Safety & pK of IV loading dose of lacosamide in the ICU

R. Eugene Ramsay, Vivek Sabharwal, Fawad Khan, Hina Dave, Cyrus Kafai, Rachel Shumate, Megan Irland

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


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 400 mg 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.

Original languageEnglish (US)
Pages (from-to)340-342
Number of pages3
JournalEpilepsy and Behavior
StatePublished - Aug 1 2015


  • IV dosing
  • Lacosamide
  • Loading dose
  • Safety
  • Status epilepticus

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience


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