<p><strong>Strong CYP3A4 or CYP2C9 Inhibitors</strong>: Patients with renal or hepatic impairment who are taking strong inhibitors of CYP3A4 and CYP2C9 may have a significant increase in exposure to Lacosamide. Dose reduction may be necessary in these patients.<br />
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<strong>Concomitant Medications that Prolong PR Interval</strong>: Lacosamide should be used with caution in patients on concomitant medications that prolong PR interval, because of a risk of AV block or bradycardia, e.g., beta-blockers and calcium channel blockers. In such patients, obtaining an ECG before beginning Lacosamide, and after Lacosamide is titrated to steady-state, is recommended. In addition, these patients should be closely monitored if they are administered Lacosamide through the intravenous route.</p>