Clinical overview of the seizure risk of dalfampridine

Sheryl R. Haut, E. Jay Bienen, Aaron Miller

Research output: Contribution to journalReview article

13 Scopus citations

Abstract

Introduction: Dalfampridine extended release tablets (dalfampridine-ER; known as prolonged-, modified or sustained-release fampridine in some countries) is a potassium channel blocker approved at 10 mg taken every 12 h, for the improvement of walking in patients with multiple sclerosis (MS). This has been demonstrated by an increase in walking speed. Its mechanism of action and narrow therapeutic range suggest the need to evaluate the seizure risk in treated MS patients. Areas covered: This paper discusses the seizure risk in clinical trials, and postmarketing experience of dalfampridine, relative to that in patients with MS. Electroencephalography as a predictive screening tool for seizure risk in dalfampridine-treated patients is also discussed. Expert opinion: The apparent seizure risk at the recommended dose of dalfampridine among patients with no prior seizure history may not be greater than the risk already present in the MS population. For MS patients, dalfampridine represents a promising new therapy for the improvement of walking impairment; its quick onset of action allows rapid determination of therapeutic response. The lack of prognostic value of electroencephalography for determining seizure risk suggests that treatment can be initiated without further screening when patients have no other contraindications. Strict adherence to the prescribed dosing regimen is essential.

Original languageEnglish (US)
Pages (from-to)651-657
Number of pages7
JournalExpert Opinion on Drug Safety
Volume11
Issue number4
DOIs
StatePublished - Jul 1 2012

Keywords

  • 4-AP
  • 4-aminopyridine
  • Dalfampridine
  • Fampridine
  • Multiple sclerosis
  • Seizures
  • Walking impairment

ASJC Scopus subject areas

  • Pharmacology (medical)

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