Home Drug Guide Dalfampridine

Drug Guide

Generic Name

Dalfampridine

Brand Names Ampyra

Classification

Therapeutic: Neurotherapeutic agent for Multiple Sclerosis

Pharmacological: Potassium channel blocker

FDA Approved Indications

Improvement of walking in patients with multiple sclerosis

Mechanism of Action

Dalfampridine enhances conduction in demyelinated nerve fibers by blocking voltage-gated potassium channels, thereby improving nerve signal transmission.

Dosage and Administration

Adult: Higher doses may be used initially, typically 10 mg orally twice daily, with careful monitoring; dosage adjustments are necessary for renal impairment.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; renal function should be assessed before use.

Renal Impairment: Dose adjustments based on renal function; contraindicated in severe impairment (eGFR <30 mL/min).

Hepatic Impairment: No specific recommendations; caution advised.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Extensively distributed; limited plasma protein binding.

Metabolism: Minimal hepatic metabolism.

Excretion: Primarily excreted unchanged in urine.

Half Life: approximately 6 hours.

Contraindications

Severe renal impairment (eGFR <30 mL/min)
History of seizures

Precautions

Increased risk of seizures in patients with history of seizures or other risk factors; renal function must be evaluated before initiating therapy.
Monitor for adverse neurological effects.

Adverse Reactions - Common

Seizures (Less than 1%)
Urinary tract infection (Common)
Insomnia (Common)
Dizziness (Common)

Adverse Reactions - Serious

Seizures (Less than 1%)

Drug-Drug Interactions

Potential increased risk of seizures when combined with other drugs lowering seizure threshold.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess baseline neurological status, renal function, and seizure risk.

Diagnoses:

Risk for seizures
Impaired mobility related to neurological status.

Implementation: Administer as prescribed, monitor renal function periodically, observe for signs of seizures.

Evaluation: Assess improvement in walking ability and monitor for adverse effects.

Patient/Family Teaching

Take medication exactly as prescribed.
Report any seizure activity immediately.
Avoid medications or substances that may increase seizure risk.
Maintain regular renal function testing as advised.

Special Considerations

Black Box Warnings:

Increased risk of seizures.

Genetic Factors: No specific genetic factors identified.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Seizures, altered mental status, neurologic deterioration.

Treatment: Supportive care, seizure management, hemodialysis may be considered in overdose.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable under recommended storage conditions.