What is the maximum lacosamide (Vimpat) dose for pediatric patients?

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Last updated: February 24, 2025View editorial policy

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From the Research

The maximum lacosamide dose for pediatric patients is generally 12 mg/kg/day, not to exceed 400 mg per day, as supported by the most recent study 1.

Key Considerations

  • The dose should be adjusted according to the child's weight, with careful monitoring for side effects such as dizziness, headache, and nausea.
  • Lacosamide is used as an adjunctive therapy for partial-onset seizures in children 4 years and older.
  • For children under 4 years of age, the dose may need to be adjusted based on age, with infants between 1 month and 1 year of age potentially requiring higher doses of 15 to 18 mg/kg/d 1.

Dosing Recommendations

  • Initiate dosing at a lower level and gradually increase to the maximum dose based on clinical response and tolerability.
  • For children weighing 50 kg or more, the adult maximum dose of 400 mg/day applies.
  • The dose should be given in two divided doses, with careful monitoring for side effects.

Supporting Evidence

  • A pharmacometric analysis of real-world data supported the use of 12 mg/kg/day in children ≥4 years of age, with higher doses potentially needed in younger children 1.
  • Clinical trials have demonstrated the safety and efficacy of lacosamide in pediatric patients with focal seizures, with a maximum dose of 12 mg/kg/day not to exceed 400 mg per day 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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