Your Patient Can't Find Lacosamide — Here's How You Can Help

You've written the prescription. The dose is right. The indication is clear. But your patient calls back the next day: their pharmacy doesn't have Lacosamide in stock, and they don't know what to do.

This scenario is increasingly common. While Lacosamide (Vimpat) isn't on the FDA's formal shortage list, pharmacy-level stock-outs continue to affect patients across the country. As a prescriber, you're often the first person patients turn to when they can't fill their medication — and there are concrete steps you can take to help.

Current Availability Landscape

Generic Lacosamide has been on the market since 2022. Multiple manufacturers now produce the drug, and overall supply is adequate at the wholesale level. However, several factors contribute to retail-level availability gaps:

• Manufacturer-specific disruptions: When an individual generic manufacturer experiences production delays, pharmacies sourcing from that supplier may be temporarily without stock
• Schedule V classification: DEA requirements for ordering and inventorying controlled substances add friction to the restocking process
• Formulary-driven ordering: Chain pharmacies may stock only the specific generic manufacturer preferred by their dominant payer contracts, limiting flexibility when that manufacturer has supply issues
• Regional variation: Distribution patterns mean some geographic areas have better access than others at any given time

Why Patients Struggle to Find It

Understanding the patient experience is important. When a pharmacy says "we don't have it," patients often face:

• Confusion about whether to call their doctor or find another pharmacy
• Anxiety about missing doses and the risk of breakthrough seizures
• Difficulty navigating the system — most patients don't know they can transfer prescriptions or ask about different formulations
• Limited awareness of tools that can help them check stock at multiple pharmacies

For patients who have experienced breakthrough seizures after missed doses, the urgency is acute. Educating patients proactively about what to do if they can't fill their prescription can prevent crises before they happen.

What Providers Can Do: 5 Practical Steps

Step 1: Direct Patients to Medfinder

The single most impactful thing you can do is point patients to Medfinder. This free tool lets patients search for Lacosamide availability at pharmacies near their zip code, eliminating the need to call pharmacy after pharmacy.

Consider adding Medfinder to your practice's patient education materials or after-visit summary. A simple line like "If your pharmacy is out of stock, visit medfinder.com to find nearby pharmacies that have your medication" can save patients significant time and stress.

Step 2: Prescribe with Flexibility

When writing or renewing Lacosamide prescriptions, build in flexibility:

• Avoid specifying a single pharmacy when possible — use e-prescribe networks that allow patients to redirect
• Include "may substitute" language to allow pharmacists to dispense any AB-rated generic manufacturer
• Consider alternative strength combinations: If 200 mg tablets are unavailable, prescribe two 100 mg tablets (same total dose). The cost may differ slightly but availability often improves
• Note the oral solution as a backup: Lacosamide oral solution (10 mg/mL) may be available when specific tablet strengths are not

Step 3: Leverage Your Pharmacy Relationships

If your practice regularly prescribes Lacosamide, build relationships with pharmacies that reliably stock it:

• Identify 2-3 pharmacies (including independents) that maintain consistent Lacosamide inventory
• Communicate with pharmacy managers about your patient population's needs
• Consider designating a "backup pharmacy" for controlled substance prescriptions

Step 4: Know the Cost-Assistance Landscape

Cost and access are intertwined. A patient who can't afford their copay may not fill the prescription even when it's available. Key programs to know:

• Generic Lacosamide with coupons: $24-$45/month via GoodRx, SingleCare, or RxSaver
• UCB Direct-to-Patient Program: Brand Vimpat for $79.99-$84.99 per 60 tablets
• UCB Cares Patient Assistance: Free Vimpat for qualifying uninsured/underinsured patients (1-844-599-CARE)
• Copay assistance: UCB offers copay cards for commercially insured patients

For a comprehensive guide you can share with patients, refer them to: How to Save Money on Lacosamide.

Step 5: Have an Alternative Agent Ready

For patients who cannot access Lacosamide despite best efforts, having a therapeutic alternative pre-identified streamlines the conversation:

• Oxcarbazepine (Trileptal): Sodium channel blocker; affordable generic; widely available; monitor sodium levels
• Levetiracetam (Keppra): Different mechanism but broad-spectrum efficacy; extremely affordable; watch for mood changes
• Eslicarbazepine (Aptiom): Most similar mechanism to Lacosamide; once-daily dosing; higher cost; limited generic
• Carbamazepine (Tegretol): Very affordable; significant drug interaction profile; HLA-B*1502 testing in at-risk populations

A more detailed breakdown is available in our alternatives to Lacosamide article.

Workflow Tips for Your Practice

Integrating availability awareness into your clinical workflow can prevent access problems before they start:

• At prescription renewal: Ask patients if they've had any trouble filling their Lacosamide. Early identification of access issues allows proactive intervention.
• In EHR notes: Document the patient's preferred pharmacy, preferred generic manufacturer (if applicable), and any history of supply difficulties.
• Patient handout: Create a one-page resource with steps to take when a medication is out of stock. Include Medfinder (medfinder.com/providers), the UCB Cares number, and instructions for transferring prescriptions.
• Staff training: Ensure clinical support staff know how to triage "I can't find my medication" calls — these are time-sensitive and should be escalated appropriately.

Final Thoughts

Pharmacy-level Lacosamide stock-outs are a frustrating reality in 2026, but they're manageable with the right tools and preparation. By directing patients to Medfinder, building prescribing flexibility into your workflow, and staying informed about cost-assistance programs, you can help ensure your patients maintain uninterrupted seizure control.

For the latest on Lacosamide supply, see our provider shortage briefing. For cost-saving strategies, see our provider's guide to helping patients save on Lacosamide.