GlobalRPh Renal Dosing Masterv6.6
GlobalRPh source record

Lacosamide (Vimpat)

Local RX List renal extractBase record retrieved 2026-09-05See the evidence for this drug2 sources available - open source summaries, references and comparisons

Vimpat

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Renal guidance at a glance

Cautions / source differences (1)

Confirm the product, indication and renal measure. The selected summary is not a complete prescribing monograph.

Choose a source to read (2)

Display order is not a clinical ranking. Date of retrieval is not the label revision date. Sources are never merged into one regimen. Other sources and conflicts remain below.

1 additional source qualifications - review before use
Reduce the maximum, not automatically every established dose

VIMPAT specifies a reduction in the maximum permitted dose in severe impairment, alongside separate titration and post-HD considerations. It also uses different adult and pediatric renal-function methods.

Before applying: Distinguish a maximum-dose ceiling from a mandatory reduction of an already lower dose. Verify adult Cockcroft-Gault versus pediatric Schwartz units, current regimen, dialysis duration and interactions.

Also check: Reduce the maximum, not automatically every established dose

Rxlist source

GlobalRPh RX List - Vimpat

Product / population
VIMPAT renal maximum and hemodialysis instructions; adult and pediatric renal methods differ.
Renal measure
Adults: Cockcroft-Gault CrCl below 30 mL/min. Pediatrics: Schwartz CLcr below 30 mL/min/1.73 m2.

RX mirror: this is not independent corroboration of its underlying label. Check dated-label and formulation limitations.

Renal dosing, restrictions and evidence limits

Mild or moderate renal impairment needs no adjustment. For severe impairment or ESRD, reduce the maximum permitted dose by 25% and titrate cautiously to response and tolerability. This is a reduction in the maximum, not necessarily a mandatory 25% decrease in every existing dose. After four-hour hemodialysis, consider a supplement of up to 50%. Strong CYP3A4 or CYP2C9 inhibitors can require further reduction in renal impairment. Do not interchange the adult unindexed and pediatric indexed renal estimates.

Source revision: Source revision date not established in selected retrieval. | Retrieved: 2026-09-07. Retrieval date is not the revision date.

Source: https://globalrph.com/rx-list/vimpat-drug/

Scope: Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph. GlobalRPh v6.6.

Full source card / provenance

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Source-first renal review

Evidence sources and renal implications

Choose a source to jump directly to its locally stored result. Qualitative precautions and evidence gaps remain visible even when no numerical clearance schedule is supplied.

Read 1 source difference / applicability notes

Preserved GlobalRPh source

Preserved original GlobalRPh source

Preserved historical content; not revalidated as current prescribing guidance.

Renal method: Read the measure and population stated in the original source sections.
Retrieved: 2026-09-05

Read local renal resultOpen original reference
GlobalRPh RX List

GlobalRPh RX List - Vimpat

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

VIMPAT renal maximum and hemodialysis instructions; adult and pediatric renal methods differ.

Renal method: Adults: Cockcroft-Gault CrCl below 30 mL/min. Pediatrics: Schwartz CLcr below 30 mL/min/1.73 m2.
Retrieved: 2026-09-07

Read local renal resultOpen original reference

Source presence is not independent validation. A label mirror is not a second independent source; review the original reference and exact formulation.

Product / population check

Confirm the exact formulation before using a renal source

These links compare product identities, not interchangeable doses. A selected summary is not a complete prescribing monograph.

Source-quality holds
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Before applying a renal protocol

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No patient-specific dose is calculated. Context choices only display reminders; they do not validate, hide or change any regimen.

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Jump to renal guidanceRead 1 difference / caution notesClinician guide

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Build a source-review outline for documentation

This creates a blank decision outline with the source identities you select, not a dose recommendation or completed clinical assessment. No patient fields are collected, saved or sent. Complete the clinical decisions in your approved documentation system.

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Renal-context checklist: population, kidney trend and dialysis

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Read the exact source scope, renal metric and date before selecting a row. No applicability assessment has been performed.

See source-specific renal methods and the clinical interpretation guide for the supporting context.

Read before choosing a regimen

Source differences and product cautions

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These are specific issues found during source review, not an automated judgment that one source is universally correct. A label mirror and its original label are not independent evidence.

dose interpretation

Reduce the maximum, not automatically every established dose

VIMPAT specifies a reduction in the maximum permitted dose in severe impairment, alongside separate titration and post-HD considerations. It also uses different adult and pediatric renal-function methods.

How to use this: Distinguish a maximum-dose ceiling from a mandatory reduction of an already lower dose. Verify adult Cockcroft-Gault versus pediatric Schwartz units, current regimen, dialysis duration and interactions.

GlobalRPh RX List - Vimpat

Source-specific interpretation; independent clinician adjudication pending.

Go directly to the relevant source section

Renal dosing and precautions

Choose a source, then jump to its renal or dialysis section. These links locate stored text; they do not merge regimens or certify that sources agree.

New source summary - independent clinical review pending. Summaries of the identified label sections are included locally. Source import and numeric transcription checks are not independent two-reference validation. Do not treat this card as an approved institutional dosing protocol.

No dialysis or renal heading shown? Read the complete source summary. Absence of a heading is not evidence that dose adjustment is unnecessary.

Compare or copy source versions

All content below is stored locally. Read a whole source version; do not combine its dose with another source's interval, renal metric or dialysis assumptions.

Original content / product scopeGlobalRPh RX List - Vimpat
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Historical source content is not a current prescription. Original GlobalRPh recommendations are preserved, not automatically certified as current. Product-label and professional additions below are separately attributed. Confirm indication, population, kidney-function method, monitoring and the full prescribing information before applying a regimen.

Important source distinctions

The source age scope and maximum-dose formulation are historical and separately retained, not silently expanded to newer indications.

Locally stored source content

Original GlobalRPh protocol

Clinical facts and comments transcribed into a structured reading format. This is not a byte-for-byte HTML archive. Original source: https://globalrph.com/renal/lacosamide/

Usual Dosing (Adults)

The precise antiseizure mechanism is not fully known. In vitro, lacosamide enhances slow voltage-gated sodium-channel inactivation, stabilizing hyperexcitable membranes and limiting repetitive firing. It binds neuronal CRMP-2, involved in differentiation/axonal outgrowth; the contribution to seizure control is unknown.

The source indication is adjunctive treatment of partial-onset seizures in patients age >=17, oral tablets/solution or IV when oral administration is temporarily infeasible. Take with or without food. Use an accurately calibrated device for solution, not household spoons; providers should recommend a device and teach measurement.

Start oral or IV at 50 mg twice daily; increase weekly by 100 mg/day in two doses to maintenance 200 to 400 mg/day by response/tolerability. In trials, 600 mg/day was not more effective than 400 mg and caused substantially more adverse reactions.

Oral-to-IV: same total daily dosage/frequency, infused over 30 to 60 minutes; source experience up to 5 days of twice-daily IV. IV-to-oral: equivalent dosage/frequency.

GRPH-lacosamide-01 · Source section: Usual Dosing (Adults)Renal section finder

Renal Dosing

Mild/moderate renal impairment: no adjustment. Severe impairment, CrCl <=30 mL/min, or ESRD: maximum 300 mg/day in the source. Titrate cautiously in all renal impairment.

GRPH-lacosamide-02 · Source section: Renal DosingRenal section finder

Hemodialysis

ESRD maximum 300 mg/day. Effectively removed by HD; after a 4-hour treatment consider a supplemental dose up to 50%.

GRPH-lacosamide-03 · Source section: HemodialysisRenal section finder
Locally imported selected renal sections

GlobalRPh RX List renal information

Rxlist

GlobalRPh RX List - Vimpat

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GlobalRPh-hosted RX List · VIMPAT renal maximum and hemodialysis instructions; adult and pediatric renal methods differ.

Renal method: Adults: Cockcroft-Gault CrCl below 30 mL/min. Pediatrics: Schwartz CLcr below 30 mL/min/1.73 m2.
Source date: Source revision date not established in selected retrieval.
Retrieved: 2026-09-07

Label mirror, not independent corroboration. This is selected locally stored RX List content. Full monograph import and current official-label review are not implied.
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.

Renal dosing, restrictions and evidence limits

Mild or moderate renal impairment needs no adjustment. For severe impairment or ESRD, reduce the maximum permitted dose by 25% and titrate cautiously to response and tolerability. This is a reduction in the maximum, not necessarily a mandatory 25% decrease in every existing dose. After four-hour hemodialysis, consider a supplement of up to 50%. Strong CYP3A4 or CYP2C9 inhibitors can require further reduction in renal impairment. Do not interchange the adult unindexed and pediatric indexed renal estimates.

RDM40-rxlist-lacosamide-8bd4a1d808-C1 · Source locator: Selected renal dosing, renal impairment, toxicity and pharmacokinetic subsections as identified in the summary.

Source identity and provenance
Source family
product_label_mirror
Source
https://globalrph.com/rx-list/vimpat-drug/
Retrieved
2026-09-07
Renal-function method
Adults: Cockcroft-Gault CrCl below 30 mL/min. Pediatrics: Schwartz CLcr below 30 mL/min/1.73 m2.
Source date/version
Source revision date not established in selected retrieval.
Hash meaning
SHA-256 of local authored summary only; not original HTML, PDF or SPL bytes.
Local summary SHA-256
f2338011a85f3a904e7b2e8334d54686b4fd96cbc6632746d34e4284e02e6f9b

Provenance and preservation

Additional summaries stored on this page: 0 official-label, 1 RX List, 0 professional, 0 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://globalrph.com/renal/lacosamide/
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
globalrph individual
Local text SHA-256
3d456ced68ef2522576766fe3d03491cbbf68c661b903bb7165cb2e26059cd06
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

The original individual GlobalRPh pages commonly cite NIH/NLM DailyMed and instruct readers to review the applicable package insert for updates. That historical reference is preserved as context; it is not counted as an independently retrieved current label.

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