dalfampridine

Absorption: Rapidly and completely absorbed.

Distribution: Unknown.

Metabolism/Excretion: 96% eliminated in urine; 0.5% in feces.

Half-Life: 5.2–6.5 hr.

Time/Action Profile ⬆ ⬇

( improvement in walking speed)

ROUTE		ONSET		PEAK		DURATION
PO		unknown		3–4 hr		24 hr

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity;
History of seizures;
Moderate to severe renal impairment (CCr ≤50 mL/min) (↑ risk of seizures).

Use Cautiously in:

Mild renal impairment (CCr 51–80 mL/min) (↑ risk of seizures);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children;
Geri: Consider age-related ↓ in renal function in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

EENT: nasopharyngitis, pharyngolaryngeal pain

GI: constipation, dyspepsia, nausea

GU: urinary tract infection

MS: back pain

Neuro: dizziness, headache, insomnia, multiple sclerosis relapse, paresthesia, SEIZURES, vertigo, weakness

Misc: ANAPHYLAXIS

Interactions ⬆ ⬇

Drug-drug:

Cimetidine may ↑ levels and ↑ risk of seizures.

Route/Dosage ⬆ ⬇

PO (Adults ): 10 mg twice daily.

Availability ⬆ ⬇

(Generic available)

Extended-release tablets: 10 mg

Assessment ⬆ ⬇

Assess walking speed in patients with multiple sclerosis before starting and periodically during therapy.
Monitor for seizures during therapy; risk ↑ with ↑ dose. May occur without seizure history and within days to wks of initiation. If seizure occurs, discontinue therapy.
Monitor for signs and symptoms of anaphylaxis (dyspnea, wheezing, urticaria, angioedema, hoarseness) during therapy; discontinuation and supportive care may be required.

Lab Test Considerations:

Monitor CCr before starting and at least yearly during therapy; renal impairment may require dose ↓ or discontinuation.

Implementation ⬆ ⬇

Administer tablets twice daily approximately 12 hr apart without regard to food. DNC: Swallow tablets whole; do not break, crush, chew, or dissolve.

Patient/Family Teaching ⬆ ⬇

Explain the purpose and side effects of dalfampridine to patient. Instruct patient to take as directed, with approximately 12 hr between tablets. If a dose is missed, omit and take next scheduled dose on time; do not double doses or take >two tablets within 24 hr. May ↑ risk of seizures. Advise patient to read Medication Guide before beginning therapy and with each Rx refill in case of changes.
May cause vertigo, dizziness, and seizures. Caution patient to avoid driving and other activities requiring alertness until response to the drug is known.
Instruct patient to notify health care professional or call 911 immediately to seek medical care if swelling of face, eyes, lips, or tongue or if difficulty swallowing or breathing occur. Do not restart medication without further evaluation.
If a seizure occurs, advise patient to notify health care professional immediately, to discontinue dalfampridine, and to not restart medication.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇