Side Effects of Lacosamide (Vimpat)
Lacosamide, also known as the common brand Vimpat, is used in partial-onset seizure treatment in patients 17 years and older as adjunctive therapy.
Vimpat and Risk of Suicide
According to the Vimpat label reported by the FDA, antiepileptic drugs (AEDs), including Vimpat, increase the risk of suicidal thoughts or behavior in patients. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and any unusual changes in mood or behavior.
Precautions Before Taking Vimpat
Vimpat should be used with caution in patients with known heart problems, such as marked first-degree AV block, second-degree or higher AV block, sick sinus syndrome (disorder in which the sinus node is not functioning properly), Brugada Syndrome (disorder of irregular heart rhythms that can lead to sudden death), or with severe cardiac diseases, such as myocardial ischemia (disease of damaged blood vessels), heart failure, and structural heart disease.
Vimpat should also be used with caution in patients on concomitant medications that prolong PR intervals, because of a risk of AV block or bradycardia. The FDA recommends obtaining an ECG (electrocardiogram) before and after treatment to manage dosages.
The FDA found abnormalities in liver function tests involving Vampit tablets. This occurred in adult patients with partial-onset seizures who were taking 1 to 3 concomitant anti-epileptic drugs.
Vampit should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. A maximum dose of 300 mg/day is recommended for patients with mild to moderate hepatic impairment, severe renal impairment, and in patients with End Stage Renal Disease (ESRD). Vampit use is not recommended in patients with severe hepatic impairment.
Common Side Effects
The most common adverse reactions of Vampit are:
- Diplopia (double vision)
- Neutropenia (low white blood cell count)
- Anemia (low red blood cell count)
- Palpitations (irregular heartbeats)
- Tinnitus (ringing in the ears)
- Dyspepsia (upset stomach)
- Dry mouth
- Hypoesthesia (reduced sense of touch)
Other side effects are irritability, fever, muscle spasms, and paresthesia (burning or prickling sensations),
About Pharmacogenetic Testing
Pharmacogenetics is the study of how specific polymorphisms affect drug metabolism. Each individual has numerous genes responsible for how medications are broken down. These gene variations explain why some individuals experience severe side effects and others don’t. Pharmacogenetics testing informs you and your healthcare providers what medications are safe, harmful, and ineffective to you.
Know Your Risk with the Rxight® Genetic Test
The Rxight® genetic test is easy to understand; reliable, and prompt that determines how your body processes Vampit and over 200 prescription and over-the-counter (OTC) medications. Rxight® guides your healthcare provider in creating an individualized and successful treatment plan.
Contributors to this Article:
Michael Sapko, MD, PhD; and Deborah Kallick, PhD, Medicinal Chemistry
Read more about Rxight® Individualized Medicine