Drug Detail:Motpoly xr (Lacosamide)
Generic Name: LACOSAMIDE 100mg
Dosage Form: capsule, extended release
Drug Class: Miscellaneous anticonvulsants
Dosage Information
The recommended dosage for monotherapy and adjunctive therapy for partial-onset seizures in adults and in pediatric patients weighing at least 50 kg is included in Table 1. Dosage should be increased based on clinical response and tolerability, no more frequently than once per week. Titration increments should not exceed those shown in Table 1.
| Age and Body Weight | Initial Dosage | Titration Regimen | Maintenance Dosage |
|---|---|---|---|
| Adults (17 years and older) | Monotherapy**: 200 mg once daily Adjunctive Therapy: 100 mg once daily |
Increase by 100 mg once daily every week | Monotherapy**: 300 mg to 400 mg once daily Adjunctive Therapy: 200 mg to 400 mg once daily |
| Pediatric patients weighing at least 50 kg | 100 mg once daily | Increase by 100 mg once daily every week | Monotherapy**: 300 mg to 400 mg once daily Adjunctive Therapy: |
*when not specified, the dosage is the same for monotherapy for partial-onset seizures and adjunctive therapy for partial-onset seizures.
**Monotherapy for partial-onset seizures only
In adjunctive clinical trials in adult patients with partial-onset seizures, a dosage higher than 400 mg per day was not more effective and was associated with a substantially higher rate of adverse reactions [see Adverse Reactions (6.1) and Clinical Studies (14.2)] .
Converting From a Single Antiepileptic (AED) to MOTPOLY XR Monotherapy for the Treatment of Partial-Onset Seizures
For patients who are already on a single AED and will convert to MOTPOLY XR monotherapy, withdrawal of the concomitant AED should not occur until the therapeutic dosage of MOTPOLY XR is achieved and has been administered for at least 4 days. A gradual withdrawal of the concomitant AED over at least 6 weeks is recommended.
Dosage Information for Patients with Renal Impairment
For patients with mild to moderate renal impairment, no dosage adjustment is necessary.
For patients with severe renal impairment [creatinine clearance (CL CR) less than 30 mL/min as estimated by the Cockcroft-Gault equation for adults; CL CR less than 30 mL/min/1.73m 2 as estimated by the Schwartz equation for pediatric patients] or end-stage renal disease, the maximum recommended dosage is 300 mg.
In all patients with renal impairment, dose initiation and titration should be based on clinical response and tolerability.
Dosage Information for Patients with Hepatic Impairment
For patients with mild or moderate hepatic impairment, the maximum recommended dosage is 300 mg. The dose initiation and titration should be based on clinical response and tolerability in patients with hepatic impairment. MOTPOLY XR use is not recommended in patients with severe hepatic impairment.
