Vimpat

Adult Dosing .

Dosage forms:  TAB: 50 mg, 100 mg, 150 mg, 200 mg; SOL: 10 mg per mL; INJ: various

partial seizures

[monotherapy]

Dose: 150-200 mg PO/IV bid; Start: 100 mg PO/IV bid, incr. by 100 mg/day no more frequently than qwk or start 200 mg PO/IV x1, then 100 mg PO/IV bid 12h later, incr. by 100 mg/day no more frequently than qwk; Max: 400 mg/day; Info: for conversion from AED monotherapy, give lacosamide maint. dose for >3 days before gradual withdrawal of previous AED over >6wk; titrate w/ caution in elderly pts; taper dose over >1wk to D/C

[adjunct tx]

Dose: 100-200 mg PO/IV bid; Start: 50 mg PO/IV bid, incr. by 100 mg/day no more frequently than qwk or start 200 mg PO/IV x1, then 100 mg PO/IV bid 12h later, may incr. by 100 mg/day no more frequently than qwk; Max: 400 mg/day; Info: titrate w/ caution in elderly pts; taper dose over >1wk to D/C

primary generalized tonic clonic seizures, adjunct tx

[100-200 mg PO/IV bid]

Start: 50 mg PO/IV bid, incr. by 100 mg/day no more frequently than qwk or start 200 mg PO/IV x1, then 100 mg PO/IV bid 12h later, may incr. by 100 mg/day no more frequently than qwk; Max: 400 mg/day; Info: titrate w/ caution in elderly pts; taper dose over >1wk to D/C

neuropathic pain, diabetic (off-label)

[100-200 mg PO bid]

Start: 50 mg PO bid x3wk, incr. by 100 mg/day qwk; Max: 400 mg/day; Info: titrate w/ caution in elderly pts; taper dose over >1wk to D/C

renal dosing

[adjust dose amount]

CrCl <30: decr. usual max dose by 25%

HD: decr. usual max dose by 25%; give up to 50% usual dose as supplement after dialysis; PD: not defined

hepatic dosing

[see below]

mild-moderate impairment: decr. usual max dose by 25%; severe impairment: avoid use

Peds Dosing .

Dosage forms:  TAB: 50 mg, 100 mg, 150 mg, 200 mg; SOL: 10 mg per mL; INJ: various

partial seizures, monotherapy

[PO route, 1 mo-16 yo, <6 kg]

Dose: 3.75-7.5 mg/kg/dose PO bid; Start: 1 mg/kg/dose PO bid, incr. by 2 mg/kg/day no more frequently than qwk or start 3.75 mg/kg/dose PO bid, may incr. by 2 mg/kg/day no more frequently than qwk; Info: for conversion from AED monotherapy, give lacosamide maint. dose for >3 days before gradual withdrawal of previous AED over >6wk; taper dose over >1wk to D/C

[IV route, 1 mo-16 yo, <6 kg]

Dose: 2.5-5 mg/kg/dose IV tid; Start: 0.66 mg/kg/dose IV tid, incr. by 2 mg/kg/day no more frequently than qwk or start 2.5 mg/kg/dose IV tid, may incr. by 2 mg/kg/day no more frequently than qwk; Info: for conversion from AED monotherapy, give lacosamide maint. dose for >3 days before gradual withdrawal of previous AED over >6wk; taper dose over >1wk to D/C

[1 mo-16 yo, 6-30 kg]

Dose: 3-6 mg/kg/dose PO/IV bid; Start: 1 mg/kg/dose PO/IV bid, incr. by 2 mg/kg/day no more frequently than qwk or start 4.5 mg/kg/dose PO/IV x1, then 3 mg/kg/dose PO/IV bid 12h later, may incr. by 2 mg/kg/day no more frequently than qwk; Info: for conversion from AED monotherapy, give lacosamide maint. dose for >3 days before gradual withdrawal of previous AED over >6wk; taper dose over >1wk to D/C

[1 mo-16 yo, 30-50 kg]

Dose: 2-4 mg/kg/dose PO/IV bid; Start: 1 mg/kg/dose PO/IV bid, incr. by 2 mg/kg/day no more frequently than qwk or start 4 mg/kg/dose PO/IV x1, then 2 mg/kg/dose PO/IV bid 12h later, may incr. by 2 mg/kg/day no more frequently than qwk; Info: for conversion from AED monotherapy, give lacosamide maint. dose for >3 days before gradual withdrawal of previous AED over >6wk; taper dose over >1wk to D/C

[1 mo-16 yo, >50 kg]

Dose: 150-200 mg PO/IV bid; Start: 50 mg PO/IV bid, incr. by 100 mg/day no more frequently than qwk or start 200 mg PO/IV x1, then 100 mg PO/IV bid 12h later, incr. by 100 mg/day no more frequently than qwk; Info: for conversion from AED monotherapy, give lacosamide maint. dose for >3 days before gradual withdrawal of previous AED over >6wk; taper dose over >1wk to D/C

[17 yo and older]

Dose: 150-200 mg PO/IV bid; Start: 100 mg PO/IV bid, incr. by 100 mg/day no more frequently than qwk or start 200 mg PO/IV x1, then 100 mg PO/IV bid 12h later, incr. by 100 mg/day no more frequently than qwk; Max: 400 mg/day; Info: for conversion from AED monotherapy, give lacosamide maint. dose for >3 days before gradual withdrawal of previous AED over >6wk; taper dose over >1wk to D/C

partial seizures, adjunct tx

[PO route, 1 mo-16 yo, <6 kg]

Dose: 3.75-7.5 mg/kg/dose PO bid; Start: 1 mg/kg/dose PO bid, incr. by 2 mg/kg/day no more frequently than qwk or start 3.75 mg/kg/dose PO bid, may incr. by 2 mg/kg/day no more frequently than qwk; Info: taper dose over >1wk to D/C

[IV route, 1 mo-16 yo, <6 kg]

Dose: 2.5-5 mg/kg/dose IV tid; Start: 0.66 mg/kg/dose IV tid, incr. by 2 mg/kg/day no more frequently than qwk or start 2.5 mg/kg/dose IV tid, may incr. by 2 mg/kg/day no more frequently than qwk; Info: taper dose over >1wk to D/C

[1 mo-16 yo, 6-30 kg]

Dose: 3-6 mg/kg/dose PO/IV bid; Start: 1 mg/kg/dose PO/IV bid, incr. by 2 mg/kg/day no more frequently than qwk or start 4.5 mg/kg/dose PO/IV x1, then 3 mg/kg/dose PO/IV bid 12h later, may incr. by 2 mg/kg/day no more frequently than qwk; Info: taper dose over >1wk to D/C

[1 mo-16 yo, 30-50 kg]

Dose: 2-4 mg/kg/dose PO/IV bid; Start: 1 mg/kg/dose PO/IV bid, incr. by 2 mg/kg/day no more frequently than qwk or start 4 mg/kg/dose PO/IV x1, then 2 mg/kg/dose PO/IV bid 12h later, may incr. by 2 mg/kg/day no more frequently than qwk; Info: taper dose over >1wk to D/C

[1 mo-16 yo, >50 kg]

Dose: 100-200 mg PO/IV bid; Start: 50 mg PO/IV bid, incr. by 100 mg/day no more frequently than qwk or start 200 mg PO/IV x1, then 100 mg PO/IV bid 12h later, may incr. by 100 mg/day no more frequently than qwk; Info: taper dose over >1wk to D/C

[17 yo and older]

Dose: 100-200 mg PO/IV bid; Start: 50 mg PO/IV bid, incr. by 100 mg/day no more frequently than qwk or start 200 mg PO/IV x1, then 100 mg PO/IV bid 12h later, may incr. by 100 mg/day no more frequently than qwk; Max: 400 mg/day; Info: taper dose over >1wk to D/C

primary generalized tonic clonic seizures, adjunct tx

[4-16 yo, 11-30 kg]

Dose: 3-6 mg/kg/dose PO/IV bid; Start: 1 mg/kg/dose PO/IV bid, incr. by 2 mg/kg/day no more frequently than qwk or start 4.5 mg/kg/dose PO/IV x1, then 3 mg/kg/dose PO/IV bid 12h later, may incr. by 2 mg/kg/day no more frequently than qwk; Info: taper dose over >1wk to D/C

[4-16 yo, 30-50 kg]

Dose: 2-4 mg/kg/dose PO/IV bid; Start: 1 mg/kg/dose PO/IV bid, incr. by 2 mg/kg/day no more frequently than qwk or start 4 mg/kg/dose PO/IV x1, then 2 mg/kg/dose PO/IV bid 12h later, may incr. by 2 mg/kg/day no more frequently than qwk; Info: taper dose over >1wk to D/C

[4-16 yo, >50 kg]

Dose: 100-200 mg PO/IV bid; Start: 50 mg PO/IV bid, incr. by 100 mg/day no more frequently than qwk or start 200 mg PO/IV x1, then 100 mg PO/IV bid 12h later, may incr. by 100 mg/day no more frequently than qwk; Info: taper dose over >1wk to D/C

[17 yo and older]

Dose: 100-200 mg PO/IV bid; Start: 50 mg PO/IV bid, incr. by 100 mg/day no more frequently than qwk or start 200 mg PO/IV x1, then 100 mg PO/IV bid 12h later, may incr. by 100 mg/day no more frequently than qwk; Max: 400 mg/day; Info: taper dose over >1wk to D/C

renal dosing

[adjust dose amount]

CrCl <30: decr. usual max dose by 25%

HD: decr. usual max dose by 25%; give up to 50% usual dose as supplement after dialysis; PD: not defined

hepatic dosing

[see below]

mild-moderate impairment: decr. usual max dose by 25%; severe impairment: avoid use