Pharmacology Precise mechanism of action is unknown- however, lacosamide selectively enhances slow inactivation of voltage-gated sodium channels, resulting in stabilization of hyperexcitable neuronal membranes and inhibition of repetitive neuronal firing. Indications and Usage Oral Adjunctive treatment of partial-onset seizures. Parenteral Adjunctive treatment of partial-onset seizures when oral route is not feasible. Dosage and Administration Partial-Onset Seizures Adults and Children 17 y of age and older PO/IV Start with 50 mg twice daily. The dosage may be increased by 50 mg twice daily at weekly intervals up to the recommended maintenance dosage of 200 to 400 mg/day, based on response and tolerability. Hepatic Function Impairment Adults and Children 17 y of age and older PO/IV Titrate the dose with caution. Max dosage of 300 mg/day is recommended in patients with mild or moderate hepatic impairment. Not recommended in patients with severe hepatic impairm