Common Registration Assessment, Part 1
Lacosamide 50mg tablet titration steps and twice-daily doses for the GPhC assessment
Three original practice questions, with the working shown. Read the stated prescription or plan before calculating.
Published 8 November 2026. Independent revision material, not GPhC questions, not for patient care.
The manufacturer's UK product information for lacosamide 50 mg film-coated tablets states that lacosamide must be taken twice a day approximately 12 hours apart, that adjunctive therapy starts at 50 mg twice a day (100 mg/day), and that the dose is increased in steps of 50 mg twice a day (100 mg/day) at weekly intervals.
The same information states that the maximum recommended dose for adjunctive therapy is up to 200 mg twice a day (400 mg/day), and that for monotherapy the maximum is up to 300 mg twice a day (600 mg/day).
It also states that if a dose is missed, it should be taken immediately unless the patient notices within 6 hours of the next dose, in which case the next dose is taken at the regularly scheduled time, and that a double dose should not be taken.
Each question fixes the values needed for its arithmetic. Write the unit beside every step and distinguish a single dose from a daily total or a supply period. All prescriptions and patients here are fictional; these are revision materials, not for patient care.
The method
- Identify the stated single dose in mg and that it is taken twice a day.
- Multiply the single dose by 2 for the daily total.
- Divide the single dose by the stated tablet strength for a tablet count per dose.
- Keep per-dose, per-day and weekly steps separate; convert only when the question asks.
Three practice questions
Work each one on paper first, then open the answer. All patients and prescriptions are fictional.
Question 1
A fictional adult starts adjunctive lacosamide at 50 mg twice a day in week 1 and increases by 50 mg twice a day at weekly intervals. In which week is 200 mg twice a day (400 mg/day) first reached?
Show the answer
Answer: Week 4
Working: Week 1: 50 mg twice daily, week 2: 100 mg, week 3: 150 mg, week 4: 200 mg twice daily. The 400 mg/day level is first reached in week 4.
Question 2
A fictional adult takes lacosamide 200 mg twice a day using 50 mg tablets. How many tablets are taken per dose, and per day?
Show the answer
Answer: 4 tablets per dose; 8 tablets per day
Working: Per dose: 200 mg / 50 mg = 4 tablets. Per day: 4 x 2 = 8 tablets.
Question 3
A fictional patient realises a lacosamide dose was missed 4 hours before the next dose is due. What does the label say to do?
Show the answer
Answer: Wait for the next scheduled dose
Working: If the missed dose is noticed within 6 hours of the next one, the next dose is taken at the regularly scheduled time. A double dose should not be taken.
eMC SmPC: Lacosamide Zentiva 50 mg film-coated tablets
https://www.medicines.org.uk/emc/product/14052/smpc
Where marks are lost
- Titrating by 50 mg per day instead of 50 mg twice a day, which halves every step.
- Reporting tablets per day when the question asks for tablets per dose.
- Advising a double dose when a missed dose is noticed within 6 hours of the next one.
Frequently asked questions
Are these official assessment questions?
No. They are original revision exercises, not official GPhC questions and not for patient care.
Does this calculation decide a real lacosamide dose?
No. Follow the stated prescription in the exercise. Real titration is adjusted to response and tolerability, with different maxima for adjunctive therapy and monotherapy.
How should I check the answer?
Check whether the answer is per dose or per day, then divide the stated dose by the tablet strength.
Sources
The questions above are original and use fictional patients and prescriptions. PreRegExamPrep is not affiliated with or endorsed by the General Pharmaceutical Council.
Practise until the method is automatic
Try 15 free questions with worked answers. No sign-up required.
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