Medical term:

dalfampridine


dalfampridine

Ampyra

Action

Unknown. May increase conduction of action potentials in demyelinated axons through inhibition of potassium channels.

Availability

Tablets (extended release): 10 mg

Indications and dosages

➣ To improve walking in patients with multiple sclerosis

Adults: 10 mg P.O. q 12 hours

Dosage adjustments

• Mild renal impairment

Contraindications

• History of seizures

• Moderate or severe renal impairment

Precautions

Use cautiously in:

• mild renal impairment

• pregnant or breastfeeding patients

• children younger than age 18 (safety and efficacy not established).

Administration

• Check creatinine clearance before starting drug.

• Administer with or without food.

Adverse reactions

CNS: insomnia, dizziness, headache, asthenia, balance disorder, paresthesia, seizures

EENT: nasopharyngitis, pharyngolaryngeal pain

GI: nausea, constipation, dyspepsia

GU: urinary tract infection

Musculoskeletal: back pain

Other: multiple sclerosis relapse

Interactions

None

Patient monitoring

Discontinue drug if seizure occurs.

• Monitor renal function tests regularly (especially creatinine clearance).

Patient teaching

• Instruct patient to take drug with or without food.

• Instruct patient to swallow tablet whole and not to break, crush, chew, or dissolve it.

Advise patient to discontinue drug and immediately report to prescriber if seizures occur.

• Instruct patient to promptly report urinary tract problems.

• As appropriate, review all other significant and life-threatening adverse reactions.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

dalfampridine

(dal-fam-pri-deen) ,

Ampyra

(trade name),

Fampyra

(trade name)

Classification

Therapeutic: anti multiple sclerosis agents
Pharmacologic: potassium channel blockers
Pregnancy Category: C

Indications

Treatment of mutiple sclerosis, to improve walking speed.

Action

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

Therapeutic effects

Increased walking speed in patients with multiple sclerosis.

Pharmacokinetics

Absorption: Rapidly and completely absorbed (96%).
Distribution: Unknown.
Metabolism and Excretion: 96% eliminated in urine, 0.5% in feces.
Half-life: 5.2–6.5 hr.

Time/action profile (improvement in walking speed)

ROUTEONSETPEAKDURATION
POunk3–4 hr24 hr

Contraindications/Precautions

Contraindicated in: HypersensitivityHistory of seizures;Moderate/severe renal impairment (CCr ≤50 mL/min)(↑ risk of seizures); Lactation: Avoid use.
Use Cautiously in: Mild renal impairment (CCr 51–80 mL/min) (↑ risk of seizures) Geriatric: Consider age-related ↓ in renal function; Obstetric: Use only if potential benefit justifies potential risk to fetus; Pediatric: Safety and effectiveness not established.

Adverse Reactions/Side Effects

Central nervous system

  • seizures (life-threatening)
  • dizziness
  • headache
  • insomnia
  • weakness

Ear, Eye, Nose, Throat

  • nasopharyngitis
  • pharyngolaryngeal pain

Gastrointestinal

  • constipation
  • dyspepsia
  • nausea

Genitourinary

  • urinary tract infection

Musculoskeletal

  • back pain

Neurologic

  • balance disorder
  • multiple sclerosis relapse
  • paresthesia

Miscellaneous

  • anaphylaxis (life-threatening)

Interactions

Drug-Drug interaction

None noted.

Route/Dosage

Oral (Adults) 10 mg twice daily.

Availability

Extended-release tablets: 10 mg

Nursing implications

Nursing assessment

  • Assess walking speed in patients with multiple sclerosis prior to and periodically during therapy.
  • Monitor for seizures during therapy, risk increases with increased dose. If seizure occurs, discontinue therapy.
  • Monitor for signs and symptoms of anaphylaxis (dyspnea, wheezing, urticaria, angioedema of the throat or tongue) during therapy.
  • Lab Test Considerations: Monitor creatinine clearance prior to and at least yearly during therapy; renal impairment may require dose reduction or discontinuation.

Potential Nursing Diagnoses

Impaired walking (Indications)

Implementation

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

Patient/Family Teaching

  • Instruct patient to take dalfampridine as directed, with approximately 12 hrs 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; new information may be available.
  • 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 report the event to Acorda (manufacturer) at 1-800-367-5109.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

  • Improved walking and increased walking speed in patients with multiple sclerosis.
Drug Guide, © 2015 Farlex and Partners

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