From the FDA Drug Label
Dalfampridine extended-release tablets are indicated as a treatment to improve walking in adult patients with multiple sclerosis (MS). Dalfampridine (Ampyra) is used to improve walking in adult patients with multiple sclerosis (MS) 1.
- The medication is specifically indicated to increase walking speed in these patients.
- It is essential to note that the maximum recommended dosage should not be exceeded to minimize the risk of adverse reactions, including seizures.
From the Research
Dalfampridine (Ampyra) Usage
Dalfampridine, also known as Ampyra, is used for the treatment of walking impairment in patients with multiple sclerosis (MS) 2, 3, 4. The medication works by blocking potassium channels on demyelinated neurons, allowing for normal electrical conduction and improving locomotor difficulty 3, 4.
Mechanism of Action
The putative mechanism of action of dalfampridine is the restoration of axonal conduction via blockade of potassium channels that become exposed during axonal demyelination 2, 3. This leads to improved action potential conduction in demyelinated axons, resulting in clinical benefits such as improved walking speed and patient-reported perceptions of walking 3.
Clinical Efficacy
Clinical trials have demonstrated that dalfampridine improves walking speed and patient-reported perceptions of walking in some patients with MS 2, 3, 5. A meta-analysis of randomized controlled trials found significant differences between dalfampridine and placebo in terms of decreased 12-item Multiple Sclerosis Walking Scale score, improved response to the timed 25-foot walk test, and increased 6-min walk test 5.
Safety Profile
Dalfampridine has a narrow therapeutic range and is generally well tolerated at the approved dose of 10 mg twice daily 2, 6. However, the risk of seizure is a concern, particularly in patients with a history of seizure or moderate-to-severe renal impairment 2, 6, 4. Common adverse events reported in clinical trials include insomnia, dizziness, headache, nausea, and weakness 6, 4.
Dosage and Administration
The recommended dosage of dalfampridine is 10 mg orally twice daily 2, 4. The medication is not appropriate for patients with seizures or moderate-to-severe renal impairment 2, 6, 4.
Key Points
- Dalfampridine is used to improve walking in patients with MS 2, 3, 4
- The medication works by blocking potassium channels on demyelinated neurons 3, 4
- Clinical trials have demonstrated improved walking speed and patient-reported perceptions of walking 2, 3, 5
- Dalfampridine has a narrow therapeutic range and is generally well tolerated at the approved dose 2, 6
- The risk of seizure is a concern, particularly in patients with a history of seizure or moderate-to-severe renal impairment 2, 6, 4