Two medicines, side by side
Lacosamide vs carbamazepine
Lacosamide and carbamazepine are both labeled for seizures and epilepsy. Drugs@FDA records approvals of lacosamide since 2008 and of carbamazepine since 1968. Pharmacies paid $0.174 per lacosamide 100 mg tablet and $0.119 per carbamazepine 200 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Only the carbamazepine label carries a boxed warning.
Check it at the source: the lacosamide FDA label on DailyMed (effective May 12, 2026); the carbamazepine FDA label on DailyMed (effective August 20, 2026).
Highlights of the lacosamide record
Lacosamide (Vimpat) · label of May 12, 2026
Used for
From the label: indicationsVIMPAT is indicated for: Treatment of partial-onset seizures in patients 1 month of age and older ( 1.1 ) Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients 4 years of age and older ( 1.2 ) 1.1 Partial-Onset Seizures VIMPAT is indicated for the treatment of partial-onset seizures in patients 1 month of age and older. 1.2 Primary Generalized Tonic-Clonic Seizures VIMPAT is indicated as adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients 4 years of age and older. […]
On the market
- Earliest approval on file
- October 28, 2008
- Generic labelers
- 57 labelers
- Pharmacy cost
- $0.174 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 8
Highlights of the carbamazepine record
Carbamazepine (Tegretol) · label of August 20, 2026
SERIOUS DERMATOLOGIC REACTIONS AND HLA-B*1502 ALLELE SERIOUS AND SOMETIMES FATAL DERMATOLOGIC REACTIONS, INCLUDING TOXIC EPIDERMAL NECROLYSIS (TEN) AND STEVENS-JOHNSON SYNDROME (SJS), HAVE BEEN REPORTED DURING TREATMENT WITH TEGRETOL. THESE REACTIONS ARE ESTIMATED TO OCCUR IN 1 TO 6 PER 10,000 NEW USERS IN COUNTRIES WITH MAINLY CAUCASIAN POPULATIONS, BUT THE RISK IN SOME ASIAN COUNTRIES IS ESTIMATED TO BE ABOUT 10 TIMES HIGHER.
Used for
From the label: indicationsEpilepsy Tegretol is indicated for use as an anticonvulsant drug. Evidence supporting efficacy of Tegretol as an anticonvulsant was derived from active drug-controlled studies that enrolled patients with the following seizure types: Partial seizures with complex symptomatology (psychomotor, temporal lobe). Patients with these seizures appear to show greater improvement than those with other types. […]
On the market
- Earliest approval on file
- March 11, 1968
- Generic labelers
- 42 labelers
- Pharmacy cost
- $0.119 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 11
Source: FDA drug labels via openFDA (Lacosamide label of May 12, 2026, Carbamazepine label of August 20, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do lacosamide and carbamazepine differ on the record?
Only the carbamazepine label carries a boxed warning.
How each works, in its label's words: Lacosamide, “The precise mechanism by which VIMPAT exerts its antiepileptic effects in humans remains to be fully elucidated.”; Carbamazepine, “It appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation.”
Half-life, in each label's words: Lacosamide, “The maximum lacosamide plasma concentrations occur approximately 1-to-4-hour post-dose after oral dosing, and …”; Carbamazepine, “Initial half-life values range from 25 to 65 hours, decreasing to 12 to 17 hours on repeated doses.”
Generics: lacosamide since 2022; carbamazepine since 1986 (Drugs@FDA).
DEA schedule: lacosamide CV; carbamazepine none.
| Lacosamide | Carbamazepine | |
|---|---|---|
| Labeled for | Seizures and epilepsy | Bipolar disorder, Seizures and epilepsy |
| Pharmacologic class | n/a | Mood Stabilizer |
| How it works (label) | The precise mechanism by which VIMPAT exerts its antiepileptic effects in humans remains to be fully elucidated. | Mechanism of Action Tegretol has demonstrated anticonvulsant properties in rats and mice with electrically and chemically induced seizures. It appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation. |
| Half-life (label) | The maximum lacosamide plasma concentrations occur approximately 1-to-4-hour post-dose after oral dosing, and elimination half-life is approximately 13 hours. | Initial half-life values range from 25 to 65 hours, decreasing to 12 to 17 hours on repeated doses. |
| Earliest approval on file (Drugs@FDA) | October 28, 2008 | March 11, 1968 |
| First generic approved | March 17, 2022 | August 14, 1986 |
| Generic labelers (NDC) | 57 labelers | 42 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.174 per tablet (Lacosamide 100 mg tablet) | $0.119 per tablet (Carbamazepine 200 mg tablet) |
| 12-month price change | -15% | +0.6% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 8 | 11 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 36,995 | 66,615 |
| DEA schedule | CV | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to lacosamide
- every medicine labeled for the same conditions