Dalfampridine

DEA Class;  Rx

Common Brand Names; Ampyra

• Urinary tract infection (12%)
• Insomnia
• Dizziness
• Headache
• Nausea
• Asthenia
• Back pain
• Balance disorder
• Multiple sclerosis relapse
• Paresthesia
• Nasopharyngitis
• Constipation
• Dyspepsia
• Pharyngolaryngeal pain
• Dose-related increased risk of seizures
• Postmarketing Reports
• Seizures; 4.6 per 1000 patient-years of use, which is comparable to the rate of seizures seen in the overall MS population
• Vomiting, vertigo

Seizures reported; permanently discontinue if seizure occurs; majority of seizures happened within days to weeks after starting the recommended dose and occurred in patients having no history of seizures

Age-related decreases in renal function, and mild renal impairment is common after age 50 yr, plasma levels may approach those seen at dose of 15 mg twice daily, a dose that may be associated with an increased risk of seizures; even when serum creatinine is normal, renal function should be assessed by estimating creatinine clearance

Do not take with other forms of 4-aminopyridine (4-AP, fampridine) to avoid adverse reaction due to the same active ingredient

Estimate CrCl before initiating (see Contraindications and Renal Impairment)

Do not double dose or take extra if dose missed

Anaphylaxis and severe allergic reactions; signs and symptoms have included respiratory compromise, urticaria, and angioedema of the throat and or tongue; discontinue immediately and do not restart (see Contraindications)

UTIs reported more frequently in clinical trials vs. placebo

There are no adequate data on developmental risk associated with use in pregnant women

There are no data on presence of drug in human milk, effects on breastfed infant, or on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition