Fampridine (Fampyra)
Fampridine is a drug that helps some people with MS (multiple sclerosis) walk faster. Its brand name in the UK is Fampyra. You say these names ‘FAM‐pri‐deen’ and ‘fam-PYE-ra’.
In American information the same drug is called dalfampridine (its generic name) or Ampyra (the brand name).
At the moment fampridine is only available on the NHS in Wales, Scotland and Northern Ireland. A decision about England is due in the first half of 2025.
What is fampridine (Fampyra)?
Fampridine is a tablet that can help some people with MS walk quicker. It’s the only drug with a licence to improve walking speed in MS. You can’t get fampridine from your GP. Only someone with specialist knowledge of MS can prescribe it, like a neurologist.
On this page we look at:
- How do I take fampridine (Fampyra)?
- How does fampridine work?
- How well does fampridine (Fampyra) work?
- What MS symptoms can fampridine (Fampyra) help with?
- Can I get fampridine (Fampyra)?
- What are the side effects of fampridine (Fampyra)?
- Can I take fampridine (Fampyra) if I’m pregnant or breastfeeding?
- Can fampridine help with balance problems?
- Can fampridine help with MS fatigue?
How do I take fampridine (Fampyra)?
You take two tablets a day, one in the morning and the second in the evening, with 12 hours between each dose. You take it without food and on an empty stomach. Your doctor will tell you more about how meal times should fit with taking this drug.
The tablet is made in a way that lets the drug into your bloodstream at a steady rate over a long period of time. That’s why you must swallow the tablet whole and not suck, chew, crush or break it. Doing that would let too much of the drug into your bloodstream too quickly. If that happens, side effects are more likely, such as the risk of a seizure. This is also why you need to take the drug without food and on an empty stomach.
How does fampridine work?
It’s not known for certain how fampridine works. But we know that fampridine keeps potassium in your nerves. Potassium is a mineral in your body that it needs to work properly. The movement of potassium in and out of cells helps signals move along nerves, which stimulates muscles to work. By keeping potassium in nerves, fampridine makes them work better, with the result that you can walk faster.
How well does fampridine (Fampyra) work?
Fampridine doesn’t work for everyone. But for those it does work for, it can speed up their walking on average by about 25%. In early trials up to four out of ten people saw this amount of improvement. Some clinics report more people than that say they benefit from the drug.
If your walking speed doesn’t improve by at least 20% after two to four weeks on the drug, you won’t be able to stay on it. This is true even if you see an improvement in other MS symptoms.
What MS symptoms can fampridine (Fampyra) help with?
Some find that because fampridine makes walking easier, this has a positive effect on other MS symptoms like foot drop, dizziness, balance or fatigue.
And some people find the drug also helps with their thinking and memory, how easy it is to use their hands, or with a tremor (uncontrollable shaking of an arm or leg).
But an MS specialist can only give fampridine to improve your walking speed. That said, you might find how you walk overall gets better, not just the speed. Some say that because their walking gets better, they can walk for longer.
Some people find it’s easier to walk and talk at the same time because they don’t need to concentrate as closely on their walking.
If any of these symptoms improve for you, that’s an added bonus. But you’ll only get fampridine on the NHS if your MS specialist sees that it helps you walk faster.
Read more about fampridine and fatigue and balance
Can I get fampridine (Fampyra)?
You can get fampridine on the NHS in Wales, Scotland and Northern Ireland. But it’s not available in all areas of these nations. In many places services aren’t yet in place to assess and monitor people who want fampridine.
Wales
Fampridine was first made available in Wales in 2019. Most regions now have fampridine clinics. After campaigning by the MS society, all Welsh health boards have put plans in place to get the drug to people who need it.
Scotland
In 2020 fampridine was given the green light for use in Scotland. It’s harder to get in some health boards than it is in others.
Northern Ireland
Fampridine was approved for use in Northern Ireland in 2023. The infrastructure isn’t yet in place to get the drug to all those who might benefit from it, but this is being worked on. If you’re interested in fampridine, talk to your MS specialist.
England
In 2022 the National Institute for Health and Care Excellence (NICE) decided not to recommend fampridine in England. They felt the benefit from it wasn’t big enough to justify what it would cost the NHS. But NHS England is looking at fampridine again in 2025. We’ll update this webpage as soon as their decision becomes public.
Who can get fampridine in Wales, Scotland and Northern Ireland?
You don’t need to have any particular type of MS to get fampridine. But you must be 18 or over and have:
- walking problems caused by MS
- kidneys that are working normally
- an EDSS (Expanded Disability Status Scale) score between 4 and 7.
EDSS 4 means:
- you can walk 500 metres without resting or using walking aids. That’s about a third of a mile
EDSS 7 means:
- you need a wheelchair most of the time and
- you can’t walk more than five metres (about 16 feet) even with a walking aid.
You must also never have had a seizure or an epileptic fit.
If you meet these conditions, an MS specialist (usually your neurologist or physiotherapist) will measure how well you can walk. This will be over a distance of 25 feet (about 7.5 metres). No one can help you, but you can use sticks or a frame if you need to.
You’ll get a prescription for enough fampridine to last two to four weeks. After this time they measure your walking again. If your walking speed hasn’t got better by at least 20%, you won’t qualify to stay on the drug.
In some places, before you can have fampridine, you might need to have tried other treatments first, like physiotherapy.
Read more about the EDSS scale
What are the side effects of fampridine (Fampyra)?
The most important side effect to know about are seizures.
Seizures happen to less than one in a hundred people who take fampridine. But if one does happen, you must stop driving straight away and hand in your licence for six months. Some other drugs you take can make the risk of a seizure higher. Your neurologist can explain if that’s a risk for you.
Less serious side effects of fampridine can include:
- bladder infections (more than one in ten people get these)
Up to one in ten might have:
- the feeling you’re going to be sick
- difficulty sleeping
- dizziness
- tiredness
- headaches
- back pain
- mild tremor (shaking in a leg or arm that you can’t control)
- anxiety
- upset stomach
- numb skin
- shortness of breath
- sore throat
- dry mouth
- constipation
- your heart beating quickly or missing beats
- colds or flu
Side effects can ease off after a few days. They go completely if you stop taking the drug. Listed in the leaflet that comes with the drug are rarer side effects that affect less than one in a hundred people (such as seizures or a serious allergic reaction).
Fampridine might make some MS symptoms worse, such as fatigue or poor balance.
Swallowing the tablets whole (not breaking or chewing it) lowers the risk of side effects.
Can I take fampridine (Fampyra) if I’m pregnant or breastfeeding?
Fampridine isn’t recommended during pregnancy. But if you’re pregnant, your doctor will weigh up the benefits to you of taking the drug against any possible risk to your baby. The advice from the drug’s makers is not to breastfeed while on fampridine.
Can fampridine help with balance problems?
For some people fampridine might cause some improvement in their MS balance symptoms. In some studies fampridine helped some people with balance. But this wasn’t seen in other studies, or the drug actually caused balance symptoms. Balance problems are among the drug’s most common side effects. More research is needed to understand how fampridine affects balance.
Because fampridine only has a licence to help people walk faster, an MS specialist can’t give it to you to treat other symptoms like poor balance.
Can fampridine help with MS fatigue?
In some studies fampridine helped some people with their fatigue symptoms. In other studies they didn’t see this result, and sometimes fampridine caused fatigue. Tiredness is one of fampridine’s most common side effects, but we need more research to know why this is happening. Fampridine only has a licence to help people walk faster, so an MS specialist can’t give it to you to treat other symptoms like fatigue.
More information on fampridine
You can hear more about fampridine in our May 2024 fampridine webinar.
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