Comparative Pharmacology
Head-to-head clinical analysis: LACOSAMIDE versus VALPROATE SODIUM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LACOSAMIDE versus VALPROATE SODIUM.
LACOSAMIDE vs VALPROATE SODIUM
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.
Increases GABA levels by inhibiting GABA transaminase and blocking voltage-gated sodium channels; also modulates T-type calcium 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.
10-15 mg/kg/day orally or intravenously in 2-3 divided doses; increase by 5-10 mg/kg/day weekly to therapeutic range of 50-100 mcg/mL. Maximum dose 60 mg/kg/day.
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
Terminal elimination half-life is 9–16 hours in adults; may be shorter in children (5–12 hours) and prolonged in hepatic impairment or elderly (up to 18 hours). Neonatal half-life: 10–67 hours. Clinically, twice-daily dosing is typical.
Renal: approximately 95% (40% unchanged, remainder as O-desmethyl metabolite). Fecal: <5%.
Primarily renal (90% as glucuronide conjugates, 3-oxo derivative, and other metabolites; <3% unchanged). Biliary/fecal excretion accounts for <10%.
Category C
Category C
Anticonvulsant
Anticonvulsant
"The serum concentration of Delavirdine can be increased when it is combined with Lacosamide."