Drug reference
Symptomatic treatment of Lambert-Eaton myasthenic syndrome (specialist use only) ▶BY MOUTH ▶Adult: Initially 15 mg daily in 3 divided doses, then increased in steps of 5 mg every 4–5 days, increased to up to 60 mg daily in 3–4 divided doses (max. per dose 20 mg); maximum 60 mg per day
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Congenital QT syndromes. epilepsy . uncontrolled asthma
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Non-paraneoplastic form of Lambert- Eaton myasthenic syndrome
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Scottish Medicines Consortium (SMC) decisions SMC No. 660/10 The Scottish Medicines Consortium has advised (August 2012) that amifampridine phosphate (Firdapse ®) is not recommended for use within NHS Scotland for the symptomatic treatment of Lambert-Eaton myasthenic syndrome (LEMS).
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→Appendix 1: amifampridine
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▶Common or very common Dizziness. gastrointestinal discomfort. nausea. oral disorders. peripheral coldness. sensation abnormal. sweat changes ▶Frequency not known Anxiety. arrhythmia. asthenia. asthmatic attack. bronchial secretion increased. cough. diarrhoea. drowsiness. gastrointestinal disorder. headache. movement disorders. palpitations. Raynaud’s phenomenon. seizures. sleep disorder. vision blurred
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Ensure effective contraception during treatment in men and women.
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Manufacturer advises avoid.
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Manufacturer advises avoid—no information available.
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Manufacturer advises caution (risk of increased exposure). Dose adjustments Manufacturer advises initial dose reduction to 5 mg twice daily in mild impairment, titrate in steps of 5 mg every 7 days. Manufacturer advises initial dose reduction to 5 mg once daily in moderate to severe impairment, titrate in steps of 5 mg every 7 days.
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Use with caution. Dose adjustments In mild impairment reduce initial dose to 10 mg daily in divided doses, increased in steps of 5 mg every 7 days. In moderate or severe impairment reduce initial dose to 5 mg daily in divided doses, increased in steps of 5 mg every 7 days.
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Clinical and ECG monitoring required at treatment initiation and yearly thereafter.
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: tablet Tablet CAUTIONARY AND ADVISORY LABELS 3, 21 ▶Firdapse (BioMarin Europe Ltd) A Amifampridine (as Amifampridine phosphate) 10 mg Firdapse 10mg tablets | 100 tablet P £1,815.00 3.3 Myotonic disorders DRUGS FOR NEUROMUSCULAR DISORDERS
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Initially 15 mg daily in 3 divided doses, then
First-line fragment. Read the complete Indications and Dose section above.
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