Vimpat
Drug - Vimpat® (lacosamide) tablets and oral suspension [UCB, Inc.]
November 2017
Therapeutic area - Antiepileptic
Approval criteria
- Patient is 4 years of age or older AND
- Patient has a diagnosis of partial-onset seizures AND
- Patient has tried and failed THREE or more anti-epileptic drugs which include: gabapentin, lamotrigine, levetiracetam, divalproex sodium, oxcarbazepine, topiramate, valproic acid or carbamazepine OR
- Prescriber is a neurologist and patient has tried and failed at least TWO anti-epileptic drugs which include: gabapentin, lamotrigine, levetiracetam, divalproex sodium, oxcarbazepine, topiramate, valproic acid or carbamazepine
Quantity limit
- Tablets (all strengths): 102 tablets per 34 days
- Oral solution 10 mg/ml: 2040 ml per 34 days
Background information
VIMPAT (lacosamide) is FDA-approved for monotherapy or adjunctive therapy in patients with partial onset seizures. The safety and effectiveness of VIMPAT injection in pediatric patients less than 17 years of age have not been established. VIMPAT injection is indicated for short term replacement when oral administration is not feasible. VIMPAT injection is not subject to prior authorization.
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411
