Three cases in which drug‐induced hyponatremia was improved by replacing carbamazepine with lacosamide

ObjectivesTo investigate the efficacy and safety of oral (PO) and subcutaneous (SC) lacosamide for refractory symptoms in the palliative setting.MethodsWe conducted a retrospective chart review of the use of lacosamide since it was introduced in our palliative care service 1½ years ago. All clinical notes, medication administration records and infusion monitoring documentation were examined to ascertain therapeutic aim, efficacy, and tolerability.ResultsLacosamide was administered to 91 patients; 90% had cancer. The most common indication was neuropathic pain (97%); there appeared to be a significant improvement in 35%; this was sometimes apparent within a few hours of an SC loading ‘test’ dose. Many recipients (44%) were in their last month of life. 59% received one or more SC doses; switching from PO to SC lacosamide was straightforward and it appeared compatible with a range of other palliative medications. Lacosamide appeared well tolerated; adverse effects were identified in 11% (10/91), half of whom (5%, 5/91) discontinued treatment. Of 59 admixtures infused SC, one mild SC site reaction occurred that resolved with the addition of dexamethasone.ConclusionsLacosamide appears to be a promising option for refractory symptoms warranting further study; SC administration is an advantage when the PO route is lost.

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Three cases in which drug‐induced hyponatremia was improved by replacing carbamazepine with lacosamide

Abstract: Carbamazepine often causes drug‐induced hyponatremia. Hyponatremia due to carbamazepine may be improved by changing to the same mechanism of action, lacosamide.

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References 18 publications

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