When your patients can't find Lacosamide, here's what you can do

If you're a neurologist, epileptologist, or primary care provider managing patients on Lacosamide (brand name Vimpat), you've likely heard a familiar concern: "My pharmacy says it's out of stock." While Lacosamide has not experienced a prolonged, FDA-listed shortage, intermittent supply disruptions at the pharmacy level have become increasingly common since generic entry in 2022. These gaps can be stressful for patients—and for the providers trying to keep their seizure control stable.

This guide walks through what's happening with Lacosamide availability in 2026, why patients are struggling to fill prescriptions, and five concrete steps you can take to help. For real-time availability data, visit medfinder.com/providers.

Current availability picture

As of early 2026, Lacosamide is manufactured by several generic companies in addition to UCB Pharma's brand-name Vimpat. Generic tablets are available in 50 mg, 100 mg, 150 mg, and 200 mg strengths. The oral solution (10 mg/mL) and IV formulation (10 mg/mL) are also on the market.

Despite multiple manufacturers, supply is not always consistent across all pharmacies. Certain strengths—particularly the 200 mg tablets—may be harder to find at any given time. Independent pharmacies and smaller chains sometimes face longer restocking timelines compared with large national chains. Rural areas can be especially affected.

For a broader look at the supply landscape, see our provider shortage briefing.

Why patients can't find it

Several factors contribute to the difficulty patients face when trying to fill a Lacosamide prescription:

• Distributor allocation limits. When demand rises or a manufacturer has a production slowdown, wholesalers may limit how much a given pharmacy can order. This is often invisible to the patient—and sometimes even to the pharmacist until the order is rejected.
• Generic manufacturer variability. Not every generic maker produces every strength at all times. If a pharmacy's primary supplier is temporarily out, switching to another generic manufacturer requires the pharmacy to place a special order.
• Schedule V classification. Lacosamide is classified as a Schedule V controlled substance. While this is the lowest DEA schedule, it still adds regulatory steps that can slow transfers, partial fills, and emergency dispensing in some states.
• Insurance and formulary restrictions. Some patients are directed to specific pharmacies (e.g., mail-order or preferred networks), which may have their own supply chain limitations.
• Patient awareness gaps. Many patients don't know they can call multiple pharmacies, request a different generic manufacturer, or use tools like medfinder.com/providers to check availability in real time.

What providers can do: 5 practical steps

Step 1: Write flexible prescriptions

When clinically appropriate, consider writing prescriptions that give the pharmacy some flexibility. For example, specifying "Lacosamide" (generic) rather than "Vimpat" (brand) allows the pharmacy to dispense whichever manufacturer's product is in stock. If you're writing for a specific strength, consider whether a combination of available strengths could work (e.g., two 100 mg tablets instead of one 200 mg tablet if the 200 mg is unavailable).

Step 2: Prescribe adequate day supply

A 90-day supply can give patients a buffer against short-term disruptions. If insurance or state regulations limit the days' supply, document the medical necessity for extended fills. For maintenance seizure medications, most insurers will approve 90-day supplies upon request.

Step 3: Educate patients proactively

At each visit, briefly discuss what patients should do if their pharmacy is out of stock. Key talking points include:

• Call ahead before your prescription runs out—at least 7 days early
• Ask the pharmacist to check other nearby locations or order from a different distributor
• Use medfinder.com to check pharmacy availability
• Never stop Lacosamide abruptly—abrupt discontinuation can trigger breakthrough seizures or status epilepticus

For a patient-facing version of this advice, share our guide on how to find Lacosamide in stock.

Step 4: Use real-time availability tools

Rather than asking patients to call pharmacy after pharmacy, direct them (or your staff) to medfinder.com/providers. The platform aggregates availability data so you can quickly identify which pharmacies near your patient have Lacosamide in stock. This saves time for everyone and reduces the risk of a gap in therapy.

Step 5: Have a backup plan on file

For patients who have experienced difficulty filling Lacosamide in the past, consider documenting an alternative medication plan in the chart. This way, if the patient calls in a crisis (pharmacy out of stock, leaving town, etc.), your team can quickly pivot. Common alternatives to consider include:

• Oxcarbazepine (Trileptal): Sodium channel blocker for focal seizures; widely available as a generic
• Carbamazepine (Tegretol): Classic option with broad availability but more drug interactions
• Levetiracetam (Keppra): Different mechanism (SV2A binding); very affordable and widely available
• Eslicarbazepine (Aptiom): Newer sodium channel blocker with once-daily dosing; mostly brand-name

For a deeper dive, see our article on alternatives to Lacosamide.

When to consider switching vs. bridging

If a patient cannot find Lacosamide for a short period (a few days), the priority is preventing abrupt discontinuation. Options include:

• Partial fill: Ask the pharmacy to dispense whatever quantity they have on hand, with the remainder to follow
• Pharmacy transfer: Transfer the prescription to a pharmacy that has stock
• IV bridge: For inpatients or patients with access to an infusion center, IV Lacosamide can bridge a gap in oral supply
• Temporary dose adjustment: In consultation with the patient, a brief dose reduction may be preferable to complete discontinuation (use clinical judgment)

If the supply disruption is prolonged or recurrent, a planned cross-taper to an alternative AED may be the safest approach. Document the rationale and taper schedule clearly.

Workflow tips for your practice

Integrating medication access into your clinic workflow can prevent last-minute crises:

• Add a supply check to intake. Have your MA or nurse ask at each visit: "Are you having any trouble getting your medications filled?" This catches problems early.
• Flag high-risk patients. Patients on less common strengths, those in rural areas, or those with limited pharmacy options should be flagged for proactive outreach.
• Build a pharmacy network. Identify 2–3 pharmacies in your area that reliably stock Lacosamide. Share this list with patients and staff.
• Designate a refill point person. Having one staff member coordinate prior authorizations, pharmacy calls, and supply issues can dramatically reduce the burden on providers.
• Bookmark provider tools. Keep medfinder.com/providers bookmarked on clinic computers for quick reference.

Cost considerations

Supply issues and cost issues often overlap. When patients can't find their usual generic at their usual pharmacy, they may face higher prices elsewhere. A few things to keep in mind:

• Generic Lacosamide costs as low as $24–$45/month with discount coupons (e.g., SingleCare, GoodRx)
• Brand-name Vimpat runs $1,000–$1,100/month at retail
• UCB's Vimpat Direct-to-Patient program offers 60 tablets for $84.99
• UCB Cares provides free Vimpat to qualifying uninsured/underinsured patients

For a comprehensive look at savings options, see our guide on helping patients save money on Lacosamide or share the patient version: how to save money on Lacosamide.

Final thoughts

Lacosamide supply disruptions are manageable—but only if providers plan ahead. By writing flexible prescriptions, educating patients, using real-time tools, and having a documented backup plan, you can minimize the risk of gaps in therapy and keep your patients' seizures under control.

For real-time Lacosamide availability data and provider-specific tools, visit medfinder.com/providers.