Lacosamide
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Lacosamide is an antiseizure medication used for focal-onset seizures and primary generalized tonic-clonic seizures in appropriate patients. Its signature safety concern is dose-dependent PR-interval prolongation, which can worsen atrioventricular block or bradyarrhythmias in susceptible patients. It is a Schedule V controlled substance in the United States.
Exploratory record, not a reviewed medical publication.
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This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.
What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Lacosamide is an antiseizure medication used for focal-onset seizures and primary generalized tonic-clonic seizures in appropriate patients. NutriStack rates the supporting evidence as strong. Common adult dosing is Adjunctive therapy often starts at 50 mg twice daily; monotherapy may start at 100 mg twice daily. Usual maintenance is 100-200 mg twice daily; maximum recommended dose is 200 mg twice daily., though a prescriber sets the actual dose. This profile indexes 3 sources.
The bottom line
Evidence rating strong. Most-documented uses: monotherapy or adjunctive treatment of focal-onset seizures, adjunctive treatment of primary generalized tonic-clonic seizures in labeled populations, oral and intravenous formulations allow inpatient transitions. 3 sources indexed (2007–2025), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Lacosamide selectively enhances slow inactivation of voltage-gated sodium channels, stabilizing hyperexcitable neuronal membranes without substantially affecting fast sodium-channel inactivation. This reduces repetitive neuronal firing and seizure propagation. It can prolong cardiac PR interval, so patients with conduction disease or other PR-prolonging drugs need ECG-focused caution.1,2
Dosing & protocol.
May be taken with or without food. Oral bioavailability is high, and IV can substitute when oral dosing is temporarily not feasible.
Full safety detail.
Side effects
- Dizziness
- Headache
- Diplopia
- Nausea
- Somnolence
- Ataxia
- PR interval prolongation
- Atrioventricular block or bradyarrhythmia in susceptible patients
- Syncope
- DRESS or multiorgan hypersensitivity
- Suicidal thoughts or behavior warning for antiepileptic drugs
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Randomized controlled trials
1- 1Efficacy and safety of oral lacosamide as adjunctive therapy in adults with partial-onset seizuresBen-Menachem E et al. · Epilepsia · 2007
Randomized trial evidence supports lacosamide efficacy as adjunctive therapy for partial-onset seizures.
Reviews & position papers
1- 2Lacosamide: a review of its use as adjunctive therapy in the management of partial-onset seizuresHoy SM · CNS Drugs · 2013
Review summarizes clinical efficacy, tolerability, and conduction-related cautions.
Reference material
1- 3LACOSAMIDE tablets, US Prescribing InformationURLU.S. National Library of Medicine · DailyMed · 2025
Labeling describes dosing, Schedule V status, PR interval warning, ECG recommendations in high-risk patients, and 13-hour half-life.
Common questions.
Quick answers about Lacosamide, drawn from the data on this page.
What is Lacosamide?
Lacosamide is an antiseizure medication used for focal-onset seizures and primary generalized tonic-clonic seizures in appropriate patients. Its signature safety concern is dose-dependent PR-interval prolongation, which can worsen atrioventricular block or bradyarrhythmias in susceptible patients. It is a Schedule V controlled substance in the United States.
What is Lacosamide used for?
Commonly cited benefits of Lacosamide include: Monotherapy or adjunctive treatment of focal-onset seizures; Adjunctive treatment of primary generalized tonic-clonic seizures in labeled populations; Oral and intravenous formulations allow inpatient transitions. NutriStack rates the overall evidence as strong.
What is a typical dose of Lacosamide?
A typical adult dose of Lacosamide is Adjunctive therapy often starts at 50 mg twice daily; monotherapy may start at 100 mg twice daily. Usual maintenance is 100-200 mg twice daily; maximum recommended dose is 200 mg twice daily.. The commonly recommended form is Oral tablet, oral solution, or intravenous infusion; extended-release capsule for selected patients. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Lacosamide?
Reported side effects include dizziness, headache, diplopia, nausea, somnolence, ataxia. This is educational information; check with a healthcare professional before use.
How strong is the evidence for Lacosamide?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Lacosamide in NutriStack.
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