Vimpat (lacosamide)
An approved treatment for Focal Epilepsy.
The same compound appears under different names depending on the context. Here is how to identify Lacosamide wherever you encounter it, plus the key facts at a glance.
- Generic name
- Lacosamide
- Brand name
- Vimpat
- Development codes
- SPM 927, harkoseride
- Drug class
- Sodium channel modulator (antiseizure medication)
- Manufacturer
- UCB
- How it's taken
- Taken by mouth twice daily as a tablet or liquid, with an intravenous form available in the hospital when someone cannot take pills.
A well-tolerated add-on and standalone seizure medication that works on sodium channels in a distinctive way, enhancing their 'slow inactivation', so it quiets the cells firing most abnormally without heavily sedating the brain.
Where Lacosamide fits
A commonly used add-on and monotherapy option with twice-daily (or extended) dosing and few drug interactions. It is FDA-approved for partial-onset (focal) seizures in patients 1 month and older, and as an add-on for primary generalized tonic-clonic seizures in patients 4 and older. People with certain heart conditions, or who take other medicines that affect heart rhythm, should have an ECG before starting and after reaching a steady dose, because lacosamide can slow the heart's electrical conduction.
How Lacosamide works
Most sodium-channel seizure drugs act on the fast on-off switching of the channel. Lacosamide is different: it promotes what scientists call 'slow inactivation,' a longer resting state the channel enters after prolonged activity. Because the neurons driving a seizure fire rapidly and repeatedly, they spend more time in this vulnerable state, so lacosamide preferentially calms the most overactive cells while leaving normal signaling relatively untouched[3].
Mechanism: Enhances the slow inactivation of voltage-gated sodium channels, selectively dampening repetitively firing neurons
Side effects and safety
Common side effects include dizziness, headache, double vision, and nausea, usually most noticeable when the dose is increased. Because lacosamide can slow electrical conduction through the heart (lengthening the PR interval), doctors are cautious in people with certain heart conditions (such as conduction problems or serious heart disease like heart failure) or who take other medicines that affect heart rhythm, and may order an ECG before starting and once on a steady dose. Rarely, serious heart rhythm problems, including cardiac arrest and death, have been reported, mostly in people with heart disease or on such medicines; get help right away for a slow, fast or irregular heartbeat, chest pain, shortness of breath, lightheadedness or fainting.
As with all antiseizure medications, it carries the class warning about a small increased risk of suicidal thoughts[1]. The label also warns about DRESS, a sometimes fatal whole-body allergic reaction (fever, rash, swollen glands or organ problems) that needs urgent care. Lacosamide can also cause dizziness, unsteady walking and fainting, and it should not be stopped suddenly because seizures may get worse. The oral solution contains aspartame, which matters for people with phenylketonuria (PKU).
This is not a complete list of side effects. Talk to your doctor or pharmacist about what to expect and when to seek medical attention.
Taking Lacosamide
Taken by mouth twice daily as a tablet or liquid, with an intravenous form available in the hospital when someone cannot take pills. It needs only a short, gentle dose build-up. Lacosamide is a Schedule V controlled substance in the U.S. because of mild euphoria reported at high doses[1].
Availability and cost
Generic versions may be available at a lower cost. Ask your pharmacist.
Help paying for Vimpat
Pick your insurance to see which help fits. Drugmaker copay cards can't be used with Medicare, Medicaid or TRICARE; charity funds are the usual route there.
No drugmaker assistance program for this medicine is published on the maker's official pages.
Good to know: Widely available as generic from many makers. Vimpat is not on UCB's current copay or patient assistance lists.
- From a charity · The Assistance FundEpilepsy fundWaitlist
Pays for: Copays, coinsurance, deductibles and other health-related expenses.
The foundation says: “WAITLIST — Accepting Waitlist Patients. TAF is currently accepting requests to join the enrollment waitlist for this program. Waitlists a…”
Clinical trial results
The FDA approved lacosamide in October 2008 as an add-on therapy for focal (partial-onset) seizures in adults, based on placebo-controlled trials showing significant seizure reduction. Later studies supported its use as monotherapy and in children, and a 2020 approval extended it to primary generalized tonic-clonic seizures[2].
Development history
Lacosamide was developed by UCB (originating from Schwarz Pharma) and launched as Vimpat in 2008. It became a popular choice for adjunctive focal-seizure treatment thanks to its clean drug-interaction profile and twice-daily dosing (a once-daily extended-release capsule from another company, Motpoly XR, was approved in 2023), and generic versions became available in the U.S. in 2022[1].
Explore Focal Epilepsy trials
Other Focal Epilepsy treatments
Common questions about Lacosamide
▸What is Lacosamide (Vimpat)?
A well-tolerated add-on and standalone seizure medication that works on sodium channels in a distinctive way, enhancing their 'slow inactivation', so it quiets the cells firing most abnormally without heavily sedating the brain.
▸How does Lacosamide work?
Most sodium-channel seizure drugs act on the fast on-off switching of the channel. Lacosamide is different: it promotes what scientists call 'slow inactivation,' a longer resting state the channel enters after prolonged activity. Because the neurons driving a seizure fire rapidly and repeatedly, they spend more time in this vulnerable state, so lacosamide preferentially calms the most overactive cells while leaving normal signaling relatively untouched[3].
▸What are the side effects of Lacosamide?
Common side effects include dizziness, headache, double vision, and nausea, usually most noticeable when the dose is increased. Because lacosamide can slow electrical conduction through the heart (lengthening the PR interval), doctors are cautious in people with certain heart conditions (such as conduction problems or serious heart disease like heart failure) or who take other medicines that affect heart rhythm, and may order an ECG before starting and once on a steady dose. Rarely, serious heart rhythm problems, including cardiac arrest and death, have been reported, mostly in people with heart disease or on such medicines; get help right away for a slow, fast or irregular heartbeat, chest pain, shortness of breath, lightheadedness or fainting.
As with all antiseizure medications, it carries the class warning about a small increased risk of suicidal thoughts[1]. The label also warns about DRESS, a sometimes fatal whole-body allergic reaction (fever, rash, swollen glands or organ problems) that needs urgent care. Lacosamide can also cause dizziness, unsteady walking and fainting, and it should not be stopped suddenly because seizures may get worse. The oral solution contains aspartame, which matters for people with phenylketonuria (PKU).
▸How is Lacosamide taken?
Taken by mouth twice daily as a tablet or liquid, with an intravenous form available in the hospital when someone cannot take pills. It needs only a short, gentle dose build-up. Lacosamide is a Schedule V controlled substance in the U.S. because of mild euphoria reported at high doses[1].
▸Is Lacosamide FDA approved?
Yes, Lacosamide (Vimpat) is FDA approved (2008) for the treatment of Focal Epilepsy.
▸What is lacosamide (Vimpat) used for?
The FDA approved lacosamide (Vimpat) in October 2008 as an add-on therapy for focal (partial-onset) seizures in adults, based on placebo-controlled trials showing significant seizure reduction. Later studies supported its use as monotherapy and in children, and a 2020 approval extended it to primary generalized tonic-clonic seizures. Generic versions of lacosamide became available in the U.S. in 2022. [2][1]
▸How does lacosamide work?
Most sodium-channel seizure drugs act on the fast on-off switching of the channel, but lacosamide instead promotes what scientists call slow inactivation, a longer resting state the channel enters after prolonged activity. Because the neurons driving a seizure fire rapidly and repeatedly, they spend more time in this vulnerable state, so lacosamide preferentially calms the most overactive cells while leaving normal signaling relatively untouched. [3]
▸What are the side effects of lacosamide?
Common side effects of lacosamide include dizziness, headache, double vision and nausea, usually most noticeable when the dose is increased. Because it can slow electrical conduction through the heart (lengthening the PR interval), doctors are cautious in people with certain heart conditions or on other medicines that affect heart rhythm and may order an ECG before starting; rarely, serious heart rhythm problems, including cardiac arrest, have been reported. Like all antiseizure medications, it carries a class warning about a small increased risk of suicidal thoughts, and the label also warns about DRESS, a sometimes fatal whole-body allergic reaction, and about worsening seizures if it is stopped suddenly. The oral solution contains aspartame, which matters for people with phenylketonuria (PKU). [1]
▸How is lacosamide taken?
Lacosamide is taken by mouth twice daily as a tablet or liquid, with an intravenous form available in the hospital when someone cannot take pills. It needs only a short, gentle dose build-up. Lacosamide is a Schedule V controlled substance in the U.S. because of mild euphoria reported at high doses, and a once-daily extended-release capsule from another company, Motpoly XR, was approved in 2023. [1]
Sources and references
Every factual claim on this page is drawn from the public sources listed below. Click any reference to open the original document.
- U.S. National Library of Medicine, DailyMed. VIMPAT (lacosamide) tablets, injection, oral solution, CV: Prescribing Information (Initial U.S. Approval: 2008). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9e79b42c-38a3-4b2c-a196-a5a1948250e2
- UCB (PR Newswire). UCB's VIMPAT (lacosamide) CV now approved by FDA for primary generalized tonic-clonic seizures and expanded pediatric use. https://www.prnewswire.com/news-releases/ucbs-vimpat-lacosamide-cv-now-approved-by-fda-for-primary-generalized-tonic-clonic-seizures-and-expanded-pediatric-use-for-people-living-with-epilepsy-301174421.html
- PMC. Cenobamate and Drug-Resistant Epilepsy: A Review of the Literature. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456719/