Lacomax
Generic Name
Lacosamide
Manufacturer
Acme Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lacomax 50 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Lacomax 50 mg Tablet contains Lacosamide, an antiepileptic drug used to treat focal-onset seizures (partial-onset seizures) in adults, adolescents, and children from 4 years of age. It can be used alone (monotherapy) or in combination with other anti-epileptic medicines (adjunctive therapy).
Uses & Indications
Dosage
Adults
Monotherapy: Initially 50 mg twice daily, increased weekly by 50 mg twice daily up to a maintenance dose of 100 mg to 200 mg twice daily. Adjunctive therapy: Initially 50 mg twice daily, increased weekly by 50 mg twice daily up to a maintenance dose of 100 mg to 200 mg twice daily.
Elderly
No specific dose adjustment is required based on age alone. However, age-related decrease in renal clearance should be considered, and dose adjustments may be needed in elderly patients with impaired renal function.
Renal_impairment
For patients with mild to moderate renal impairment (creatinine clearance >30 mL/min to <80 mL/min), no dose adjustment is necessary. For patients with severe renal impairment (creatinine clearance ≤30 mL/min), a maximum dose of 300 mg/day is recommended. For patients on hemodialysis, an additional dose of up to 50% of the daily dose should be considered after dialysis.
How to Take
Lacomax 50 mg Tablet should be taken orally, with or without food, usually twice a day (morning and evening). Swallow the tablet whole with a glass of water. Do not crush or chew it.
Mechanism of Action
Lacosamide selectively enhances slow inactivation of voltage-gated sodium channels (VGSCs), resulting in stabilization of hyperexcitable neuronal membranes and inhibition of repetitive neuronal firing. This mechanism is distinct from other antiepileptic drugs that act on VGSCs.
Pharmacokinetics
Onset
Within a few hours of administration, reaching steady-state plasma concentrations within 3 days.
Excretion
Mainly renal excretion. Approximately 95% of the dose is excreted in the urine, with about 40% as unchanged drug and 30% as the O-desmethyl metabolite.
Half life
Approximately 13 hours.
Absorption
Rapid and complete oral absorption with approximately 100% bioavailability. Peak plasma concentrations are reached 0.5 to 4 hours post-oral administration.
Metabolism
Primarily by hydrolysis (approximately 30-40%) to inactive O-desmethyl metabolite. Minor metabolism by CYP2C19, CYP3A4, and CYP2C9 enzymes. Less than 10% of Lacosamide is metabolized by these pathways.
Side Effects
Contraindications
- Hypersensitivity to the active substance Lacosamide or to any of the excipients.
- Known second- or third-degree atrioventricular (AV) block.
Drug Interactions
Strong CYP2C19 inhibitors (e.g., fluconazole, fluvoxamine)
May increase Lacosamide exposure, caution advised and potential dose reduction.
Strong enzyme inducers (e.g., rifampicin, carbamazepine, phenytoin, phenobarbital)
May reduce the plasma concentration of Lacosamide, potentially requiring dose adjustment.
Drugs known to prolong PR interval (e.g., beta-blockers, calcium channel blockers, digoxin)
Use with caution due to potential additive effects on cardiac conduction. ECG monitoring may be considered.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, nausea, vomiting, nystagmus, tremor, ataxia, convulsions/seizures, and cardiac conduction abnormalities (e.g., prolonged PR interval, AV block). Management involves supportive care, including gastric lavage or activated charcoal if appropriate, and close monitoring of vital signs and cardiac function.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted into human milk; therefore, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Check the expiry date on the packaging.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Generically available
Clinical Trials
Lacosamide has been extensively studied in various randomized, placebo-controlled clinical trials for the treatment of focal-onset seizures in both monotherapy and adjunctive therapy settings. These trials demonstrated its efficacy and safety profile.
Lab Monitoring
- Routine liver function tests may be considered. ECG monitoring is recommended before initiating Lacosamide and after dose titration in patients with underlying cardiac conditions or those taking other drugs that prolong the PR interval.
Doctor Notes
- Counsel patients on the risk of suicidal thoughts and behaviors and advise them to report any mood or behavioral changes.
- Monitor for cardiac conduction abnormalities, especially in patients with pre-existing cardiac disease or those on concomitant medications that affect the PR interval.
- Titrate dose gradually to minimize adverse effects, particularly dizziness and ataxia.
Patient Guidelines
- Take Lacomax exactly as prescribed by your doctor.
- Do not stop taking Lacomax suddenly, as this may lead to an increase in seizures. Any dose reduction or discontinuation should be gradual and under medical supervision.
- Report any unusual changes in mood or behavior, including thoughts of self-harm, to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Lacomax may cause dizziness, blurred vision, or drowsiness. Patients should be advised not to drive or operate complex machinery until they have gained sufficient experience with Lacosamide to assess whether it adversely affects their ability to perform such tasks.
Lifestyle Advice
- Avoid driving or operating heavy machinery until you know how Lacosamide affects you, as it can cause dizziness and drowsiness.
- Avoid alcohol consumption while taking this medicine, as it may enhance CNS depressant effects.
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