Drug Interaction Report

Nicardipine and Lacosamide: Interaction Details

A pharmacist-reviewed analysis of the Nicardipine and Lacosamide interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Lacosamide

Motpoly Vimpat
+

Nicardipine

Cardene Cardene® Cardene® SR
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 57 documented Nicardipine interactions, 34 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

An increased risk of AV block, bradycardia, and ventricular tachyarrhythmia

Interaction Deep Dive

Lacosamide should be used with caution in patients on concomitant medications that affect cardiac conduction such as calcium channel blockers due to the risk of AV block, bradycardia, and ventricular tachyarrhythmia. Obtain an ECG before beginning lacosamide, and after lacosamide is titrated to steady-state maintenance dose12. In addition, closely monitor if lacosamide is administered via the IV route 2.

Why it happens (mechanism)

Additive effects on cardiac conduction

Common questions

Can I take Nicardipine and Lacosamide together?

An increased risk of AV block, bradycardia, and ventricular tachyarrhythmia Always confirm with your pharmacist or prescriber before making any change.

How serious is the Nicardipine and Lacosamide interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Nicardipine or Lacosamide need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (2)

  1. Product Information: Motpoly XR oral extended-release capsules, lacosamide oral extended-release capsules. Aucta Pharmaceuticals, Inc, Piscataway, NJ, 2023. DailyMed
  2. Product Information: VIMPAT(R) oral tablets, intravenous injection, oral solution, lacosamide oral tablets, intravenous injection, oral solution. UCB Inc (per FDA), Smyrna, GA, 2018. DailyMed
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Lacosamide

Keep reading about Lacosamide

All Lacosamide interactions (49)
Also serious with: Penbutolol Cetirizine Injection Hydroxychloroquine Nadolol
Nicardipine

Keep reading about Nicardipine

All Nicardipine interactions (57) Nicardipine drug information
Also serious with: Levoketoconazole Clomipramine Carbamazepine Atazanavir
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Lacosamide + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato American Elder Astaxanthin + 143 more
Nicardipine + Activated Charcoal American Hellebore American Mistletoe Arsenic Cesium Coleus Ephedra Grapefruit + 235 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.