Comparative Pharmacology
Head-to-head clinical analysis: LACOSAMIDE versus LAMICTAL XR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LACOSAMIDE versus LAMICTAL XR.
LACOSAMIDE vs LAMICTAL XR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Selectively enhances slow inactivation of voltage-gated sodium channels, stabilizing hyperexcitable neuronal membranes and inhibiting repetitive neuronal firing.
Lamotrigine inhibits voltage-sensitive sodium channels, stabilizing neuronal membranes and inhibiting the release of excitatory neurotransmitters such as glutamate and aspartate.
Oral or IV: 50 mg twice daily initially; increase by 50 mg twice daily weekly to maintenance 100-200 mg twice daily. Maximum 200 mg twice daily.
Lamotrigine extended-release tablets: Initial 25 mg orally once daily for 2 weeks, then 50 mg once daily for 2 weeks, then 100 mg once daily for 1 week, then 200 mg once daily; maintenance 200–400 mg once daily as adjunctive therapy for epilepsy. For bipolar disorder, dose titration as per prescribing information; typical maintenance 200 mg once daily.
None Documented
None Documented
Clinical Note
moderateLacosamide + Sulfisoxazole
"The serum concentration of Sulfisoxazole can be increased when it is combined with Lacosamide."
Clinical Note
moderateLacosamide + Fluconazole
"The serum concentration of Fluconazole can be increased when it is combined with Lacosamide."
Clinical Note
moderateLacosamide + Ketoconazole
"The serum concentration of Ketoconazole can be increased when it is combined with Lacosamide."
Clinical Note
moderateLacosamide + Delavirdine
Terminal elimination half-life is approximately 13 hours (range 12–16 hours) in adults. Steady state achieved after 3 days with BID dosing.
Terminal elimination half-life is approximately 25-33 hours in healthy adults, increasing to 50-60 hours in patients taking valproate, and decreasing to 15-27 hours in patients taking enzyme-inducing drugs like carbamazepine, phenytoin, or phenobarbital.
Renal: approximately 95% (40% unchanged, remainder as O-desmethyl metabolite). Fecal: <5%.
Primarily renal; ~70% of lamotrigine is excreted in urine as glucuronide conjugates, 10% as parent drug, and 20% via feces.
Category C
Category C
Anticonvulsant
Anticonvulsant
"The serum concentration of Delavirdine can be increased when it is combined with Lacosamide."