title: Safety & pK of IV loading dose of lacosamide in the ICU.
abstract: A restrospective review of patients treated in the ICU for refractory status epilepticus who had received an initial IV loading dose of lacosamide (LCS) was performed. A total of 142 patients were identified. The first 34 patients received 400mg which by weight-based measurement ranged from 2 to 11 mg/kg. Higher mg/kg dosing had been used subsequently with doses up to 13 mg/kg. No patient required reduction in rate or cessation of infusion. Initiation of pressor agents was not needed during the infusion of the loading dose. Postinfusion LCS blood levels were drawn, and dosing of 10-12 mg/kg and higher resulted in blood levels above 15 μg/ml while doses of 2-6 mg/kg resulted in levels below 10 μg/ml. We conclude that a weight-based loading dose of 10-12 mg/kg at an infusion rate of 0.4 mg/kg/min is safe and will produce levels of 15 μg/ml and higher. This article is part of a Special Issue entitled "Status Epilepticus".
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA. Electronic address: eramsay@ochsner.org.
authors.forename: R Eugene
authors.initials: RE
authors.lastname: Ramsay
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Vivek
authors.initials: V
authors.lastname: Sabharwal
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Fawad
authors.initials: F
authors.lastname: Khan
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Hina
authors.initials: H
authors.lastname: Dave
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Kafai
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Shumate
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Irland
mesh_terms: D000081:Acetamides / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics*; D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics*; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy*; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D000078334:Lacosamide; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D000078334:Lacosamide
keywords: IV dosing; Lacosamide; Loading dose; Safety; Status epilepticus