Comparative Pharmacology
Head-to-head clinical analysis: LACOSAMIDE versus MYSOLINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LACOSAMIDE versus MYSOLINE.
LACOSAMIDE vs MYSOLINE
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.
Primidone is a barbiturate anticonvulsant that acts by enhancing GABA-A receptor activity and possibly by blocking sodium channels.
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.
250 mg orally 3 times daily; may increase by 250 mg/day every 3 days; usual maintenance 250 mg 3-4 times daily; maximum daily dose 1500 mg.
None Documented
None Documented
Terminal elimination half-life is approximately 13 hours (range 12–16 hours) in adults. Steady state achieved after 3 days with BID dosing.
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
Primidone: 5-15 hours (mean 10 hours); PEMA: 10-18 hours; Phenobarbital: 50-120 hours. Steady state achieved in 2-4 weeks due to accumulation of phenobarbital.
Renal: approximately 95% (40% unchanged, remainder as O-desmethyl metabolite). Fecal: <5%.
Primidone is excreted primarily in urine; approximately 60-80% as unchanged drug and metabolites (PEMA, phenobarbital), with less than 10% in feces.
Category C
Category C
Anticonvulsant
Anticonvulsant
"The serum concentration of Delavirdine can be increased when it is combined with Lacosamide."