Comparative Pharmacology
Head-to-head clinical analysis: LACOSAMIDE versus PARADIONE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LACOSAMIDE versus PARADIONE.
LACOSAMIDE vs PARADIONE
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.
Paradione (paramethadione) is an oxazolidinedione anticonvulsant that suppresses neuronal activity in the motor cortex by increasing the threshold for repetitive neuronal firing and reducing synaptic transmission. Its exact mechanism is unclear but involves modulation of T-type calcium channels and enhancement of GABAergic inhibition.
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.
100 mg orally three times daily; maximum 600 mg/day.
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.
12-24 hours (terminal); prolonged in renal impairment
Renal: approximately 95% (40% unchanged, remainder as O-desmethyl metabolite). Fecal: <5%.
Renal: 70% unchanged; biliary/fecal: 25%; metabolic: 5%
Category C
Category C
Anticonvulsant
Anticonvulsant
"The serum concentration of Delavirdine can be increased when it is combined with Lacosamide."