sideeffectsThe compounded version of this medication is NOT made with a slow-release filler. It is NOT equivalent to any of the commercial products and must not be substituted for the commercial product.With years of experience with this treatment approach, we have observed that the slow release is not a superior product. While the regular compounded capsule requires ramping and multiple doses each day, users report that the compounded preparation works very well.

Medication: 4-Aminopyridine Capsules, COMPOUNDED (Sometimes referred to as DALFAMPRIDINE

Use: This medication is a potassium channel blocker and aids in the conduction of electrical impulses in demyelinated nerves.  The prescribing physician determines the exact usage of this medication.  Common uses include symptomatic treatment for Multiple Sclerosis.

Side Effects: Tingling sensations around the mouth and in the hands and feet, dizziness, anxiety, abdominal pain and headache.  4-AP is generally tolerated well at doses of 0.5 mg/kg per day or less.  Higher than recommended doses (greater than 0.5 mg/kg per day) have been associated with seizures.

Precautions: The patient should use exactly according to the physician’s directions.

  • The patient should report any side effects or abnormal physical symptoms to the patient’s doctor or pharmacist.
  • The patient should not exceed dosage prescribed by the physician.

Directions: The dosage should not be deviated from unless instructed to by the physician.  Doses are individually customized. Bodyweight is oftenh used to determine starting and total daily doses.

Storage: Store in the original container at room temperature – preferably NOT in the bathroom.

What is ramping and should I ramp my 4-AP dosing? Ramping is a way to allow the body to get used to a dose, which typically takes two weeks.  The goal is to reach 30 – 40 milligrams per day in four doses, spread four to five hours apart.  We have been reluctant to give direct recommendations of dosing since you should work with your doctor. However, we will suggest the following general ramp-up schedule.

  • 5mg per day – in the morning – for 2 days
  • Then, 5mg BID (twice daily; breakfast and late afternoon) for 3 days.
  • Then, 5mg TID (3 times a day; every 5-6 hours while awake) for 4 days = 15 mg/day
  • Then, 5mg QID (4 times a day; every 4-5 hours while awake) for 5 days = 20 mg/day
  • Then, IF TOLERATED, 10mg QID (4 times a day; every 4-5 hours while awake) = 40 mg/day