Ampyra (dalfampridine)


Ampyra (dalfampridine), formerly known as fampridine SR, is a symptomatic treatment for improving walking in people with MS, manufactured by Acorda Therapeutics. About two-thirds of people with MS report difficulty walking and the majority of these patients say that walking difficulty is the most challenging aspect of MS for them. Ampyra is the first drug treatment approved specifically for the treatment of an MS symptom such as difficulty walking. As a symptomatic treatment, Ampyra doesn’t undo the damage caused by MS or change the course of the disease, but it is useful in improving walking mobility.


How does Ampyra work?

Ampyra is a potassium channel blocker, also known as 4-aminopyridine (4-AP) when made by a compounding pharmacy. Ampyra works by blocking tiny pores (called potassium channels) on the surface of nerve fibers. Blocking of potassium channels is thought to improve the ability of nerve fibers, specifically those that have been damaged by demyelination, to conduct electrical impulses or nerve signals.


How is Ampyra taken?

Ampyra is an oral medication (taken by mouth) available in an extended-release tablet. One tablet of Ampyra is taken twice daily at 12-hour intervals. Do not take more than 2 tablets of Ampyra during a 24-hour period. You must be able to swallow the tablet whole (do not break, crush, chew, or dissolve it before swallowing), so if you have a difficult time swallowing, tell your doctor. It is important to take Ampyra as instructed because it is specially formulated to be released over an extended period of time. If you break the tablet, the medicine can be released too quickly which may increase the risk of certain side effects, such as seizures. Ampyra can be taken with or without food.


What if I miss a dose of Ampyra?

If you miss a dose of Ampyra, DO NOT try to make up the missed dose by taking 2 pills at one time or by taking tablets with less than 12 hours between doses. Just take Ampyra at the next scheduled time. If you think you’ve taken too much Ampyra, call your doctor or go to the nearest hospital.


Are there people who should not take Amypra?

Ampyra should not be taken by persons who have ever had a seizure or certain kinds of kidney problems. Your doctor will determine whether you can take Ampyra safely.


What evidence do we have that Ampyra works?

The evidence that Ampyra helps improve walking in people with MS comes from two large phase III clinical trials involving 540 people with MS. These studies were required by the US FDA as proof that Ampyra is effective and appropriately safe. In these clinical trials, some participants received Ampyra and others were given a placebo (sugar pill). In one study, the group of people who took Ampyra had a greater increase in walking speed (25% greater) than those who took placebo. The second study had similar results. More people who took Amypra had improvements in walking speed than those who took placebo. Additionally, people who took Ampyra and had improved walking speed also had increases in leg strength.


Does Ampyra help all types of MS patients?

In clinical studies, Ampyra helped people with all four types of MS. Ampyra was effective in about 35% to 43% of trial participants who included people with each type of MS disease course.


Can Ampyra be taken with a disease-modifying treatment?

Ampyra can be taken with a disease-modifying treatment. In clinical studies, persons who received Ampyra were also taking a disease-modifying treatment.


How much does Ampyra cost and is a generic alternative available?

The cost of Ampyra will depend on several factors, including what type of insurance coverage you have and the price that your insurer has negotiated to pay for Ampyra. An Acorda company press release dated February 2010 quoted the wholesale price for a one month supply (30 days) of Ampyra at 1,056 US dollars.

There is no generic alternative to Ampyra at this time. However, the active ingredient in Ampyra is the same as fampridine, also known as 4-aminopyridine (4-AP) which has been available from compounding pharmacies (a pharmacy that gets ingredients and custom mixes them for the customer) for years. 4-AP has been used to improve walking in people with MS. However, because of the potential for inconsistent dosing with compounded drugs, there is an increased risk for seizures with 4-AP and some people who have taken 4-AP have had significant problems. With its extended-release formulation, Ampyra is especially designed to minimize risk of seizures. Therefore, 4-AP is not a safe alternative to Ampyra.


Do health insurance plans cover Ampyra?

Whether a health insurance plan will cover Ampyra depends on the specific plan. However, Acorda Therapeutics does offer patient assistance and support services and a representative of the company can be reached at 1-888-881-1918.