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Fampyra - Effects, Dosage and MS Treatment

Fampyra is a prescription medication used to improve walking ability in adults with Multiple Sclerosis. Its active ingredient is fampridine, a potassium channel blocker.

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Things worth knowing about "Fampyra"

Fampyra is a prescription medication used to improve walking ability in adults with Multiple Sclerosis. Its active ingredient is fampridine, a potassium channel blocker.

What is Fampyra?

Fampyra is a prescription-only medicine used to improve walking ability in adults with Multiple Sclerosis (MS). Its active ingredient is fampridine (also known as dalfampridine), which belongs to the class of potassium channel blockers. Fampyra is available as a prolonged-release tablet, meaning the active substance is released slowly and consistently over time.

Indication

Fampyra is approved for adult patients with Multiple Sclerosis who experience impaired walking ability. Reduced mobility is one of the most common and burdensome symptoms of MS. Fampyra can be used regardless of the MS subtype, including relapsing-remitting MS (RRMS), primary progressive MS (PPMS), and secondary progressive MS (SPMS).

Mechanism of Action

In Multiple Sclerosis, the myelin sheaths surrounding nerve fibers are damaged. These protective coverings are essential for the rapid transmission of electrical signals. As a result of demyelination, potassium ions leak uncontrollably out of the nerve fibers, impairing nerve impulse conduction.

Fampridine, the active ingredient in Fampyra, blocks these potassium channels. This restores electrical conductivity in the damaged nerve fibers, which can lead to improved muscle control and increased walking speed. Fampyra is a symptomatic treatment -- it does not halt the underlying disease progression but may meaningfully improve the quality of life for affected individuals.

Dosage and Administration

The recommended dose of Fampyra is 10 mg twice daily, taken approximately 12 hours apart. Tablets should be swallowed whole with water and may be taken with or without food. The tablets must not be split, crushed, or chewed, as this would interfere with the controlled-release mechanism.

After approximately 2 weeks of treatment, the prescribing physician should assess whether walking ability has improved. If no improvement is observed, treatment should be discontinued, as not all patients respond to the medication.

Side Effects

Like all medicines, Fampyra can cause side effects. Common side effects include:

Urinary tract infections
Insomnia (difficulty sleeping)
Dizziness
Headache
Numbness or tingling sensations
Nausea

An important but rare and serious side effect is the occurrence of epileptic seizures. The risk increases when blood levels of the active substance rise above the therapeutic range. Therefore, strict adherence to the recommended dosage is essential.

Contraindications and Interactions

Fampyra must not be used in patients with:

Known epilepsy or a history of seizures
Moderate to severe renal impairment (as fampridine is primarily excreted by the kidneys)
Known hypersensitivity to the active substance or any of the excipients

Drug interactions may occur with other medicines that share the same renal transport pathway, such as cimetidine. Concurrent use with other potassium channel blockers should also be avoided.

Approval and Clinical Evidence

Fampyra was approved in the European Union in 2011 by the European Medicines Agency (EMA). The approval was based on clinical trials in which a significant proportion of MS patients demonstrated measurable improvement in walking speed, assessed using the Timed 25-Foot Walk (T25FW) test.

References

European Medicines Agency (EMA): Fampyra - European Public Assessment Report (EPAR). Accessed 2024. Available at: https://www.ema.europa.eu
Goodman AD et al. - Sustained-release oral fampridine in multiple sclerosis: a randomised, double-blind, controlled trial. The Lancet, 2009;373(9665):732-738.
Fampyra 10 mg prolonged-release tablets - Summary of Product Characteristics (SmPC). Biogen Idec Ltd. Current version as per EMA approval.

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