Lamotrigine

The recommended dose of lamotrigine varies according to a person's need and the other antiepileptic medications they are taking. In adults, lamotrigine is started at a low dose, ranging from 25 mg every other day to 50 mg once a day. Over a number of weeks, the dose is gradually increased until a maintenance dose is reached. The maintenance dose ranges from 50 mg to 250 mg twice a day. For children, lamotrigine is given according to the weight of the child. It should not be used for children who weigh less than 9 kg.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

The regular tablets must be swallowed whole and not chewed or crushed. The chewable tablets may be swallowed whole, chewed, or dissolved in a teaspoonful of water or fruit juice. The tablets take about 1 minute to dissolve. Once dissolved, swirl the solution and drink the entire amount immediately. Add some water to the glass and drink that as well to make sure there is no medicine left in the glass.

Lamotrigine may be taken with or without food.

It is important that Lamotrigine be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If your next dose is less than 4 hours away, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice. If you miss more than a few days of lamotrigine doses, talk to your doctor before restarting the medication. You may need to start taking the medication at a lower dose than you were taking previously.

Store Lamotrigine at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; occasionally it can cause a severe skin rash - contact your doctor if this occurs; it may cause drowsiness or dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause nausea or, rarely, vomiting; it may cause blurred vision. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

25 mg
Each white-to-off-white, shield-shaped tablet, marked with "LG" scoreline "25" on one side and "G" on the other side, contains 25 mg of lamotrigine. Nonmedicinal ingredients: lactose anhydrous, magnesium stearate, microcrystalline cellulose, povidone, and sodium starch glycolate.

100 mg
Each peach, shield-shaped tablet, marked with "LG" scoreline "100" on one side and "G" on the other side, contains 100 mg of lamotrigine. Nonmedicinal ingredients: coloring agent Lake Blend Orange (FD&C Yellow No. 6/Sunset Yellow FCF, Aluminum Lake and FD&C Red No. 40/Allura Red AC Aluminum Lake), lactose anhydrous, magnesium stearate, microcrystalline cellulose, povidone, and sodium starch glycolate.

150 mg
Each light yellow, shield-shaped tablet, marked with "LG" scoreline "150" on one side and "G" on the other side, contains 150 mg of lamotrigine. Nonmedicinal ingredients: iron oxide yellow, lactose anhydrous, magnesium stearate, microcrystalline cellulose, povidone, and sodium starch glycolate.

Do not take Lamotrigine if you are allergic to lamotrigine or any ingredients of the medication.

There may be an interaction between lamotrigine and any of the following:

• Acetaminophen
• alcohol
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• azelastine
• barbiturates (e.g., butalbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• birth control pills
• brimonidine
• Buprenorphine
• Buspirone
• cannabis
• chloral hydrate
• Desmopressin
• dofetilide
• efavirenz
• Entacapone
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• Guanfacine
• HIV protease inhibitors (e.g., atazanavir, lopinavir, ritonavir)
• kava kava
• magnesium sulfate
• Mefloquine
• Metformin
• Methotrexate
• Mirtazapine
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine)
• Nabilone
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• Olopatadine
• Orlistat
• Pramipexole
• Pregabalin
• procainamide
• progestins (e.g., Dienogest, Levonorgestrel, medroxyprogesterone, Norethindrone)
• rifampin
• Ropinirole
• Rotigotine
• scopolamine
• other seizure medications (e.g., Carbamazepine, Divalproex, Gabapentin, Levetiracetam, Phenytoin, primidone)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• sodium oxybate
• Tapentadol
• Tetrabenazine
• thalidomide
• tolcapone
• Tramadol
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Lamotrigine. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Lamotrigine.

Aseptic meningitis: Rarely, lamotrigine can cause symptoms of aseptic meningitis (inflammation or swelling of the membranes around the brain and spinal cord that is not caused by bacteria). If you have an autoimmune condition (e.g., systemic Lupus erythematosus, mixed connective tissue disease), you are more at risk for developing this. If you experience symptoms such as stiff neck, severe headache, nausea, vomiting, fever, or changes in consciousness, stop taking Lamotrigine and get immediate medical attention.

Birth control pills/hormone replacement therapy: The dose of lamotrigine you take may need to be adjusted if you start or stop oral contraceptives or other female hormonal treatments, such as hormone replacement therapy.

According to some case reports, when lamotrigine was taken in combination with birth control pills or other hormone replacement, rarely seizures, unexpected pregnancies, and menstrual bleeding disorders (e.g., breakthrough bleeding) occurred.

Do not start or stop taking these medications without consulting your doctor. If you experience changes in your menstrual pattern such as breakthrough bleeding while taking lamotrigine with these medications, contact your doctor.

Blood counts: Lamotrigine can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

Drowsiness/reduced alertness: If you have uncontrolled epilepsy, you should not drive or handle potentially dangerous machinery. Common side effects of lamotrigine include dizziness, problems with muscle coordination, drowsiness, double vision, and blurred vision. You should not undertake activities requiring mental alertness or physical coordination until you determine how lamotrigine affects you.

Heart disease: Lamotrigine can cause a change in the rhythm of the heart, particularly for people who already have certain heart conditions. If you have any heart condition, discuss with your doctor how Lamotrigine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Lamotrigine, and whether any special monitoring is needed.

Hypersensitivity reaction: Lamotrigine has occasionally caused a Anaphylaxis (severe allergic reaction) called hypersensitivity syndrome. This reaction involves a number of organs in the body and may be fatal if not treated quickly. Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.

Kidney function: Kidney Disease or reduced kidney function may cause Lamotrigine to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how Lamotrigine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Lamotrigine, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Lamotrigine to build up in the body, causing side effects. If you have reduced liver function or liver disease, discuss with your doctor how Lamotrigine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Lamotrigine, and whether any special monitoring is needed.

Lamotrigine may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Rashes: Severe skin rashes leading to hospitalization have been reported by people taking lamotrigine. This appears more likely to happen if the dose is increased too quickly. The risk of a serious rash is higher for children and may be higher for people who have experienced rashes when taking other medication for epilepsy. Nearly all cases of serious rashes associated with lamotrigine have occurred within 2 to 8 weeks of the start of treatment. If you notice a skin rash, fever, or swollen glands, seek medical attention immediately.

Stopping the medication: Suddenly stopping any antiepileptic medication may cause rebound seizures. In general, the medication should be stopped gradually, as directed by your doctor, to minimize this risk. Before stopping lamotrigine, contact your doctor for guidance.

Suicidal or agitated behaviour: People with epilepsy sometimes experience depression. If you have depression or bipolar disorder, you may be at an increased risk of feeling agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or wanting to hurt yourself or others. If you experience these side effects or notice them in a family member who is taking Lamotrigine, contact your doctor immediately.

Pregnancy: The use of lamotrigine during pregnancy has been associated with an increased number of cases of cleft palate, a birth defect. Lamotrigine should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Lamotrigine, contact your doctor immediately.

Do not stop taking the medication until you've consulted your doctor, since doing so can cause rebound seizures that may be harmful to the mother and unborn baby.

Breast-feeding: Lamotrigine passes into breast milk. If you are a breast-feeding mother and are taking lamotrigine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. Generally, breast-feeding while taking lamotrigine is not recommended.

Children: The safety and effectiveness of using lamotrigine for children under 16 years of age, other than those with Lennox-Gastaut syndrome, have not been established. Lamotrigine should not be used in children who weigh less than 9 kg.

This medication is typically used twice a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose and there is more than 4 hours left before the next dose, take immediately the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food. Consuming alcohol may intensify the effect of this product. Limit alcohol consumption to occasional small quantities.