Vimpat (Lacosamide) at a glance: schedule, half-life, and class
- Generic name
- Lacosamide
- Brand names
- Vimpat; Motpoly XR (extended release)
- Drug class
- Antiseizure medicine; enhances slow inactivation of sodium channels
- US legal status
- Schedule V, prescription only
- Approved uses
- Partial-onset seizures (age 1 month and older); add-on for primary generalized tonic-clonic seizures (age 4 and older)
- Forms
- Tablets, oral solution, injection, extended-release capsules
- Half-life
- About 13 hours
Vimpat uses: what lacosamide is prescribed for
Lacosamide treats focal (partial-onset) seizures alone or with other medicines, and is added to other treatment for primary generalized tonic-clonic seizures.[1]
It is available as an injection for use when people cannot take it by mouth, and generics have been available since 2022.
Vimpat dosage: how lacosamide is usually prescribed
The figures below come from the FDA-approved label and describe how prescribers typically use lacosamide. They are not personal dosing advice. A prescriber sets the dose for each person and adjusts it over time.[1]
| Product | Typical adult dose | Notes from the label |
|---|---|---|
| Adults, partial-onset seizures (monotherapy) | 100 mg twice a day | Increase weekly by 50 mg twice a day to 150 to 200 mg twice a day |
| Adults, add-on therapy | 50 mg twice a day | Increase weekly to 100 to 200 mg twice a day |
| Severe kidney or mild to moderate liver impairment | Maximum 300 mg a day | Monitor closely |
Vimpat (lacosamide) side effects and risks
Common side effects include dizziness, double vision, headache, nausea, and unsteadiness.[1]
Heart conduction: it lengthens the PR interval and can cause heart block, slow heartbeat, or atrial fibrillation, especially in people with heart disease. An ECG may be done before and after starting.[1]
Mood: like all antiseizure medicines, it carries a warning about a small increase in suicidal thoughts and behavior. Report new or worsening depression, anxiety, or agitation.[1]
Allergic reactions: rare multi-organ hypersensitivity (DRESS).
Vimpat interactions: what not to mix with lacosamide
Choose what it would be combined with:
| Combined with | What happens | Label guidance |
|---|---|---|
| Drugs that prolong the PR interval (beta blockers, calcium channel blockers, other sodium channel blockers) | Heart block, slow heartbeat | Monitor with ECG |
| Alcohol and sedatives | More dizziness and drowsiness | Use caution |
| Strong CYP3A4 or CYP2C9 inhibitors with kidney or liver impairment | Higher lacosamide levels | Dose reduction may be needed |
This is not a full list. A pharmacist can check a complete medication list, including supplements and over-the-counter products.[1]
Vimpat overdose: signs of lacosamide overdose and what to do
Overdose causes dizziness, nausea, seizures, and heart conduction problems, including heart block and cardiac arrest at very high doses.[1]
If someone may have taken too much
- Call 911 for fainting, a seizure, chest pain, a racing or irregular heartbeat, confusion, or if the person cannot be woken.
- If the person collapses and is not breathing normally, start CPR and use an AED if one is available.
- Give naloxone if opioids could be involved. It is safe even if they are not.
- For advice when the person is awake and stable, call Poison Help at 1-800-222-1222 (US, free, 24 hours). Bring the product packaging to the hospital.
What happens if you stop lacosamide suddenly?
Lacosamide has low misuse potential, which is why it is in Schedule V. The main danger of stopping suddenly is not withdrawal but a rise in seizures.[1]
- DaysSeizure riskSeizures can return or become more frequent, including prolonged seizures.
- TaperGradual reductionThe label advises tapering over at least a week or longer.
- OngoingReassessChanges in seizure medicines should be planned with a neurologist.
Warning: Do not stop lacosamide suddenly without talking to the prescriber. Stopping antiseizure medicines abruptly can trigger prolonged, dangerous seizures.
How to get prescribed Vimpat (lacosamide) legally in the US
In the United States, lacosamide is a Schedule V controlled substance. The only legal way to get it is with a prescription from a clinician registered with the Drug Enforcement Administration (DEA), filled by a licensed pharmacy. Depending on state law, that can be a physician, nurse practitioner, or physician assistant.[2]
- Refills: Schedule V prescriptions can be refilled as the prescriber authorizes, subject to state law.[2]
- Telehealth: federal flexibilities let DEA-registered clinicians prescribe Schedule II to V medicines after a telemedicine visit, without a prior in-person exam, through December 31, 2026. A permanent DEA rule was under final review in late 2026. State rules can be stricter.[3]
- Monitoring: prescribers and pharmacists in most states check a prescription drug monitoring program, a database of controlled-substance prescriptions, before prescribing or dispensing.
- Pharmacies: a legitimate pharmacy always requires a valid prescription, has a licensed pharmacist available, and is licensed in the state it ships to. The FDA's BeSafeRx tool and the NABP's safe pharmacy list help confirm a pharmacy is real.[4][5]
- Cost: generic lacosamide is now widely available and much less expensive than the brand.
Traveling: keep the medicine in its original pharmacy container and carry a copy of the prescription. Check the rules of the destination country before travel, because many countries restrict controlled medicines or require a permit.
Can you order Vimpat (lacosamide) online legally?
Yes, but only with a valid prescription and only from a pharmacy licensed in your state. Many licensed pharmacies, including mail-order pharmacies run by insurers, fill lacosamide prescriptions online and ship them. Buying lacosamide from a website that does not require a prescription is illegal, and the product is often fake.[4][6]
- See a licensed clinicianA clinician evaluates you in person or by telemedicine and decides whether lacosamide is appropriate.
- The prescription goes to a pharmacyPrescriptions are usually sent electronically, straight from the prescriber to the pharmacy you choose.
- The pharmacy checks and fills itA pharmacist verifies the prescription and your identity, then dispenses the medicine in person or by mail.
Signs that an online seller is illegal:
- It sells lacosamide with no prescription, or after only a short online questionnaire.
- It takes orders through social media, messaging apps, or email.
- It asks for payment in cryptocurrency, gift cards, or money transfers.
- It has no US street address, no state pharmacy license, and no pharmacist to speak to.
- Its prices are far below those of ordinary pharmacies, or it ships from another country.
The FDA's BeSafeRx tool links to each state's license lookup, and the National Association of Boards of Pharmacy lists verified online pharmacies.[4][5]
Vimpat price: how much does Vimpat (lacosamide) cost without insurance?
Generic lacosamide is now widely available and much less expensive than the brand.
What you pay depends on the strength, the number of doses, your insurance plan, and the pharmacy. Cash prices for the same prescription can differ several times over between pharmacies in the same town, so check current prices before you fill it.
Ways to pay less, legally:
- Ask the prescriber whether a generic lacosamide is available. FDA-approved generics work the same way as the brand and usually cost much less.
- Compare cash prices between pharmacies before you fill the prescription.
- Use a free prescription discount card, such as GoodRx or SingleCare, when you pay cash. These cards cannot be combined with insurance on the same fill.
- For brand-name medicines, check the manufacturer's savings program or patient assistance program.
- Ask about a 90-day supply or your insurer's mail-order pharmacy, which often lowers the cost per dose when your prescriber agrees it is appropriate.
Warning: A price far below what licensed pharmacies charge, especially with no prescription required, is a strong sign of an illegal seller and counterfeit medicine.[4]
Is Vimpat legal? Lacosamide legal status in other countries
| Country | Status |
|---|---|
| United Kingdom | Prescription-only medicine; not controlled |
| European Union | Prescription only |
| International | Not under UN control |
Laws change and differ in detail. Check current rules before carrying any controlled medicine across a border.[7]
Common questions about Vimpat (lacosamide)
Why is Vimpat a controlled substance?
In studies, high doses caused euphoria in some people, so the DEA placed it in Schedule V, the lowest schedule.
Does Vimpat (lacosamide) affect the heart?
It can slow electrical conduction. People with heart disease may need an ECG before starting.
Can Vimpat (lacosamide) make you dizzy?
Yes. Dizziness and double vision are the most common side effects, especially at higher doses.
Is Vimpat (lacosamide) used in status epilepticus?
It is sometimes given intravenously off-label for prolonged seizures.
Can you stop Vimpat (lacosamide) suddenly?
No. It should be tapered to avoid breakthrough seizures.
Can you buy Vimpat (lacosamide) without a prescription?
No. Vimpat (lacosamide) is a Schedule V controlled substance in the US, so it is illegal to buy or possess it without a valid prescription. Websites and social media sellers that offer it without one are not legal pharmacies, and the FDA warns that products sold this way are often counterfeit, contaminated, or the wrong strength. The legal route is a visit with a licensed clinician, in person or by telehealth, and a prescription filled at a state-licensed pharmacy. The FDA's BeSafeRx tool and the NABP's safe pharmacy list help confirm an online pharmacy is real.
Sources
- Vimpat (lacosamide) prescription information. DailyMed, US National Library of Medicine.
- Controlled Substance Schedules. DEA Diversion Control Division.
- Prescribing controlled substances via telehealth. US Department of Health and Human Services.
- BeSafeRx: Your Source for Online Pharmacy Information. US Food and Drug Administration.
- Safe Pharmacy. National Association of Boards of Pharmacy.
- One Pill Can Kill. US Drug Enforcement Administration.
- International drug control conventions. United Nations Office on Drugs and Crime.
