Lacosamide
Clinical data | |
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Trade names | Vimpat |
Other names | (2R)-2-(acetylamino)-N-benzyl-3-methoxypropanamide |
AHFS/Drugs.com | Monograph |
MedlinePlus | a609028 |
License data |
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Pregnancy category |
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Routes of administration | By mouth, intravenous |
ATC code | |
Legal status | |
Legal status | |
Pharmacokinetic data | |
Bioavailability | High |
Elimination half-life | 13 hours |
Excretion | Kidney |
Identifiers | |
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JSmol) | |
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Lacosamide, sold under the brand name Vimpat among others, is a
It is available as a
Medical uses
Lacosamide is
Off-label use
As with other
Contraindications
The
Side effects
Lacosamide was generally well tolerated in adult patients with partial-onset seizures.
Gastrointestinal
A generally well-tolerated drug, the most commonly reported gastrointestinal side effects of lacosamide are nausea, vomiting, and diarrhea.[10]
Central nervous system
Psychiatric
Cardiovascular
There is the risk of
Allergies
There have been reports of
Warnings
Suicidal behavior and ideation have been observed as early as one week after starting treatment with lacosamide, and is an
In pregnancy
In a study conducted to assess the
Overdose
There is no known antidote in the event of an overdose.[15]
Pharmacology
Pharmacodynamics
Lacosamide is a functionalized amino acid that produces activity in the maximal electroshock seizure (MES) test, that, like some other
Lacosamide does not affect
Preclinical research
In preclinical trials, the effect of lacosamide administration on animal models of epilepsy was tested using the Frings audiogenic seizures (AGS)-susceptible mouse model of seizure activity with an effective dose (ED50) of 0.63 mg/kg, i.p..[23] The effect of lacosamide was also assessed using the MES test to detect inhibition of seizure spread.[24][25] Lacosamide administration was successful in preventing the spread of seizures induced by MES in mice (ED50 = 4.5 mg/kg, i.p.) and rats (ED50 = 3.9 mg/kg, p.o.).[23] In preclinical trials, administration of lacosamide in combination with other AEDs resulted in synergistic anticonvulsant effects. Lacosamide produced effects in animal models of essential tremor, tardive dyskinesia, schizophrenia, and anxiety.[26] Preclinical trials found the S-stereoisomer to be less potent than the R-stereoisomer in the treatment of seizures.[27]
Pharmacokinetics
When administered orally in healthy individuals, lacosamide is rapidly absorbed from the
The
Chemistry
Lacosamide is a powdery, white to light yellow crystalline compound. The chemical name of lacosamide is (R)-2-acetamido-N-benzyl-3-methoxypropionamide and the systemic name is N2-Acetyl-N-benzyl-O-methyl-D-serinamide.
Synthesis
The following three-step synthesis of lacosamide was proposed in 1996.
(R)-2-amino-3-hydroxypropanoic acid is treated with
More efficient routes to synthesis have been proposed in recent years, including the following.[40]
History
Lacosamide was discovered at the University of Houston in 1996.[39][42] They hypothesized that modified amino acids may be therapeutically useful in the treatment of epilepsy. A few hundred such molecules were synthesized over several years and these were tested phenotypically in an epilepsy disease model performed in rats. N-benzyl-2-acetamido-3-methoxypropionamide was found to be highly efficacious in this model, with the biological activity traced specifically to its R enantiomer.[39]
This compound was to become lacosamide after being licensed by Schwarz Pharma, which completed its pre-clinical and early clinical development. After its purchase of Schwarz Pharma in 2006, UCB completed the clinical development program and obtained marketing approval for lacosamide. Its precise mechanism of action was unknown at the time of approval, and the exact amino acid targets involved remain uncertain to this day.[16]
The U.S. Food and Drug Administration (FDA) accepted UCB's New Drug Application for lacosamide as of November 29, 2007, beginning the approval process for the drug.[43][44] UCB also filed for marketing approval in the European Union (EU); the European Medicines Agency accepted the marketing application for review in May 2007.[43][45]
The drug was approved in the EU on September 3, 2008.[46] It was approved in the US on October 29, 2008.[47] The release of lacosamide was delayed owing to an objection about its placement into schedule V of the Controlled Substances Act. The FDA issued their final rule of placement into Schedule V on June 22, 2009.[48]
Lacosamide's US patent expired on March 17, 2022.[49]
Partial-onset seizures
Lacosamide was tested in three placebo-controlled,
Peripheral neuropathy
In a smaller trial of patients with diabetic neuropathy, lacosamide also provided significantly better pain relief when compared to placebo.[52] Lacosamide administration in combination with 1-3 other AEDs was well tolerated in patients. Lacosamide administered at 400 mg/day was found to significantly reduce pain in patients with diabetic neuropathy in a multi center, double-blind, placebo-controlled Phase III trial with a treatment duration of 18 weeks.[53]
A small (n=24) study for small fiber peripheral neuropathy also showed positive results.[54]
Society and culture
Names
Lacosamide is the international nonproprietary name (INN). It was formerly known as erlosamide, harkoseride, SPM-927, and ADD 234037.[21]
Lacosamide is sold under the brand name Vimpat by UCB, and under the brand name Motpoly XR by Acute Pharmaceuticals.[55][56] In Pakistan, it is marketed by G.D. Searle as Lacolit.[57]
Research
This section needs to be updated.(March 2022) |
Clinical trials are underway for the use of lacosamide as monotherapy for partial-onset seizures.[50] There is no evidence that lacosamide provides additional value over current antiepileptic drugs (AEDs) for the treatment of partial-onset seizures, but it may offer a safety advantage.[33] Newer AEDs, including lacosamide, vigabatrin, felbamate, gabapentin, tiagabine, and rufinamide have been found to be more tolerable and safer than older drugs such as carbamazepine, phenytoin, and valproate.[58]
References
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- ^ a b c d e "Vimpat- lacosamide tablet, film coated VIMPAT- lacosamide kit VIMPAT- lacosamide injection VIMPAT- lacosamide solution". DailyMed. December 13, 2021. Archived from the original on March 25, 2022. Retrieved March 24, 2022.
- ^ "Lacosamide Adroiq". Union Register of medicinal products. June 1, 2023. Retrieved June 6, 2023.
- ^ "Drugs@FDA: Lacosamide". U.S. Food and Drug Administration (FDA). Archived from the original on March 25, 2022. Retrieved March 24, 2022.
- ^ "2022 First Generic Drug Approvals". U.S. Food and Drug Administration (FDA). March 3, 2023. Archived from the original on June 30, 2023. Retrieved June 30, 2023.
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- ^ Vimpat Side Effects Center http://www.rxlist.com/vimpat-side-effects-drug-center.html Archived August 21, 2016, at the Wayback Machine
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- ^ "SCHWARZ PHARMA Highlights the Results of 13 Lacosamide Data Presentations at North American Regional Epilepsy Congress in San Diego". Schwarz Pharma. December 5, 1996. Archived from the original on June 25, 2016. Retrieved April 2, 2014.
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- ^ a b "UCB Announces FDA Filing for lacosamide in the Treatment of Diabetic Neuropathic Pain" (Press release). UCB. November 29, 2007. Archived from the original on September 25, 2008. Retrieved November 29, 2007.
- ^ "UCB Announces FDA Filing for lacosamide in the Treatment of Partial Onset Seizures in Adults with Epilepsy" (Press release). UCB. November 29, 2007. Archived from the original on September 25, 2008. Retrieved November 29, 2007.
- ^ Wan Y (August 17, 2007). "Marketing application for lacosamide (Vimpat) filed in EU for treatment of diabetic neuropathic pain". PharmaTimes through the UK National electronic Library for Medicines. Archived from the original on February 9, 2012. Retrieved November 30, 2007.
- ^ "Vimpat Approved in Europe" (Press release). UCB. September 3, 2008. Archived from the original on September 19, 2008. Retrieved September 17, 2008.
- ^ "UCB's Vimpat approved by U.S. FDA as adjunctive therapy for partial onset seizures in adults" (Press release). UCB. October 29, 2008. Archived from the original on November 14, 2008. Retrieved November 25, 2008.
- ^ "FDA places lacosamide in Schedule V" (Press release). U.S. Food and Drug Administration (FDA). June 22, 2009. Retrieved June 28, 2009.
- ^ "Generic Vimpat Availability". Drugs.com. Archived from the original on January 13, 2022. Retrieved January 13, 2022.
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- ^ "Lacosamide". Epilepsy Foundation. February 22, 2023. Retrieved July 5, 2023.
- ^ "Motpoly XR (lacosamide) – New drug approval". professionals.optumrx.com. Retrieved July 5, 2023.
- ^ "Alternate brands of LACOLIT". www.druginfosys.com. Retrieved July 5, 2023.
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Further reading
- Dean L (2018). "Lacosamide Therapy and CYP2C19 Genotype". In Pratt VM, McLeod HL, Rubinstein WS, Scott SA, Dean LC, Kattman BL, et al. (eds.). Medical Genetics Summaries. PMID 29671994. Bookshelf ID: NBK493589.
External links
- "Lacosamide". Drug Information Portal. U.S. National Library of Medicine.