Provider Briefing: Vimpat (Lacosamide) Supply in 2026

For neurologists, epileptologists, and primary care providers managing patients on Lacosamide, medication access is a clinical issue — not just a pharmacy logistics problem. When a patient with epilepsy can't fill their prescription, the downstream consequences include breakthrough seizures, emergency department visits, and disrupted treatment plans.

This article provides a concise, evidence-based overview of the current Vimpat (Lacosamide) supply landscape, prescribing considerations, and practical resources to help ensure your patients maintain uninterrupted access to their medication.

Supply Timeline: How We Got Here

Lacosamide (brand name Vimpat, manufactured by UCB Pharma) has had a relatively stable oral supply history, though not without disruption:

• 2008: FDA approval of Vimpat for adjunctive treatment of partial-onset seizures in adults
• 2014: Monotherapy indication approved
• 2017: Pediatric indication expanded (down to 4 years, later to 1 month)
• 2020-2021: IV formulation experienced intermittent shortages due to COVID-19-related manufacturing disruptions; oral supply remained largely intact
• 2022: Patent expiration — generic Lacosamide tablets entered the market from multiple manufacturers
• 2023-2025: Generic availability continued to expand; brand-name Vimpat market share declined but the product remained available
• 2026: No active FDA-listed shortage for oral Lacosamide; IV formulation availability is stable but should be verified for inpatient settings

Prescribing Implications

Several factors warrant attention when prescribing Lacosamide in the current environment:

Generic Substitution Considerations

Most pharmacies now default to generic Lacosamide unless the prescription specifies "dispense as written" (DAW). For the majority of patients, generic substitution is appropriate and FDA-approved as therapeutically equivalent (AB-rated). However, some patients with well-controlled seizures may report perceived differences when switching between brand and generic, or between generic manufacturers. While bioequivalence standards ensure comparable pharmacokinetics, individual patient variability and the narrow therapeutic index of AEDs merit clinical judgment.

Recommendation: Unless a patient has demonstrated clinical sensitivity to formulation changes, allowing generic substitution improves access and affordability. If a patient requires a specific manufacturer's product, document this clearly on the prescription.

Controlled Substance Status

Lacosamide is classified as a Schedule V controlled substance by the DEA. While this is the lowest schedule, it still imposes ordering and dispensing restrictions on pharmacies. Providers should be aware that:

• Some pharmacies may not routinely stock Lacosamide if patient volume is low
• Refill timing may be subject to state-specific controlled substance regulations
• Electronic prescribing for controlled substances (EPCS) is required in many states

Cardiac Monitoring

Lacosamide prolongs the PR interval in a dose-dependent manner. For patients being initiated on therapy or undergoing dose adjustments, an ECG is recommended — particularly in patients with:

• Known cardiac conduction problems (first-degree AV block, second-degree or higher)
• Concurrent use of other PR-prolonging drugs (beta-blockers, calcium channel blockers, digoxin)
• Severe cardiac disease or history of myocardial infarction

Patients with second- or third-degree AV block without a pacemaker should not receive Lacosamide.

Current Availability Picture

As of early 2026:

• Generic Lacosamide tablets (50 mg, 100 mg, 150 mg, 200 mg): Widely available from multiple manufacturers. This is what most pharmacies stock.
• Brand-name Vimpat tablets: Available but less commonly stocked. May require special ordering at some pharmacies.
• Lacosamide oral solution (10 mg/mL): Available but less commonly stocked than tablets. Important for pediatric patients and those who cannot swallow tablets.
• Lacosamide IV solution (10 mg/mL): Generally available; verify with your hospital pharmacy for inpatient needs. Historically more supply-sensitive.

Localized stock-outs remain possible, particularly at chain pharmacies that limit controlled substance inventories. Independent and specialty pharmacies tend to be more reliable sources for less commonly dispensed formulations.

Cost and Access Considerations

Cost remains a significant barrier for some patients:

Insurance coverage: Generic Lacosamide is covered by most commercial and Medicare Part D plans, typically on Tier 2. Brand Vimpat may require prior authorization and/or step therapy through generic first.

Patient assistance resources:

• UCB Vimpat Savings Card: Commercially insured patients may pay as little as $0 (not valid for government insurance)
• UCB Cares Patient Assistance Program: Free brand-name Vimpat for qualifying uninsured/underinsured patients (UCBCares.com or 1-844-599-2273)
• Discount cards: GoodRx, SingleCare, and RxSaver offer discounted pricing for generic Lacosamide at participating pharmacies

For a patient-facing resource on cost reduction, refer patients to our guide to saving money on Vimpat.

Tools and Resources for Providers

Medfinder for Providers offers tools to help you and your staff check pharmacy-level stock availability in real time. This can be especially valuable when:

• A patient reports difficulty filling their prescription
• You're discharging a patient from the hospital and need to ensure outpatient access
• You're prescribing a less common strength or formulation

Additionally, consider these workflow integrations:

• Include preferred pharmacy options in your discharge or after-visit summaries
• Have your nursing or pharmacy staff verify stock availability before sending prescriptions for patients who have previously reported access issues
• Maintain a list of local independent and specialty pharmacies that reliably stock Lacosamide

For a detailed provider workflow guide, see our article on how to help your patients find Vimpat in stock.

Alternative AEDs to Consider

When Lacosamide is unavailable or clinically inappropriate, the following alternatives may be considered for partial-onset seizures:

• Brivaracetam (Briviact): SV2A ligand, well-tolerated, no cardiac conduction effects. Brand-only, higher cost.
• Oxcarbazepine (Trileptal): Sodium channel blocker, generic available, affordable. Risk of hyponatremia; more drug interactions.
• Levetiracetam (Keppra): SV2A mechanism, generic widely available, minimal drug interactions. Behavioral side effects in some patients.
• Zonisamide (Zonegran): Multiple mechanisms, once-daily dosing, generic available. Sulfa derivative — contraindicated in sulfa allergy.

For a patient-facing comparison, refer patients to our alternatives to Vimpat article.

Looking Ahead

The Lacosamide supply outlook for 2026 is positive. Generic competition has stabilized both pricing and availability. Key points for ongoing monitoring:

• FDA Drug Shortage Database for any new shortage listings
• ASHP Drug Shortage Resource Center for hospital-focused updates
• UCB Pharma communications for any brand-specific changes

The primary ongoing challenges are not supply-related but access-related: controlled substance regulations, insurance barriers, and cost for uninsured patients. Proactive prescribing practices and awareness of patient assistance resources can help bridge these gaps.

Final Thoughts

Lacosamide remains a valuable tool in the AED armamentarium. While large-scale shortages are not anticipated in 2026, localized access barriers persist. Providers who stay informed about availability, utilize tools like Medfinder, and proactively address cost concerns can help ensure their patients maintain consistent seizure control.

For questions about Vimpat availability or to access provider tools, visit medfinder.com/providers.