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This medication comes with several important safety precautions that users should be aware of before starting treatment. It is crucial to discuss any concerns with your healthcare provider.

• Seizure Risk: Using Ampyra (dalfampridine) can lead to seizures, even if you have never experienced them before. These events may occur within days to weeks of beginning the medication. Inform your healthcare provider if you have a history of seizures or conditions that increase your seizure risk. In the event of a seizure, seek medical attention immediately and expect to discontinue the medication. Higher risk factors include a history of seizures and taking more than the recommended dose of 10 mg twice daily.

• Increased Side Effects for Individuals with Kidney Issues: Ampyra (dalfampridine) is eliminated from the body through the kidneys. If you have kidney problems, the drug may accumulate in your system, increasing the likelihood of side effects, including seizures. Dosage reduction is not an option for those with kidney issues, making it unsuitable for individuals with impaired kidney function.

• Severe Allergic Reactions: There is a risk of severe allergic reactions to Ampyra (dalfampridine), which can be life-threatening. Symptoms may include swelling of the mouth or face, shock, anaphylaxis (throat closure), hives, rash, red skin, or difficulty breathing. Discontinue use and seek immediate medical assistance if these symptoms occur.

Contraindications: This medication should not be used under the following conditions due to potential serious health risks:

• If you have a history of seizures.
• If you have moderate or severe kidney problems.

Always consult your healthcare provider for personalized advice and guidance.

Common side effects:

• Urinary tract infections
• Insomnia or trouble sleeping
• Dizziness
• Headache
• Nausea
• General weakness or lack of energy

Less common but important to monitor:

• Back pain
• Balance problems
• Multiple sclerosis (ms) relapse
• Burning or prickling sensation in the hands or feet
• Runny nose or symptoms resembling a common cold
• Constipation
• Upset stomach

Serious side effects:

• Severe allergic responses (hives, rash, red skin, swelling of the lips or tongue, closure of the throat, difficulty breathing)
• Seizures

When taking dalfampridine, it's important to be aware of potential interactions with other medications, as these can affect how dalfampridine works and may increase the risk of side effects, including seizures. Here are some key considerations:

Medications That May Increase Dalfampridine Levels:

• Cimetidine: This medication can increase dalfampridine levels in the blood, potentially raising the risk of seizures.

• Trimethoprim: Often found in combination with Sulfamethoxazole (as in Cotrim), trimethoprim may elevate dalfampridine levels, increasing the likelihood of side effects such as nausea, dizziness, and seizures.

Medications That Lower Seizure Threshold:

• Bupropion: Used for depression and smoking cessation, bupropion can lower the seizure threshold. When combined with dalfampridine, this may further increase seizure risk.

• Other Seizure Threshold-Lowering Drugs: Medications like certain antidepressants, antipsychotics, and other central nervous system stimulants can also lower the seizure threshold. Combining these with dalfampridine may heighten seizure risk.

Other Considerations:

• Renal Function: Dalfampridine is primarily eliminated through the kidneys. Impaired kidney function can lead to higher drug levels and an increased risk of side effects. It's crucial to assess kidney function before starting dalfampridine.

• Concurrent Use with Other Forms of 4-Aminopyridine: Avoid using dalfampridine alongside other forms of 4-aminopyridine (such as compounded 4-AP) to prevent additive effects and increased side effects.

Always inform your healthcare provider about all medications and supplements you're taking to ensure safe and effective use of dalfampridine.