VIMPAT 10 MG 200 ML SYRUP

Indications

Approved Uses

Adjunctive therapy for partial-onset seizures in patients aged 1 month and older, Monotherapy for partial-onset seizures in patients 4 years of age and older, Adjunctive therapy for primary generalized tonic-clonic seizures in patients 4 years of age and older.

Dosage & Administration

Dosing by Condition

Partial-onset (focal) seizures (adults): start 50 mg twice daily (100 mg/day) and increase by 50 mg twice daily (100 mg/day) at weekly intervals as needed; maintenance typically 100-200 mg twice daily (200-400 mg/day). Primary generalized tonic-clonic seizures (adjunctive, adults): start 50 mg twice daily and increase by 50 mg twice daily at weekly intervals; maintenance 100-200 mg twice daily (200-400 mg/day). Pediatric dosing is weight-based per labeling.

Initial Dose

Adjunctive therapy (Adults): 50 mg twice daily. Monotherapy (Adults): 100 mg twice daily.

Maintenance Dose

200-400 mg/day in two divided doses (adjunctive); 150-300 mg/day (monotherapy)

Maximum Dose

400 mg per day.

Children's Dosage

Ages 1 month to <17 years: weight-based dosing (e.g., <6 kg: initial 1 mg/kg BID, maint up to 15 mg/kg/day; 6-<30 kg: initial 1 mg/kg BID, maint up to 12 mg/kg/day; etc.); specific regimens per FDA label Table 1. IV limited in young peds.

Dose Adjustment Notes

Titrate based on response/tolerability (commonly at weekly intervals); in severe renal impairment (CrCl ≤30 mL/min) or end-stage renal disease, reduce the maximum recommended dose by ~25% and consider supplemental dosing after hemodialysis; in mild-moderate hepatic impairment, limit maximum to 300 mg/day and use caution; not recommended in severe hepatic impairment; when discontinuing, taper gradually (e.g., over ≥1 week).

How to Take

Oral solution (10 mg/mL) is taken by mouth twice daily (about every 12 hours) with or without food; measure each dose with an accurate calibrated oral syringe/measuring device (do not use a household spoon) and swallow the measured dose; do not switch between oral solution and tablets on a mg-for-mg basis without confirming the prescribed dose.

How to Prepare

Ready-to-use oral solution/syrup; no reconstitution or dilution required. Shake only if the product labeling instructs; otherwise administer as supplied using an accurate measuring device.

Side Effects

Side Effect Frequency

Very common (≥10%): dizziness, headache, diplopia, nausea. Common (1-10%): blurred vision, vomiting, fatigue/asthenia, somnolence, ataxia/coordination or gait disturbance, tremor, nystagmus, vertigo, balance disorder, memory impairment/confusion. Uncommon/rare but clinically important: PR-interval prolongation, AV block/atrial arrhythmias, syncope, suicidal ideation/behavior, serious hypersensitivity reactions (e.g., DRESS, SJS/TEN).

Safety & Warnings

Contraindications

Known hypersensitivity to lacosamide or any excipients, Second- or third-degree atrioventricular (AV) block

Warnings & Precautions

Precautions: cardiac conduction abnormalities-consider baseline/periodic ECG in patients with known conduction disease, significant cardiac disease, or on PR-prolonging drugs; do not abruptly discontinue (taper); monitor for suicidal thoughts/behavior; discontinue if hypersensitivity/DRESS suspected; caution for dizziness/ataxia and impaired ability to drive/operate machinery; avoid/add caution with CNS depressants/alcohol.

Age Restriction

Approved for use in children ≥1 month of age (for partial-onset/focal seizures); not established for <1 month.

Driving Warning

May Cause Drowsiness

Drug Interactions

Drug Interactions

Key interactions: additive PR-interval prolongation/AV block risk with PR-prolonging drugs (e.g., beta-blockers, non-DHP calcium channel blockers, digoxin, amiodarone); strong enzyme inducers (e.g., rifampin, carbamazepine, phenytoin, phenobarbital) can decrease lacosamide exposure; strong CYP3A4/CYP2C9 inhibitors may increase exposure; additive CNS effects with other CNS depressants/alcohol.

Interaction Severity

MAJOR/clinically significant: additive PR-interval prolongation/AV block risk with other PR-prolonging or conduction-slowing drugs (e.g., beta-blockers, non-DHP calcium channel blockers such as verapamil/diltiazem, digoxin, amiodarone) and in patients with underlying conduction disease. MODERATE: strong enzyme inducers (e.g., carbamazepine, phenytoin, phenobarbital, rifampin) may lower lacosamide exposure; strong CYP2C19 inhibitors may increase exposure. CAUTION: additive CNS depression with alcohol/other sedatives.

Food Interaction

No clinically meaningful food restriction; may be taken with or without food.

Special Populations

Breastfeeding

Consult Doctor

Children

Ages 1 month to <17 years: weight-based dosing (e.g., <6 kg: initial 1 mg/kg BID, maint up to 15 mg/kg/day; 6-<30 kg: initial 1 mg/kg BID, maint up to 12 mg/kg/day; etc.); specific regimens per FDA label Table 1. IV limited in young peds.

Elderly

No specific dose adjustment required based on age alone; however, titrate cautiously given increased likelihood of cardiac conduction abnormalities and renal impairment; monitor renal function and ECG

Storage & Patient Advice

Preparation Instructions

Ready-to-use oral solution/syrup; no reconstitution or dilution required. Shake only if the product labeling instructs; otherwise administer as supplied using an accurate measuring device.

Patient Counseling

Take lacosamide exactly as prescribed (usually twice daily) at the same times each day; may be taken with or without food. Measure doses with an oral syringe/accurate measuring device (not a household spoon). Do not stop suddenly-taper only under prescriber direction to avoid increased seizure risk. May cause dizziness, drowsiness, blurred/double vision and coordination problems-avoid driving/operating machinery until effects are known; avoid alcohol/CNS depressants. Seek medical advice urgently for palpitations, fainting, or slow/irregular heartbeat (PR prolongation/AV block risk), severe rash or hypersensitivity, or new/worsening mood changes or suicidal thoughts. Store below 30°C; keep bottle tightly closed and out of reach of children.

Pharmacology

Mechanism of Action

Enhances slow inactivation of voltage-gated sodium channels, stabilizing hyperexcitable neuronal membranes and reducing repetitive neuronal firing.

Onset of Action

After oral dosing, peak plasma concentrations occur in about 1-4 hours; clinical seizure reduction may be seen early but is typically assessed after titration to an effective maintenance dose.

Duration of Effect

Clinical dosing interval is approximately 12 hours (twice daily), supported by an elimination half-life of about 13 hours.

Half-Life

Approximately 13 hours.

Bioavailability

Approximately 100% (oral solution is bioequivalent to tablets).

Excretion

Primarily renal: ~95% recovered in urine (about 40% as unchanged lacosamide; remainder mainly as inactive metabolites).

Protein Binding

Less than 15%.

Product Information

Available Dosage Forms

Film-coated tablets; oral solution/syrup (10 mg/mL); solution for intravenous infusion (IV).

Composition per Dose

Each 1 ml: 10 mg lacosamide; Each 5 ml: 50 mg lacosamide

Generic Availability

Yes

OTC Alternatives

No OTC alternative

Also Used For

Partial-onset seizures; primary generalized tonic-clonic seizures

Reviewed by Al Mujtama Pharmacy Medical Review Team. Last reviewed 16-06-2026