Lacosamide Adroiq: Uses, Dosage & Side Effects
An intravenous antiepileptic solution for the treatment of focal (partial-onset) seizures in adults and children aged 4 years and older
Lacosamide Adroiq is a prescription intravenous formulation of lacosamide, an antiepileptic drug used for the treatment of focal (partial-onset) seizures with or without secondary generalization in adults and adolescents aged 4 years and older. The solution for infusion (10 mg/ml) is administered when oral lacosamide therapy is temporarily not feasible, providing a critical bridge in epilepsy management during surgical procedures, acute seizure episodes, or situations where the patient cannot take medication by mouth. Lacosamide works through a novel mechanism of selectively enhancing the slow inactivation of voltage-gated sodium channels, distinguishing it from other antiepileptic drugs that target fast inactivation. Clinical trials have demonstrated significant seizure frequency reduction, and the IV-to-oral switch is seamless with equivalent dosing.
Quick Facts: Lacosamide Adroiq
Key Takeaways
- Lacosamide Adroiq is an intravenous formulation of lacosamide (10 mg/ml) used as a temporary alternative when oral lacosamide cannot be taken, providing seamless mg-for-mg switching between IV and oral administration.
- It is approved for the treatment of focal (partial-onset) seizures with or without secondary generalization in adults and children aged 4 years and older, both as monotherapy and adjunctive therapy.
- Lacosamide has a unique mechanism of action – it selectively enhances slow inactivation of voltage-gated sodium channels, which is distinct from traditional antiepileptic drugs and may contribute to its favorable tolerability profile.
- The most common side effects are dizziness, headache, nausea, and double vision; serious but less common effects include PR interval prolongation on ECG, requiring cardiac monitoring in at-risk patients.
- The IV infusion should be administered over 15 to 60 minutes and can be used without further dilution or diluted with compatible IV solutions. Treatment duration with the IV formulation should be as short as clinically necessary.
What Is Lacosamide Adroiq and What Is It Used For?
Lacosamide Adroiq contains the active substance lacosamide, a functionalized amino acid that was specifically designed as an antiepileptic drug. Unlike many other antiepileptic medications that were discovered serendipitously or repurposed from other therapeutic areas, lacosamide was developed through a systematic medicinal chemistry program by the Anticonvulsant Screening Program (ASP) at the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health. This deliberate design process resulted in a compound with a novel mechanism of action that sets it apart from other antiepileptic drugs currently available.
The primary mechanism of action of lacosamide involves the selective enhancement of slow inactivation of voltage-gated sodium channels. To understand why this is significant, it is helpful to consider how sodium channels function in the brain. Voltage-gated sodium channels are essential for the generation and propagation of action potentials in neurons. These channels exist in three primary states: resting (closed), open (activated), and inactivated. Inactivation occurs in two phases: fast inactivation (which occurs within milliseconds and is the target of traditional sodium channel blockers such as carbamazepine, phenytoin, and lamotrigine) and slow inactivation (which occurs over seconds to minutes and represents a deeper state of channel inactivity).
By selectively enhancing slow inactivation, lacosamide preferentially targets neurons that are firing in a pathologically sustained or repetitive manner – the hallmark of epileptic seizure activity. This means that lacosamide can reduce the excitability of seizure-generating neurons without significantly affecting the normal, physiological firing patterns of healthy neurons. This selective action is believed to contribute to the favorable tolerability profile observed in clinical practice, as patients may experience fewer central nervous system side effects compared to drugs that broadly suppress neuronal activity.
Lacosamide has also been shown to interact with collapsin response mediator protein 2 (CRMP-2), a protein involved in neuronal differentiation and axonal growth. While the clinical significance of this interaction in the context of epilepsy treatment is not fully established, research suggests it may contribute to the neuroprotective properties of lacosamide observed in preclinical models.
Lacosamide Adroiq is specifically the intravenous formulation, available as a solution for infusion at a concentration of 10 mg/ml. This formulation is intended as a temporary substitute for oral lacosamide when patients are unable to take medications by mouth. Common clinical scenarios requiring IV administration include perioperative management of epilepsy patients undergoing surgery, management of patients in intensive care units who are unable to swallow, status epilepticus or acute repetitive seizures requiring rapid drug loading, and gastrointestinal conditions that prevent oral absorption.
The approved indications for lacosamide encompass both monotherapy and adjunctive therapy for the treatment of focal (partial-onset) seizures with or without secondary generalization in adults and adolescents aged 4 years and older with epilepsy. The pivotal clinical trials that supported the approval of lacosamide included three key studies:
- SP667 Trial: A multicenter, randomized, double-blind, placebo-controlled trial in 418 adults with uncontrolled focal seizures. Lacosamide 400 mg/day and 600 mg/day significantly reduced seizure frequency compared to placebo, with median seizure reductions of 36.4% and 20.5% respectively versus 10.4% for placebo.
- SP754 Trial: A similar trial in 485 patients demonstrating that lacosamide 200 mg/day and 400 mg/day provided statistically significant reductions in seizure frequency. The 50% responder rates were 33.3% and 40.5% for the 200 mg and 400 mg groups compared to 21.9% for placebo.
- SP755 Trial: A trial of 405 patients confirming the efficacy of lacosamide 400 mg/day and 600 mg/day, with both doses achieving significant reductions in seizure frequency and meaningful improvements in 50% responder rates.
The intravenous bioequivalence of lacosamide has been established through pharmacokinetic studies demonstrating that IV and oral lacosamide provide equivalent plasma exposure when administered at the same dose. This allows for straightforward switching between formulations without the need for dose adjustment, a significant clinical advantage.
Lacosamide was first approved by the European Medicines Agency (EMA) and the U.S. Food and Drug Administration (FDA) in 2008. It is now approved in more than 80 countries worldwide and is recognized by the International League Against Epilepsy (ILAE) as an effective treatment option for focal seizures. Lacosamide Adroiq is a generic intravenous formulation that provides the same therapeutic benefit as the originator product.
The key advantage of Lacosamide Adroiq is its 100% bioavailability and mg-for-mg dose equivalence with oral lacosamide. This means patients can seamlessly transition between oral and IV therapy without any dose adjustments. The IV formulation can be administered as a rapid loading dose over 15 minutes in acute settings, or as a standard infusion over 30–60 minutes for maintenance dosing, providing flexibility for various clinical situations.
What Should You Know Before Taking Lacosamide Adroiq?
Contraindications
Lacosamide Adroiq is contraindicated in patients with known hypersensitivity to lacosamide or to any of the excipients in the formulation (sodium chloride, hydrochloric acid, sodium hydroxide, and water for injections). Additionally, lacosamide is contraindicated in patients with known second-degree or third-degree atrioventricular (AV) block. This cardiac contraindication is related to lacosamide's pharmacological effect on cardiac sodium channels, which can prolong the PR interval on electrocardiogram (ECG).
Patients with pre-existing first-degree AV block, significant cardiac conduction abnormalities, or those taking concomitant medications that prolong the PR interval should be carefully evaluated before initiating lacosamide. In these patients, an ECG should be obtained prior to starting treatment and periodically during therapy. The degree of PR prolongation is generally dose-dependent and usually not clinically significant at therapeutic doses, but it can become relevant in patients with underlying cardiac conduction disease or when combined with other PR-prolonging agents.
Warnings and Precautions
Antiepileptic drugs, including lacosamide, have been associated with an increased risk of suicidal thoughts and behavior. Patients and caregivers should be advised to monitor for the emergence or worsening of depression, unusual changes in mood or behavior, and suicidal thoughts. If such symptoms occur, seek medical advice immediately.
Before starting Lacosamide Adroiq, discuss the following with your healthcare provider:
- Cardiac conduction disorders: Lacosamide causes dose-dependent prolongation of the PR interval on ECG. Cases of second- and third-degree AV block, as well as atrial fibrillation and atrial flutter, have been reported in post-marketing surveillance. Patients with underlying cardiac conditions such as ischemic heart disease, heart failure, structural heart disease, or those receiving Class I antiarrhythmic drugs or other PR interval-prolonging medications require careful cardiac monitoring.
- Dizziness and ataxia: Lacosamide can cause dizziness and coordination difficulties that may increase the risk of falls, particularly in elderly patients. These effects are usually dose-dependent and often occur during the titration period.
- Multiorgan hypersensitivity reactions (DRESS): Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) has been reported with lacosamide. DRESS typically presents with fever, skin rash, lymphadenopathy, and organ involvement. If DRESS is suspected, lacosamide should be discontinued immediately.
- Hepatic impairment: In patients with mild to moderate hepatic impairment, dose adjustment may be necessary. Lacosamide is not recommended in patients with severe hepatic impairment due to insufficient clinical data.
- Renal impairment: No dose adjustment is required in patients with mild to moderate renal impairment. In patients with severe renal impairment (creatinine clearance ≤30 ml/min) or end-stage renal disease, a maximum dose of 250 mg/day is recommended.
Pregnancy and Breastfeeding
Lacosamide Adroiq should not be used during pregnancy unless clearly necessary and the potential benefit to the mother outweighs the potential risk to the fetus. There are limited data from the use of lacosamide in pregnant women. Animal reproductive toxicology studies have demonstrated adverse effects on embryo-fetal development at doses associated with maternally toxic levels, including increased perinatal mortality, reduced fetal body weight, and increased skeletal variations.
All antiepileptic drugs carry some teratogenic risk, and uncontrolled seizures during pregnancy also pose significant risks to both mother and fetus, including injury, hypoxia, and potential harm from falls or prolonged convulsions. The decision to continue or modify antiepileptic therapy during pregnancy must therefore be made on an individual basis in close consultation with a neurologist and obstetrician. Women of childbearing potential should use effective contraception during treatment.
Lacosamide is excreted into human breast milk. The ratio of lacosamide concentration in breast milk to maternal plasma has been reported to be approximately 0.7–1.0 in published studies. Given the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue breastfeeding or to discontinue lacosamide, taking into account the importance of epilepsy control for the mother.
Never stop taking lacosamide abruptly without medical supervision. Sudden discontinuation of any antiepileptic drug can trigger rebound seizures, including potentially life-threatening status epilepticus. If lacosamide needs to be discontinued, the dose should be gradually reduced over a minimum of 1 week under the guidance of your treating physician.
How Does Lacosamide Adroiq Interact with Other Drugs?
One of the clinical advantages of lacosamide is its relatively clean drug interaction profile. Lacosamide has low plasma protein binding (less than 15%), which means it is unlikely to displace other highly protein-bound drugs from their binding sites. It is partially metabolized by CYP2C19 and also undergoes renal elimination of both the unchanged parent compound and the inactive O-desmethyl metabolite. Lacosamide does not significantly induce or inhibit major CYP enzymes at therapeutic concentrations, reducing the potential for clinically significant pharmacokinetic interactions.
Major Interactions
| Drug / Class | Interaction | Clinical Recommendation |
|---|---|---|
| Carbamazepine, Phenytoin, Oxcarbazepine | Other sodium channel blockers – additive pharmacodynamic effects may increase risk of CNS side effects (dizziness, diplopia, coordination difficulties) and cardiac conduction effects | Monitor closely during titration; consider slower dose escalation |
| Class I antiarrhythmics (flecainide, propafenone, lidocaine) | Additive effect on cardiac conduction – increased risk of PR prolongation and AV block | ECG monitoring before and during treatment; avoid combination if possible |
| PR interval-prolonging drugs (beta-blockers, calcium channel blockers, digoxin) | Additive PR prolongation on ECG – increased risk of AV block | ECG monitoring recommended; dose adjustment may be necessary |
Minor Interactions
| Drug / Class | Interaction | Clinical Recommendation |
|---|---|---|
| CYP2C19 inhibitors (fluconazole, fluvoxamine, omeprazole) | May modestly increase lacosamide plasma levels (up to ~20%) | No routine dose adjustment; monitor for increased side effects |
| CYP3A4/CYP2C9 inducers (rifampicin, carbamazepine, phenytoin) | May modestly reduce lacosamide plasma levels through enhanced hepatic metabolism | Monitor seizure control; dose increase may be needed |
| Oral contraceptives | No clinically relevant pharmacokinetic interaction demonstrated | No dose adjustment needed for either drug |
| Metformin | No clinically relevant interaction | No dose adjustment needed |
| Warfarin | No effect on warfarin pharmacokinetics or INR | No dose adjustment needed; standard INR monitoring continues |
Population pharmacokinetic analyses from clinical trials have demonstrated that concomitant use of other antiepileptic drugs (including levetiracetam, valproate, lamotrigine, topiramate, and zonisamide) does not significantly affect the pharmacokinetics of lacosamide. Similarly, lacosamide does not significantly alter the plasma concentrations of these commonly used antiepileptic drugs.
Regarding alcohol and central nervous system depressants: lacosamide may enhance the sedative effects of alcohol and other CNS depressants such as benzodiazepines and opioids. Patients should be advised to avoid or limit alcohol consumption while taking lacosamide.
Lacosamide has a favorable interaction profile compared to older antiepileptic drugs like carbamazepine, phenytoin, and phenobarbital, which are strong enzyme inducers with multiple drug interactions. The main concerns are pharmacodynamic interactions with other sodium channel blockers and PR interval-prolonging drugs. Always inform your healthcare provider about all medications you are taking.
What Is the Correct Dosage of Lacosamide Adroiq?
Lacosamide Adroiq is intended as a temporary substitute for oral lacosamide when the oral route is not feasible. The IV formulation is bioequivalent to oral lacosamide, meaning the same dose provides the same plasma drug levels regardless of the route of administration. Treatment with IV lacosamide should be as short as clinically necessary, and the patient should be switched back to oral therapy as soon as possible.
Adults
Adjunctive Therapy
The recommended starting dose is 50 mg twice daily (100 mg/day). Based on response and tolerability, the dose can be increased by 50 mg twice daily at weekly intervals. The recommended maintenance dose is 100–200 mg twice daily (200–400 mg/day). The maximum recommended dose is 200 mg twice daily (400 mg/day).
Monotherapy
The recommended starting dose is 50 mg twice daily (100 mg/day). Based on response and tolerability, the dose should be increased by 50 mg twice daily at weekly intervals to a recommended maintenance dose of 150–200 mg twice daily (300–400 mg/day).
Loading Dose (when rapid onset is required)
An initial loading dose of 200 mg may be administered as a single dose, followed approximately 12 hours later by a maintenance dose of 100 mg twice daily. This is particularly useful in acute situations such as status epilepticus management or perioperative settings.
Children (aged 4 years and older)
Pediatric Dosing (weight-based)
For children weighing 50 kg or more, the adult dosing regimen applies. For children weighing less than 50 kg, the recommended starting dose is 1 mg/kg twice daily (2 mg/kg/day). The dose may be increased by 1 mg/kg twice daily at weekly intervals. The recommended maintenance dose is 3–6 mg/kg twice daily (6–12 mg/kg/day), with a maximum of 6 mg/kg twice daily not exceeding 400 mg/day.
Elderly
No specific dose reduction is required in elderly patients based on age alone. However, age-related decline in renal function should be considered, and dose adjustments based on creatinine clearance may be necessary. Elderly patients may also be more susceptible to dizziness and falls associated with lacosamide, and a slower titration schedule may be advisable.
| Population | Recommended Adjustment | Maximum Dose |
|---|---|---|
| Mild-moderate hepatic impairment | Titrate with caution; maximum dose 300 mg/day | 300 mg/day |
| Severe hepatic impairment | Not recommended (insufficient data) | N/A |
| Mild-moderate renal impairment (CrCl >30 ml/min) | No dose adjustment required | 400 mg/day |
| Severe renal impairment (CrCl ≤30 ml/min) | Reduced maximum dose | 250 mg/day |
| Hemodialysis patients | Supplemental dose of up to 50% after dialysis session | 250 mg/day |
Missed Dose
Because Lacosamide Adroiq is administered in a clinical setting by healthcare professionals, missed doses are unlikely. However, if a scheduled IV infusion is delayed, it should be administered as soon as possible. If the time is close to the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. A double dose should never be given to compensate for a missed one.
Overdose
There is limited clinical experience with lacosamide overdose in humans. In reported cases of intentional overdose (doses up to 12,000 mg), symptoms included dizziness, nausea, vomiting, seizures (paradoxically), cardiac conduction abnormalities (including PR prolongation, QRS widening, and AV block), reduced level of consciousness, and coma. There is no specific antidote for lacosamide. Treatment is supportive and may include continuous ECG monitoring and hemodialysis (which effectively removes approximately 50% of lacosamide over a 4-hour session).
What Are the Side Effects of Lacosamide Adroiq?
Like all medicines, lacosamide can cause side effects, although not everyone who takes it will experience them. The side effect profile has been well characterized through extensive clinical trial data (involving more than 3,800 patients) and post-marketing pharmacovigilance experience spanning more than 15 years. Most side effects are dose-related and tend to occur more frequently during the initial titration period, often improving with continued treatment or dose reduction.
With the IV formulation specifically, additional local effects may occur at the infusion site. These include pain, irritation, erythema, and in rare cases, phlebitis. Using larger veins, appropriate dilution, and slower infusion rates can help minimize these local reactions.
Very Common
May affect more than 1 in 10 people
- Dizziness
- Headache
- Diplopia (double vision)
- Nausea
Common
May affect up to 1 in 10 people
- Vomiting
- Blurred vision
- Coordination difficulties (ataxia)
- Tremor
- Nystagmus (involuntary eye movements)
- Memory impairment
- Cognitive disorder
- Drowsiness (somnolence)
- Fatigue
- Balance disorder
- Pruritus (itching)
- Depression
- Tinnitus (ringing in ears)
- Infusion site pain or irritation (IV specific)
Uncommon
May affect up to 1 in 100 people
- PR interval prolongation on ECG
- First-degree AV block
- Atrial fibrillation or flutter
- Syncope (fainting)
- Abnormal liver function tests
- Falls
- Skin rash
- Muscle spasms
- Dysarthria (slurred speech)
- Hypoesthesia (reduced sensation)
Rare
May affect up to 1 in 1,000 people
- Second- or third-degree AV block
- Ventricular tachyarrhythmia
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
- Angioedema
- Agranulocytosis
Not Known
Frequency cannot be estimated from available data
- Severe bradycardia
- Multiorgan hypersensitivity
Dizziness is the most commonly reported side effect, occurring in approximately 16–53% of patients depending on the dose. In clinical trials, the discontinuation rate due to dizziness was approximately 4–8%. Dizziness and other CNS side effects are most pronounced during the titration phase and typically diminish with continued treatment. Slow, gradual dose titration is the most effective strategy for minimizing these effects.
Cardiac effects deserve particular attention. PR interval prolongation is a known pharmacological effect of lacosamide, occurring in a dose-dependent manner. In clinical trials, the mean PR prolongation at therapeutic doses was approximately 3–8 milliseconds. However, in some patients, particularly those with pre-existing cardiac conduction disorders or those receiving other PR-prolonging medications, more pronounced effects may occur. Routine ECG monitoring is recommended in at-risk patients.
DRESS syndrome is a rare but potentially life-threatening multiorgan hypersensitivity reaction. It typically manifests 2–8 weeks after starting treatment with fever, widespread skin rash, facial swelling, lymphadenopathy, and internal organ involvement. If DRESS is suspected, lacosamide must be discontinued immediately and the patient should receive appropriate medical care.
Contact your doctor or seek emergency care immediately if you experience: chest pain, irregular or very slow heartbeat, fainting episodes, widespread skin rash with fever and swollen glands, severe dizziness that prevents normal activities, signs of liver problems (yellowing of skin/eyes, dark urine), or thoughts of self-harm.
How Should You Store Lacosamide Adroiq?
Proper storage of Lacosamide Adroiq is essential to maintain the stability, safety, and efficacy of the medication. As an intravenous solution, it is primarily handled and stored by healthcare professionals in clinical settings.
- Unopened vials: Store at room temperature, not exceeding 25 °C (77 °F). Do not freeze. Keep the vials in the outer carton to protect from light.
- After opening or dilution: The product should be used immediately. From a microbiological standpoint, the diluted solution may be stored for up to 24 hours at 2–8 °C (36–46 °F). Any remaining solution should be discarded after this period.
- Compatible diluents: Lacosamide Adroiq may be diluted with sodium chloride 9 mg/ml (0.9%), glucose 50 mg/ml (5%), or Ringer’s lactate solution.
- Visual inspection: Before administration, inspect the solution visually. The solution should be clear and colorless. Do not use if cloudy, discolored, or contains visible particulate matter.
- Single use: Each vial is intended for single use only. Any unused portion should be discarded in accordance with local pharmaceutical waste disposal regulations.
- Expiration date: Do not use after the expiration date printed on the vial label and outer carton.
- Keep out of reach of children: Store all medications in a secure location inaccessible to children.
Healthcare professionals should be aware that Lacosamide Adroiq is physically and chemically compatible with common IV infusion sets, including PVC bags and polyethylene-lined bags. The diluted solution has been shown to be stable for at least 24 hours under recommended storage conditions.
What Does Lacosamide Adroiq Contain?
Understanding the composition of Lacosamide Adroiq is important for healthcare professionals, particularly for identifying potential allergens and ensuring compatibility with other IV medications.
Active Ingredient
The active substance is lacosamide, a functionalized amino acid chemically designated as (R)-2-acetamido-N-benzyl-3-methoxypropionamide. Each milliliter of solution contains 10 mg of lacosamide. Lacosamide is a chiral molecule; only the R-enantiomer possesses antiepileptic activity. It has a molecular weight of 250.30 g/mol and is freely soluble in water.
Inactive Ingredients (Excipients)
| Ingredient | Role | Notes |
|---|---|---|
| Lacosamide | Active substance (antiepileptic) | 10 mg per ml |
| Sodium chloride | Tonicity agent | Makes the solution isotonic with blood |
| Hydrochloric acid | pH adjuster | Adjusts solution pH to appropriate range |
| Sodium hydroxide | pH adjuster | Works with HCl to achieve target pH |
| Water for injections | Solvent | Pharmaceutical grade |
Presentation and Pack Sizes
Lacosamide Adroiq is supplied as a clear, colorless solution for infusion in glass vials. The solution contains no preservatives and is intended for single use only. Typical pack sizes include 20 ml vials (200 mg lacosamide). The solution has a pH range of approximately 3.5–5.0 and an osmolality that is approximately isotonic with human plasma.
Sodium Content
Healthcare professionals should note that Lacosamide Adroiq contains sodium chloride as an excipient. The sodium content should be taken into consideration for patients on a sodium-restricted diet or those with conditions where sodium intake needs to be carefully monitored, such as heart failure, renal impairment, or hepatic cirrhosis.
Frequently Asked Questions About Lacosamide Adroiq
Lacosamide Adroiq is an intravenous antiepileptic medication used to treat focal (partial-onset) seizures with or without secondary generalization in adults and children aged 4 years and older. It is specifically intended as a temporary alternative when oral lacosamide cannot be taken, for example during surgical procedures, in intensive care settings, or when the patient is unable to swallow. Lacosamide can be used as sole treatment (monotherapy) or in combination with other antiepileptic drugs (adjunctive therapy).
Lacosamide Adroiq is the intravenous formulation of the same active substance found in oral lacosamide tablets and oral solution. The key difference is the route of administration: IV versus oral. Pharmacokinetically, the two formulations are bioequivalent, meaning they produce identical plasma drug concentrations at the same dose. This allows seamless mg-for-mg switching between oral and IV lacosamide without any dose adjustment. The IV formulation is used when oral intake is not possible and should be replaced with oral therapy as soon as the patient can take medication by mouth.
The most common side effects of lacosamide are dizziness, headache, nausea, and diplopia (double vision). These effects are usually dose-dependent and most pronounced during the initial titration period. With the IV formulation, local infusion site reactions may also occur. Most side effects are mild to moderate and tend to improve as the body adjusts to the medication. Serious side effects, including cardiac conduction abnormalities and severe skin reactions, are rare.
Lacosamide Adroiq should only be used during pregnancy when the potential benefit clearly outweighs the potential risk to the fetus. There is limited human data on the safety of lacosamide in pregnancy. Women of childbearing potential should use effective contraception during treatment. If pregnancy occurs, do not stop taking lacosamide without consulting your neurologist, as abrupt discontinuation may cause breakthrough seizures. Discuss the risks and benefits with your healthcare provider.
Lacosamide has a favorable drug interaction profile compared to many older antiepileptic drugs. It has low protein binding, does not significantly induce or inhibit CYP enzymes, and does not affect the levels of most concomitant medications. However, caution is needed when combining lacosamide with other sodium channel-blocking antiepileptics or with PR interval-prolonging drugs due to additive effects. Always inform your healthcare team about all medications and supplements you are taking.
Lacosamide Adroiq is typically administered as an intravenous infusion over 15 to 60 minutes, depending on the clinical situation and the dose being administered. In emergency settings, a 15-minute infusion can be used for rapid loading. For routine maintenance dosing, a 30–60 minute infusion is standard. The infusion rate may be adjusted based on patient tolerance.
References
- European Medicines Agency (EMA). Lacosamide – Summary of Product Characteristics. Last updated 2025. Available from: www.ema.europa.eu
- U.S. Food and Drug Administration (FDA). Lacosamide – Prescribing Information. Revised 2024. Available from: www.accessdata.fda.gov
- Halász P, Kälviäinen R, Mazurkiewicz-Beldzińska M, et al. Adjunctive lacosamide for partial-onset seizures: efficacy and safety results from a randomized controlled trial. Epilepsia. 2009;50(3):443-453.
- Ben-Menachem E, Biton V, Jatuzis D, et al. Efficacy and safety of oral lacosamide as adjunctive therapy in adults with partial-onset seizures. Epilepsia. 2007;48(7):1308-1317.
- Chung S, Sperling MR, Biton V, et al. Lacosamide as adjunctive therapy for partial-onset seizures: a randomized controlled trial. Epilepsia. 2010;51(6):958-967.
- International League Against Epilepsy (ILAE). Updated ILAE Evidence Review of Antiseizure Medication Efficacy and Effectiveness as Initial Monotherapy for Epileptic Seizures and Syndromes. Epilepsia. 2022;63(8):1-12.
- National Institute for Health and Care Excellence (NICE). Epilepsies in children, young people and adults. NICE guideline NG217. Updated 2024. Available from: www.nice.org.uk
- Krauss GL, Edwards HB, Lin X, et al. Lacosamide IV formulation: bridging pharmacokinetic study in epilepsy patients with partial-onset seizures. Epilepsy Research. 2012;98(2-3):178-184.
- Wechsler RT, Li G, French J, et al. Conversion to lacosamide monotherapy in the treatment of focal epilepsy: results from a historical-controlled, multicenter, double-blind study. Epilepsia. 2014;55(7):1088-1098.
- World Health Organization (WHO). Model List of Essential Medicines – 23rd list, 2023. Geneva: WHO; 2023.
Medical Editorial Team
This article has been reviewed and approved by the iMedic Medical Review Board, consisting of licensed specialist physicians in neurology, epileptology, and clinical pharmacology.
Medical Content Team
Specialist physicians in neurology and clinical pharmacology with expertise in epilepsy management and antiepileptic drug therapy
Medical Review Board
Independent panel of medical experts who review all content according to ILAE, EMA, FDA, and NICE guidelines
Evidence Standards
GRADE framework Level 1A – based on systematic reviews and randomized controlled trials (SP667, SP754, SP755)
Editorial Independence
No pharmaceutical company sponsorship or advertising. Independent medical editorial content funded entirely by iMedic
Last medical review: • Content version: 1.0 • Next scheduled review: