An anti-epileptic (anti-seizure) medicine
Lacosamide
An anti-epileptic medicine used to help control focal (partial) seizures, on its own or with other treatments.
What is Lacosamide?
Lacosamide is an anti-epileptic (anti-seizure) medicine used mainly for focal (partial) seizures. It calms over-active electrical signals in the brain to reduce how often seizures happen. It does not cure epilepsy, should not be stopped suddenly, and your doctor may check your heart rhythm before and during treatment.
Education and reference only. This is a plain-language guide to Lacosamide — 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
Lacosamide is a newer anti-epileptic medicine used to help control focal (partial) seizures, the type that start in one part of the brain. It can be used on its own or alongside other anti-seizure medicines. It does not cure epilepsy but aims to reduce how often seizures happen. It is taken long-term as tablets, a liquid, or sometimes given as an infusion in hospital.
How it works
Seizures happen when brain cells fire electrical signals in an abnormal, excessive way. Lacosamide works on sodium channels in nerve cells in a way that helps stabilise over-active nerves, making it harder for seizures to build up and spread. By calming this electrical activity, it can reduce how often seizures occur.
Company & origin
Originated / developed by: UCB (originator).
A newer anti-seizure medicine introduced to help control focal (partial) epileptic seizures.
What it treats
Conditions Lacosamide is used for
Practical use
How to take Lacosamide
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is usually taken twice a day, at evenly spaced times such as morning and evening.
- It can be taken with or without food; a liquid form is available if you find tablets hard to swallow.
- Take it regularly at the same times each day to keep seizure control steady.
- Do not stop taking it suddenly; any changes should be made slowly under your doctor's guidance.
- If you miss a dose, take it as soon as you remember unless it is almost time for the next; never take two doses together.
Weighing it up
Advantages & disadvantages of Lacosamide
Advantages
- Helps reduce focal (partial) seizures, on its own or with other medicines.
- Available as tablets, a liquid and a hospital infusion, giving flexible options.
- Generally has fewer drug interactions than some older anti-seizure medicines.
Disadvantages
- Does not cure epilepsy and must be taken consistently long-term.
- Commonly causes dizziness, double vision and unsteadiness, especially as the dose goes up.
- Can affect heart-rhythm timing, so may need an ECG and caution with some heart medicines.
Practical use
Good to know
Lacosamide is usually started at a low dose and increased gradually to reduce dizziness and other early side effects. Dizziness, double vision and unsteadiness are common, especially at higher doses, and may improve with time. Because it can slightly affect the heart's electrical timing (the PR interval), your doctor may check an ECG (heart tracing) before or during treatment, particularly if you have heart problems or take other medicines that affect the heart. Like all anti-seizure medicines, it should never be stopped suddenly, as this can trigger seizures. If you are pregnant or planning a pregnancy, discuss it with your specialist before making changes.
Who should not take it / use with caution
- People with certain heart-rhythm problems, such as some types of heart block, need caution or may be unsuitable.
- People with severe liver or kidney problems may need a different dose or closer monitoring.
- People who have had an allergic reaction to lacosamide should not take it.
Monitoring
- An ECG (heart tracing) may be checked before or during treatment, especially with heart problems.
- Seizure frequency, dizziness and vision are reviewed as the dose is adjusted.
- Mood and mental wellbeing are monitored, as with all anti-seizure medicines.
Side effects
- Common: dizziness, double or blurred vision, headache, nausea, unsteadiness and tiredness.
- It can affect heart-rhythm timing; report palpitations, fainting or a very slow or irregular heartbeat.
- Seek help for mood changes or thoughts of self-harm, which can rarely occur with anti-seizure medicines.
Key interactions
- Other medicines that affect heart-rhythm timing (the PR interval) add to the effect and may need an ECG.
- Alcohol and other sedating medicines can increase drowsiness and dizziness.
- Some anti-seizure and other medicines can change how lacosamide is handled, so tell your doctor about all medicines.
Available as: Tablets, an oral liquid, and a solution for infusion (used in hospital).
Answers
Lacosamide: frequently asked questions
Can I stop lacosamide if my seizures stop?
No. Stopping suddenly can trigger seizures. Any change must be made slowly and only on your specialist's advice.
Why might I need an ECG?
Lacosamide can slightly affect the heart's electrical timing. An ECG may be done before or during treatment, especially if you have heart problems or take heart medicines.
Why do I feel dizzy or see double?
Dizziness and double vision are common, particularly as the dose increases. They often improve with time, but tell your doctor if they are troublesome.
Does it interact with many medicines?
It generally has fewer interactions than some older anti-seizure medicines, but it can add to heart-rhythm and sedative effects, so list all your medicines.
Is it safe in pregnancy?
All anti-seizure medicines need careful discussion in pregnancy. Speak to your specialist before planning a pregnancy or making any changes.
The wider class
About Antiepileptic medicines
Lacosamide belongs to the antiepileptic medicines class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.