Fampridine


Concise Prescribing Info
Indications/Uses
Improve walking in patients with multiple sclerosis.
Dosage/Direction for Use
Adult : PO 10 mg 12 hrly, discontinue therapy if no improvement. Max: 20 mg/day.
Dosage Details
Oral
Multiple sclerosis
Adult: To improve walking disability: 10 mg 12 hrly, discontinue therapy if no improvement. Max: 20 mg daily.
Renal Impairment
 CrCl (mL/min) Dosage
 ≤50  Contraindicated.
Contraindications
Hypersensitivity. History of seizures. Moderate to severe renal impairment (CrCl ≤50 mL/min).
Special Precautions
Patient w/ arrhythmia, SA/AV conduction disorder. Mild renal impairment (CrCl 51-80 mL/min).
Adverse Reactions
Significant: Anaphylaxis or severe allergic reactions (e.g. resp compromise, urticaria, tongue/throat angioedema), seizures, UTI.
Nervous: Insomia, dizziness, headache, anxiety, asthenia, paraesthesia, balance disorder, fatigue, risk of fall, tremor, exacerbation of multiple sclerosis.
CV: Palpitations, tachycardia, peripheral oedema.
GI: Constipation, dyspepsia, nausea, vomiting.
Resp: Nasopharangytis, dyspnoea, pharyngolaryngeal pain.
Musculoskeletal: Back pain, weakness, muscle spasm.
Patient Counseling Information
This drug may cause dizziness, if affected, do not drive or operate machinery.
MonitoringParameters
Assess risk of seizures, walking ability. Monitor EEG, renal function before initiation of therapy and monitor thereafter.
Overdosage
Symptoms: Confusion, tremulousness, diaphoresis, seizures, status epilepticus, amnesia, involuntary and choreoathetoid movements, cardiac arrhythmias (e.g. supraventricular tachycardia/bradycardia), ventricular tachycardia, hypotension. Management: Supportive treatment. Repeated seizure activity may be treated w/ benzodiazepines, phenytoin or other anti-seizure therapy.
Drug Interactions
Increased risk of seizures w/ drugs that lower seizure threshold (e.g. TCA, SSRI(s), phenothiazines, butyrophenones, tramadol). Increased serum concentration w/ organic cation transporter-2 (OCT2) inhibitor (e.g. cimetidine) or substrate (e.g. metformin, carvedilol, propranolol).
Action
Description: Fampridine is a potassium channel blocker. The exact mechanism of action has not been fully elucidated, but it is thought that the inhibition of potassium channel reduces leakage of ionic current, thereby delaying repolarization and increasing conduction of action potentials in demyelinated axons. This results in improved peripheral motor neurologic function and strengthening of muscle fibre twitch activity.
Pharmacokinetics:
Absorption: Rapidly and extensively absorbed from the GI tract. Bioavailability: 96%. Time to peak plasma concentration: 3-4 hr.
Distribution: Crosses blood-brain barrier. Volume of distribution: 2.6 L/kg. Plasma protein binding: 1-3%.
Metabolism: Small portion (<10%) is metabolised in the liver via oxidation by CYP2E1 into 3-hydroxy-4-aminopyridine and conjugated 3-hydroxy-4-aminopyridine sulfate.
Excretion: Mainly via urine (96%, 90% as unchanged drug; 4.3% as 3-hydroxy-4-aminopyridine, 2.6% as 3-hydroxy-4-aminopyridine sulfate); faeces (0.5%). Elimination half-life: 5.2-6.5 hr.
Chemical Structure

Chemical Structure Image
Fampridine

Source: National Center for Biotechnology Information. PubChem Database. 4-Aminopyridine, CID=1727, https://pubchem.ncbi.nlm.nih.gov/compound/4-Aminopyridine (accessed on Jan. 20, 2020)

Storage
Store below 25°C. Protect from light and moisture.
ATC Classification
N07XX07 - fampridine ; Belongs to the class of other nervous system drugs.
References
Ampyra Tab, Film Coated, Extended Release (Acroda Therapeutics, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/09/2017.

Anon. Dalfampridine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 08/09/2017.

Buckingham R (ed). Fampridine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/09/2017.

Joint Formulary Committee. Fampridine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/09/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Dalfampridine. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 08/09/2017.

Preston CL (ed). Fampridine (Dalfampridine) + Miscellaneous. Stockley’s Drug Interactions [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/09/2017.

Disclaimer: This information is independently developed by MIMS based on Fampridine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in