Safety Profile of High-Dose Intravenous Push Lacosamide
Sterling C Torian1, G Morgan Jones2,3
1Department of Pharmacy, Tristar Centennial Medical Center, Nashville, TN, USA.
The Neurohospitalist
|July 13, 2023
Summary
High-dose intravenous push lacosamide (LCM) at 300 mg and 400 mg is safe for treating status epilepticus (SE). This rapid administration method showed no increased risk of infusion reactions, hypotension, or bradycardia in patients.
Area of Science:
- Neurology
- Clinical Pharmacology
Background:
- Status epilepticus (SE) requires prompt and effective treatment.
- Intravenous push (IVP) administration of lacosamide (LCM) offers rapid delivery.
- Limited data exists on the safety of high-dose IVP LCM (300 mg and 400 mg).
Purpose of the Study:
- To evaluate the safety of high-dose IVP LCM (300 mg and 400 mg).
- To assess the incidence of infusion site reactions, hypotension, and bradycardia within 2 hours of administration.
- To determine the rate of PR prolongation as a secondary outcome.
Main Methods:
- Single-center, retrospective, single-arm analysis.
- Inclusion of patients receiving IVP LCM 300 mg or 400 mg.
- Evaluation of primary outcomes (infusion site reactions, hypotension, bradycardia) and secondary outcome (PR prolongation).
Main Results:
- 113 patients evaluated; 85.8% received 400 mg IVP LCM.
- Incidence of infusion reactions: 6.2% (7/113).
- Incidence of hypotension: 11.1% (12/108); no bradycardia reported. Adverse events unlikely related to LCM.
Conclusions:
- High-dose IVP LCM (300 mg and 400 mg) is a safe option for rapid SE treatment.
- This administration route does not increase the risk of infusion site reactions, hypotension, or bradycardia.
- Further research may support wider adoption in high-acuity settings.
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