Schedule V controlled substance. It can be abused and lead to drug dependence. Speak with your healthcare provider if you have questions or concerns about potential dependence.

  • What is the most important information I should know about Vimpat?

    Like other antiepileptic drugs, Vimpat may cause potentially harmful thoughts.

    Call your healthcare provider if you or anyone have any of these symptoms:

    • Suicidal thoughts
    • New or worsening depression, anxiety, or irritability
    • Feeling agitated or restless
    • Panic attacks
    • Insomnia (trouble sleeping)
    • Aggressive or violent behavior
    • Dangerous impulses
    • Mania (an extreme increase in energy levels, activity levels, and emotions)
    • Unusual behavior or mood changes

    Seek immediate medical and social help if you experience any of these.

How Can I Stay Healthy While Taking Vimpat?

Vimpat is a relatively safe and effective antiepileptic treatment, and its typical side effects are dizziness, headache, drowsiness, nausea, and cardiovascular abnormalities. Your healthcare provider will decide the best suitable drug for you to control your seizures.

Epilepsy is a condition that causes repetitive, unprovoked seizures. It has numerous causes, each reflecting underlying brain dysfunction. While living with epilepsy does have its challenges, there are ways to help improve your quality of life. Refer below for some general tips to support your health:

  • Take epilepsy-related medications as recommended by your healthcare provider.
  • Consider keeping a diary to become more aware of your triggers.
  • Certain physical or psychological factors might trigger epilepsy. Avoid the respective triggers as much as you can. Consider working with a registered healthcare professional to help you identify and manage the triggers.
  • Consider support groups or working with a mental health professional to help you find coping strategies to change the way you think, feel, react, or respond to living with epilepsy.
  • Keep a close check on your mental health.
  • In the case of negative, harmful, or suicidal feelings, immediately seek medical help.
  • Never discontinue your drug without asking your healthcare provider, even if you feel well.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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