Fampridine Extended-Release Tablets (Fampyra) are a potassium channel blocker used to improve walking ability in adult patients with multiple sclerosis (MS). As a medication requiring strict dose control, its use must follow a standardized medication management process.
Precautions for Fampyra Extended-Release Tablets (Fampyra) Use
Absolute Contraindications
Patients with a history of epilepsy: Epileptic patients were excluded from clinical studies, and medication use may significantly increase the risk of seizures.
Moderate to severe renal impairment: Contraindicated in patients with creatinine clearance (CrCl) ≤ 50 mL/min.
History of hypersensitivity to 4-aminopyridine: Including a history of severe allergic reactions such as angioedema and laryngeal edema.
Baseline Assessment Items
Renal function test: CrCl must be calculated using the Cockcroft-Gault formula (multiply by 0.85 for female patients).
Neurological assessment: Including screening for seizure risk.
Ophthalmic examination: Documentation of baseline visual acuity and fundus conditions.
Renal Function Adjustments
Mild renal impairment (CrCl 51–80 mL/min): The benefits and seizure risks must be weighed, and dose reduction may be required.
Elderly patients: For patients over 50 years old, CrCl should be monitored annually, as age-related decline in renal function is common.
Special Precautions
Drug interactions: Avoid concurrent use with OCT2 inhibitors (e.g., cimetidine), which may increase blood drug concentration.
Other 4-AP formulations: Concurrent use with other formulations containing 4-aminopyridine is prohibited.
Monitoring During Fampyra Extended-Release Tablets (Fampyra) Use
Seizure Monitoring
High-risk period: The risk is highest within days to weeks of initiating medication.
Warning symptoms: Altered consciousness, involuntary muscle twitches, etc.
Management principle: Discontinue the medication immediately and permanently once a seizure occurs, and seek emergency medical attention.
Dynamic Renal Function Monitoring
Monitoring frequency: CrCl testing should be performed at least once a year; the frequency may be increased as appropriate for elderly patients.
Abnormality management: Discontinue the medication immediately if CrCl decreases to ≤ 50 mL/min.
Identification of Allergic Reactions
Typical manifestations: Dyspnea, laryngeal edema, urticaria.
Emergency management: Discontinue the medication immediately and seek emergency medical treatment if symptoms occur.
Management of Other Adverse Reactions
Common reactions: Urinary tract infections (12%), insomnia (9%), dizziness (7%), etc.
Neurological symptoms: Balance disorders (5%) require fall prevention measures; headaches (7%) may be managed with symptomatic treatment.
Gastrointestinal reactions: For nausea (7%), small, frequent meals are recommended; for constipation (3%), increase dietary fiber intake.
