4-Aminopyridine (4-AP) also known as Dalfampridine, Fampridine and Fampyra is used for the treatment of walking impairment in multiple sclerosis (MS). MS is estimated to affect more than 2.1million people worldwide and is the most common disabling neurological disease in young adults (NMSS, 2010; Frohman, 2003). We compound 4- AP into several strengths, the main ones are 5mg,10mg and 20mg regular release capsules. In slow release/sustained release (SR) also called controlled release we compound 10mg and 20mg capsules. 4-AP is a schedule 4 medication requiring a doctors prescription. Should you require further information do not hesitate to telephone Captain Stirling Pharmacy on 08 93863380 and ask to speak to Tom or Sol.
Fampridine is a potassium channel blocker indicated for symptomatic improvement of walking in adults with multiple sclerosis, including relapsing remitting, secondary progressive, relapsing and primary progressive. Currently there are no other drugs for this indication.
Fampridine is thought to increase conduction in demyelinated nerves by inhibiting potassium channels. It can be used on its own or with other treatments for multiple sclerosis, including immunomodulatory drugs. This means that it can block the flow of potassium ions in nerve cells, which results in a more effective nerve impulse traveling down toward the muscles. It has been studied most extensively in MS and other demyelinating neurological disorders, however its exact mechanism of action of this drug remains uncertain. 4-AP has been used for many years to treat symptoms associated with MS. The poor nerve impulses in patients with MS is the cause of most of the symptoms of the disease including visual deficits, weakness, numbness, paralysis and other sensory disturbances. (Compston and Coles, 2008; Smith and McDonald, 1999; McDonald, 1974), Weakness and fatigue are probably the most common problems people who suffer from Multiple Sclerosis (MS) face on a daily basis.
STANDARD CONSIDERATIONS
Before you take any medication inform your doctor and our pharmacists of any other medical conditions, including other prescription and non-prescription medicines, vitamins and herbal supplements. It is important that you understand and know your medications, keep a list of them and show it to your doctor and our Healthcare pharmacists prior to commencing any new medication. If in doubt please ask and we will explain your medications to you.
PRACTICAL POINTS
Before commencing treatment and or obtaining a repeat of 4-AP, we recommend you read this Consummer Medication Information (CMI). We may have updated this CMI with new information. As with all prescription medications the information provided is for your evaluation purposes only, talk to your Doctor and or one of our Healthcare pharmacists about your medical condition or your treatment.• Take 4-AP exactly as prescribed by your doctor, should you have any adverse effects, stop taking the 4-AP and call your doctor right away.
ADVERSE EFFECTS
Do not take 4-AP if you have ever had a seizure or have kidney problems, you could have a seizure even if you never had a seizure before.
Patients report that side effects are usually minor, and include parenthesis (usually tingling sensations around the face) and occasional stomach problems. As mentioned above the most serious side effect is seizures, which may be a dose-related problem. For this reason the dosage is tailored to each individual and the person’s maximum dose should never be exceeded.
ALLERGY
Do not take 4-AP if your are allergic to4-aminopyridine (dalfampridine)
BENEFITS
4-AP has shown an increase in walking speed and may produce meaningful improvement in MS patients
PREGNANCY AND LACTATION (BREAST FEEDING)
It is not known if 4-AP will harm your unborn baby, tell your doctor if you are contemplating pregnancy
Avoid using 4-AP if you are breast-feeding or plan to breast-feed, as it is not known if 4-AP passes into your breast milk. Safety has not been established
DOSAGE
We compound two versions of 4-A, an immediate release or standard release formulation and a slow/sustained release also known as controlled release capsules.
For both versions we recommend a staged dosing procedure, to allow the body to come a custom to the new medication we recommend that a single daily dose betaken for two to three days, then increase to two capsules daily.
Immediate Release. ( 5mg and 10mg capsules)
Take ONE capsule (5mg) once a day in the morning may be taken with or with out food, for two to three days, then increase to ONE capsule twice day (every 12 hours) thereafter. Note: On advice from your doctor the dose may be increased to One capsule three times a day.
Slow Release (SR) or Controlled Release (CR) 10mg and 20mg capsules
Take ONE capsule (10mg SR) daily in the morning for two to three days, then increase to ONE capsule twice a day ( every 12 hours) with or immediately after food.
Note: Your doctor will decided on whether to increase to the 20mg strength.
Note: SR capsules are to be swallowed whole
LACTOSE INTOLERANT
For those patients who are lactose in tolerant, we compound a lactose cellulose (veggie) version.
References *†
1. Goodman AD, Brown TR,Krupp LB, Schapiro RT, Schw