Comparative Pharmacology
Head-to-head clinical analysis: LACOSAMIDE versus TOPAMAX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LACOSAMIDE versus TOPAMAX.
LACOSAMIDE vs TOPAMAX
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.
Antiepileptic; modulates voltage-gated sodium channels, enhances GABA-A activity, antagonizes AMPA/kainate glutamate receptors, weakly inhibits carbonic anhydrase.
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.
Initial dose 25 mg orally twice daily; titrate by 25-50 mg weekly to effective dose; usual maintenance dose 200-400 mg/day divided twice daily; maximum 1600 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.
Terminal elimination half-life is 21 hours (range 18-23 hours). Linear pharmacokinetics. Half-life is prolonged in renal impairment (CrCl <70 mL/min: ~35 hours).
Renal: approximately 95% (40% unchanged, remainder as O-desmethyl metabolite). Fecal: <5%.
Renal: ~70% (unchanged drug); remainder as metabolites. Biliary/fecal: minimal (<5%).
Category C
Category C
Anticonvulsant
Anticonvulsant
"The serum concentration of Delavirdine can be increased when it is combined with Lacosamide."