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The intravenous formulation of lacosamide can be used when patients are unable to take their tablets, for example because of surgery. As the tablets have very high bioavailability the intravenous dose is the same as the oral dose.

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There is a dose-dependent prolongation of the PR interval on the ECG. Second or third degree heart block is therefore a contraindication to lacosamide.

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The exact mechanism of action of lacosamide is uncertain. It is thought to stabilise neuronal membranes by enhancing the slow inactivation of voltage-gated sodium channels.

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