From the Research
Vimpat (lacosamide) oral solution is typically dosed based on body weight and age, with adjustments for kidney or liver function, starting at 50 mg twice daily for adults and 2 mg/kg twice daily for children, with potential increases to 100-200 mg twice daily for adults and 4-6 mg/kg twice daily for children. The liquid formulation (10 mg/mL) allows for precise measurement using the provided oral syringe, especially beneficial for patients who have difficulty swallowing tablets. Key considerations for dosing include:
- Starting dose: 50 mg twice daily for adults, 2 mg/kg twice daily for children
- Maintenance dose: 100-200 mg twice daily for adults, 4-6 mg/kg twice daily for children
- Adjustments for kidney or liver function may be necessary, particularly for patients with severe renal impairment or mild to moderate hepatic impairment, as noted in studies such as 1 and 2. Vimpat should be taken consistently at the same times each day with or without food. Dosage adjustments may be needed for patients with severe renal impairment or mild to moderate hepatic impairment, as the drug is eliminated predominantly via the kidneys and its pharmacokinetics can be affected by renal impairment, as shown in 1. Never stop taking Vimpat suddenly as this may trigger seizures; dose reduction should always be gradual under medical supervision. The most recent and highest quality study, 3, supports the use of lacosamide as a valuable option in elderly patients with focal onset epilepsy, with a favorable pharmacokinetic profile and high rate of long-term seizure freedom. Overall, the evidence suggests that Vimpat can be an effective and well-tolerated treatment option for patients with epilepsy, with careful consideration of dosing and potential adjustments for kidney or liver function.