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Lacosamide (brand name Vimpat) is an antiepileptic drug used to treat partial-onset (focal) seizures in patients as young as 1 month old. It is approved as both an add-on therapy and as a standalone treatment for focal seizures in patients 4 years and older. Lacosamide is also approved as adjunctive therapy for primary generalized tonic-clonic seizures in patients 4 years of age and older. It belongs to the functionalized amino acid class of antiepileptic medications and is manufactured by UCB Pharma.
Lacosamide works by selectively enhancing the slow inactivation of voltage-gated sodium channels in the brain. Unlike many other sodium channel-blocking seizure medications that affect fast inactivation, Lacosamide targets slow inactivation, which helps reduce abnormal neuronal hyperexcitability without completely shutting down normal nerve signaling. It also binds to collapsin response mediator protein-2 (CRMP-2), though the clinical significance of this binding is still being studied. The typical dose ranges from 100 mg to 400 mg per day, taken in two divided doses approximately 12 hours apart.
Lacosamide has a findability score of 65 out of 100, placing it in the moderate range. Generic Lacosamide has been available since 2022 and is stocked at most major chain and independent pharmacies. However, periodic supply disruptions from individual generic manufacturers can make specific strengths temporarily harder to locate. Brand-name Vimpat remains consistently available but at a significantly higher cost. If your pharmacy is out of stock, checking nearby locations or using Medfinder can help you find it quickly.
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Lacosamide is most commonly prescribed by neurologists and epileptologists who specialize in seizure disorders. Pediatric neurologists prescribe it for younger patients. Once a patient is stabilized on the medication, primary care physicians often manage ongoing refills. Emergency medicine doctors may administer the IV formulation of Lacosamide in hospital settings. Lacosamide is also available through telehealth consultations for established patients needing prescription renewals.
Yes, Lacosamide is classified as a Schedule V controlled substance by the DEA. This is the lowest level of controlled substance scheduling, reflecting a low potential for abuse relative to Schedule IV drugs. In practice, this means prescriptions for Lacosamide may have some additional regulations compared to non-controlled medications, such as limits on refills or transfer between pharmacies in certain states. However, Schedule V restrictions are generally minimal, and most patients experience few obstacles when filling their prescriptions.
Lacosamide is an effective and well-tolerated antiepileptic medication with a unique mechanism of action that sets it apart from older sodium channel blockers. Since generic versions became available in 2022, the cost has dropped dramatically — from over $1,000 per month for brand-name Vimpat to as low as $24 per month with a discount coupon. Most insured patients pay just $10 to $50 for a monthly supply. While it generally has stable availability, occasional supply hiccups from specific generic manufacturers can make certain strengths temporarily hard to find. If your pharmacy is out of stock, use Medfinder to quickly locate Lacosamide at a nearby pharmacy. For uninsured patients, the UCB Cares Patient Assistance Program may provide free brand-name Vimpat to those who qualify.
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