【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，不建議用於有骨折風險之老年人(除非用於癲癇、調節情緒)。

Monotherapy for focal (partial) onset seizures; Adjunctive therapy for complex partial seizure, simple or complex partial seizure with secondary generalization, primary generalized tonic–clonic seizures combined with idiopathic generalized epilepsy<20230807>.

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Antiseizure Agent, Miscellaneous

Absorption: Completely.
Distribution: Vd: ~0.6 L/kg.
Protein binding: <15%.
Metabolism: Hepatic via CYP3A4, CYP2C9, and CYP2C19; forms metabolite, O-desmethyl-lacosamide (inactive).
Bioavailability: ~100%.
Time to peak, plasma: 1 to 4 hours.
Excretion: Urine ; feces.

Hypersensitivity to lacosamide or any component of the formulation; second- or third-degree atrioventricular (AV) block.

Lacosamide is present in breast milk.

>10%: nausea (up to 24% ), dizziness (16% to 30% ), headache (11% to 16% ), diplopia (9% to 11% ).
1% to 10%: pruritus (2% to 3%), diarrhea (5%), vomiting (6% to 9%), bruise (4%), abnormal gait (2%), asthenia (2%), ataxia (4% to 7%), balance impairment (1% to 5%), depression (2%), fatigue (7%), tremor (6%), vertigo (3% to 5%), blurred vision (9%), diplopia (6% to 10%), nystagmus disorder (5%), laceration (3%).

Monotherapy for focal (partial) onset seizures; Adjunctive therapy for complex partial seizure, simple or complex partial seizure with secondary generalization, primary generalized tonic–clonic seizures combined with idiopathic generalized epilepsy<20230807>.

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recommended dose for people>50kg

-	Monotherapy	Adjunctive therapy
Initial	100mg/day, 200mg/day	100mg/day
loading dose	200mg	200mg
dose adjustment	increased at weekly intervals by 50 mg twice daily	increased at weekly intervals by 50 mg twice daily
maximum	400mg/day	400mg/day

Infants, Children, and Adolescents <17 years:
Seizures, focal (partial) onset:
<6 kg:
Initial: 1 mg/kg/dose twice daily; may be increased at weekly intervals by 1 mg/kg/dose twice daily based on response and tolerability.
Maintenance: 3.75 to 7.5 mg/kg/dose twice daily.
6 to <30 kg:
Initial: 1 mg/kg/dose twice daily; may be increased at weekly intervals by 1 mg/kg/dose twice daily based on response and tolerability.
Maintenance: 3 to 6 mg/kg/dose twice daily.
30 to <50 kg:
Initial: 1 mg/kg/dose twice daily; may be increased at weekly intervals by 1 mg/kg/dose twice daily based on response and tolerability.
Maintenance: Oral, IV: 2 to 4 mg/kg/dose twice daily.
Seizures, primary generalized tonic-clonic and ≥ 4years; adjunctive therapy:
11 to <30 kg:
Initial: 1 mg/kg/dose twice daily; may be increased at weekly intervals by 1 mg/kg/dose twice daily based on response and tolerability.
Maintenance: 3 to 6 mg/kg/dose twice daily.
30 to <50 kg:
Initial: 1 mg/kg/dose twice daily; may be increased at weekly intervals by 1 mg/kg/dose twice daily based on response and tolerability.
Maintenance: 2 to 4 mg/kg/dose twice daily.
Seizures, refractory:
Initial: 0.5 to 1 mg/kg/dose twice daily (usual maximum initial dose: 50 mg/dose); may titrate by 0.5 to 1 mg/kg/dose weekly based on response and tolerability.
Mean maintenance dose: 3.6 mg/kg/dose; reported range: 0.5 to 10 mg/kg/dose twice daily

Mild to moderate impairment: No dosage adjustment is necessary.
Severe impairment: reduce maximum dosage by 25%.
Renal impairment and taking a concomitant strong inhibitor of CYP3A4 or CYP2C9:dose reduction may be necessary .

Mild to moderate impairment: Titrate dose cautiously and reduce maximum dosage by 25%.
Severe impairment: Use is not recommended.
Hepatic impairment and taking a concomitant strong inhibitor of CYP3A4 or CYP2C9: dose reduction may be necessary.

store under 25 degree C