• To improve walking speed in patients with multiple sclerosis.

Contraindicated in:

• Hypersensitivity
• History of seizures
• Moderate/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.

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.

Drug-Drug:

• Cimetidine may ↑ levels and ↑ risk of seizures.

(Generic available)

• Extended-release tablets: 10 mg;

• PO (Adults): 10 mg twice daily.

Ampyra

• Acts as a potassium channel blocker, which may increase conduction of action potentials.

• Increased walking speed in patients with multiple sclerosis.

Therapeutic Classification: anti-multiple sclerosis agents

Pharmacologic Classification:

Absorption: Rapidly and completely absorbed (96%).

Distribution: Unknown.

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

Half-life: 5.2–6.5 hr.

Fampyra

(improvement in walking speed)

• Instruct patient to take dalfampridine 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. May increase risk of seizures. Advise patient to read Medication Guide prior to 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 of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
• If a seizure or signs or symptoms of anaphylaxis occur, advise patient to notify health care professional immediately, to discontinue dalfampridine, and to not restart medication.
• Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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