A medicine to help walking in MS
Fampridine
A tablet that can improve walking speed in some people with multiple sclerosis, with a seizure risk and a need to consider kidney function.
What is Fampridine?
Fampridine is a tablet taken to improve walking in some adults with multiple sclerosis who have difficulty walking. It works on the nerves to help signals travel more effectively along damaged pathways, which can improve walking speed for those who respond. It does not treat the underlying disease and is only continued if it clearly helps. Its main safety concern is a risk of seizures, so it must not be used by people with a history of seizures, and it depends on the kidneys to clear it, so kidney function is checked before and during use.
Education and reference only. This is a plain-language guide to Fampridine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Fampridine is an oral medicine used specifically to improve walking ability in adults with multiple sclerosis who have a walking problem. It is not a disease-modifying treatment and does not slow the MS itself; instead, it aims to improve a symptom. It is taken as a modified-release tablet twice a day. Only some people respond, so it is usually trialled for a short period and continued only if a clear improvement in walking is seen.
How it works
In multiple sclerosis, the protective coating around nerves is damaged, which leaks electrical signals and slows the messages that control movement. Fampridine blocks tiny channels on the nerves in a way that helps the signal keep travelling along these damaged nerves, which can improve walking speed in people who respond. Because it makes nerves more excitable, it can also lower the threshold for seizures, which is the basis of its main safety warning. It is removed from the body mainly through the kidneys.
Company & origin
Originated / developed by: Biogen.
An oral medicine used in the UK to improve walking ability in some adults with multiple sclerosis.
Practical use
How to take Fampridine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the tablets by mouth twice a day, swallowed whole without crushing or chewing.
- Take the doses spaced apart as directed, usually on an empty stomach, and never take extra to catch up on a missed dose.
- Understand that it is a trial: it will only be continued if your walking clearly improves.
- Tell your team immediately if you have any blackout, fit or seizure-like episode, and stop the medicine.
- Attend kidney-function blood tests before starting and during treatment.
- Report dizziness, balance problems or urinary symptoms to your healthcare team.
Weighing it up
Advantages & disadvantages of Fampridine
Advantages
- Can improve walking speed and ease in people with MS who respond to it.
- Taken as a tablet, targeting a specific and often disabling symptom.
- Used as a short trial, so it is only continued if it genuinely helps.
Disadvantages
- Carries a risk of seizures and must not be used by anyone with a history of seizures.
- Depends on the kidneys, so it is unsuitable for people with reduced kidney function.
- Helps only some people and does not treat the underlying multiple sclerosis.
Practical use
Good to know
Fampridine helps only a proportion of people, so it is started as a trial and stopped if walking does not clearly improve within a short assessment period. The most important safety point is that it can trigger seizures, so it must not be used by anyone who has ever had a seizure, and any new blackout or fit should be reported and the medicine stopped. Because the kidneys clear it, kidney function is checked before starting and during treatment, and it is avoided if the kidneys do not work well enough, as levels can build up and increase the seizure risk. Taking more than prescribed is dangerous. Other effects can include dizziness, balance problems, insomnia and urinary infections.
Who should not take it / use with caution
- Anyone who has ever had a seizure must not take it.
- People with reduced kidney function should not use it, as levels can build up dangerously.
- It is avoided alongside certain other medicines that affect the same kidney clearance pathway.
Monitoring
- Kidney-function blood tests before starting and during treatment.
- A short trial assessment of walking to decide whether to continue.
- Watching for seizures, dizziness or balance problems.
Side effects
- Dizziness, balance problems, headache and difficulty sleeping.
- Urinary tract infections and nausea.
- Rarely, seizures, which is why it must be stopped and reviewed if one occurs.
Key interactions
- It should not be combined with other medicines that block the same kidney transport pathway, as this can raise its levels.
- Caution is needed with other medicines that can lower the seizure threshold.
- Tell your prescriber about all your medicines, including those for the kidneys and bladder.
Available as: Modified-release tablets taken by mouth.
Answers
Fampridine: frequently asked questions
What does fampridine actually do?
It can improve walking speed and ease in some people with MS by helping nerve signals travel along damaged nerves; it does not treat the MS itself.
Why can't I take it if I've had a seizure?
The medicine can make nerves more excitable and trigger seizures, so it must not be used by anyone with a history of seizures.
Why are my kidneys checked?
The medicine is cleared by the kidneys, so if they do not work well enough, levels can build up and increase the seizure risk; kidney function is checked before and during use.
How will I know if it is working?
It is started as a trial, and your walking is assessed over a short period; it is only continued if there is a clear improvement.
Can I take an extra tablet if I forget one?
No. Never take extra to make up for a missed dose, as taking more than prescribed increases the risk of seizures.
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.