Lamotrigine

What is Lamotrigine?

• Lamotrigine (LAMICTAL) is an antiepileptic drug (AED) used to treat epilepsy and stabilize mood in bipolar disorder.

Lamotrigine

Lamotrigine ball-and-stick

Lamotrigine 3d

What are the uses of this medicine?

Lamotrigine (LAMICTAL) is a prescription medicine used:

• together with other medicines to treat certain types of seizures (partial seizures, primary generalized tonic-clonic seizures, generalized seizures of Lennox-Gastaut syndrome) in people 2 years or older.
• alone when changing from other medicines used to treat partial seizures in people 16 years or older.
• for the long-term treatment of Bipolar I Disorder to lengthen the time between mood episodes in people 18 years or older who have been treated for mood episodes with other medicine.

How does this medicine work?

• Lamotrigine (la moe' tri jeen) is a phenyltriazine and belongs to an anticonvulsant class of its own.
• Lamotrigine is believed to inhibit the release of excitatory neurotransmitters, particularly glutamate and aspartate but may also act directly on sodium channels on neuronal cells.

Who Should Not Use this medicine ?

This medicine cannot be used in patients who:

• are allergic reaction to lamotrigine or to any of the inactive ingredients in LAMICTAL.

What drug interactions can this medicine cause?

• Valproate increases lamotrigine concentrations more than 2-fold.
• Carbamazepine, phenytoin, phenobarbital, and primidone decrease lamotrigine concentrations by approximately 40%.
• Oral estrogen-containing contraceptives and rifampin also decrease lamotrigine concentrations by approximately 50%.

Is this medicine FDA approved?

• Lamotrigine was approved for use in the United States for epilepsy in 1994 and it is still in common use.

How should this medicine be used?

Recommended dosage:

• Lamotrigine is available tablets of 25, 100, 150 and 200 mg in generic formulations and under the brand name Lamictal.
• Pediatric formulations as chewable tablets are available in doses of 2, 5 and 25 mg.
• The recommended starting dose is 25 mg taken orally once daily, escalating to a maximum dose of 400 mg in two divided doses daily.

Administration:

• Take LAMICTAL exactly as prescribed.
• Your healthcare provider may change your dose. Do not change your dose without talking to your healthcare provider.
• Do not stop taking LAMICTAL without talking to your healthcare provider. Stopping LAMICTAL suddenly may cause serious problems. For example, if you have epilepsy and you stop taking LAMICTAL suddenly, you may get seizures that do not stop. Talk with your healthcare provider about how to stop LAMICTAL slowly.
• If you miss a dose of LAMICTAL, take it as soon as you remember. If it is almost time for your next dose, just skip the missed dose. Take the next dose at your regular time. Do not take two doses at the same time.
• You may not feel the full effect of LAMICTAL for several weeks.
• If you have epilepsy, tell your healthcare provider if your seizures get worse or if you have any new types of seizures.
• Swallow LAMICTAL tablets whole.
• If you have trouble swallowing LAMICTAL Tablets, there may be another form of LAMICTAL you can take.
• LAMICTAL ODT should be placed on the tongue and moved around the mouth. The tablet will rapidly disintegrate, can be swallowed with or without water, and can be taken with or without food.
• LAMICTAL Chewable Dispersible tablets may be swallowed whole, chewed, or mixed in water or diluted fruit juice. If the tablets are chewed, drink a small amount of water or diluted fruit juice to help in swallowing. To break up LAMICTAL Chewable Dispersible tablets, add the tablets to a small amount of liquid (1 teaspoon, or enough to cover the medicine) in a glass or spoon. Wait at least 1 minute or until the tablets are completely broken up, mix the solution together and take the whole amount right away.
• If you receive LAMICTAL in a blisterpack, examine the blisterpack before use. Do not use if blisters are torn, broken, or missing.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Tablets: 25 mg, 100 mg, 150 mg, and 200 mg scored.
• Chewable Dispersible Tablets: 2 mg, 5 mg, and 25 mg.
• Orally Disintegrating Tablets: 25 mg, 50 mg, 100 mg, and 200 mg.

This medicine is available in fallowing brand namesː

• LAMICTAL

What side effects can this medication cause?

The most common side effects of this medicine include:

• dizziness
• tremor
• headache
• rash
• blurred or double vision
• fever
• lack of coordination
• abdominal pain
• sleepiness
• back pain
• nausea, vomiting
• tiredness
• insomnia
• dry mouth

LAMICTAL may cause a serious side effects including:

• skin rash
• allergic reactions
• suicidal thoughts

What special precautions should I follow?

• Do not drive a car or operate complex, hazardous machinery until you know how LAMICTAL affects you.
• Life-threatening serious rash and/or rash-related death may result.
• Hypersensitivity reaction may be fatal or life-threatening. Early signs of hypersensitivity (e.g., fever, lymphadenopathy) may present without rash; if signs present, patient should be evaluated immediately. LAMICTAL should be discontinued if alternate etiology for hypersensitivity signs is not found.
• Multiorgan failure, which in some cases has been fatal or irreversible, has been observed in patients receiving LAMICTAL.
• Blood dyscrasias (e.g., neutropenia, thrombocytopenia, pancytopenia), may result either with or without an associated hypersensitivity syndrome.
• Antiepileptic drugs (AEDs), including LAMICTAL, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.
• Clinical worsening, emergence of new symptoms, and suicidal ideation/behaviors may be associated with treatment of bipolar disorder. Patients should be closely monitored, particularly early in treatment or during dosage changes.
• Medication errors involving LAMICTAL have occurred. In particular the names LAMICTAL or lamotrigine can be confused with names of other commonly used medications. Medication errors may also occur between the different formulations of LAMICTAL.
• It is not known if LAMICTAL is safe or effective in children or teenagers under the age of 18 with mood disorders such as bipolar disorder or depression.
• It is not known if LAMICTAL is safe or effective when used alone as the first treatment of seizures in adults.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• ataxia
• nystagmus
• increased seizures
• decreased level of consciousness
• coma
• intraventricular conduction delay

Treatment of overdosage:

• There are no specific antidotes for lamotrigine.
• General supportive care is indicated, including frequent monitoring of vital signs and close observation of the patient. If indicated, emesis should be induced; usual precautions should be taken to protect the airway.
• It is uncertain whether hemodialysis is an effective means of removing lamotrigine from the blood.
• 20% of the amount of lamotrigine in the body was removed by hemodialysis during a 4-hour session.

Can this medicine be used in pregnancy?

• There are no adequate and well-controlled studies in pregnant women.

Can this medicine be used in children?

• LAMICTAL is indicated for adjunctive therapy in patients ≥2 years of age for partial seizures, the generalized seizures of Lennox-Gastaut syndrome, and primary generalized tonic-clonic seizures.
• Safety and effectiveness in patients below the age of 18 years with Bipolar Disorder have not been established.

What are the active and inactive ingredients in this medicine?

LAMICTAL Tablets

• Active ingredient: lamotrigine.
• Inactive ingredients: lactose; magnesium stearate, microcrystalline cellulose, povidone, sodium starch glycolate, FD&C Yellow No. 6 Lake (100-mg tablet only), ferric oxide, yellow (150-mg tablet only), and FD&C Blue No. 2 Lake (200-mg tablet only).

LAMICTAL Chewable Dispersible Tablets

• Active ingredient: lamotrigine.
• Inactive ingredients: blackcurrant flavor, calcium carbonate, low-substituted hydroxypropylcellulose, magnesium aluminum silicate, magnesium stearate, povidone, saccharin sodium, and sodium starch glycolate.

LAMICTAL ODT Orally Disintegrating Tablets

• Active ingredient: lamotrigine
• Inactive ingredients: artificial cherry flavor, crospovidone, ethylcellulose, magnesium stearate, mannitol, polyethylene, and sucralose.

Who manufactures and distributes this medicine?

• LAMICTAL Tablets and Chewable Dispersible Tablets are manufactured by
• DSM Pharmaceuticals, Inc., Greenville, NC or
• GlaxoSmithKline, Research Triangle Park, NC

What should I know about storage and disposal of this medication?

• Store LAMICTAL at room temperature between 68oF to 77oF (20oC to 25oC).
• Keep LAMICTAL and all medicines out of the reach of children.

• Dailymed label info on Lamotrigine
• FDA Lamotrigine

Lamotrigine Resources
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