Lamictal (Lamotrigine)

Drug Uses

Lamictal is used in combination with other anti-seizure drugs in the treatment of some types of seizures. It also is used alone for treating partial seizures in patients of 16 years old and older when converting from the anti-epileptic drug valproate.

How Taken

The initial dose of lamictal in patients, not taking valproic acid (Depakote), is 50 mg once daily for two weeks, followed by 100 mg daily, given in two divided doses for two weeks. Thereafter, the usual maintenance dose is 300 to 500 mg daily, given in two divided doses. In patients taking valproic acid, the initial dose of lamictal is 25 mg every other day for two weeks, then 25 mg once daily for two weeks, slowly increasing the dose (by 25 to 50 mg per day) every one to two weeks) until a dose of 100 to 150 mg daily is reached. Standard doses of lamictal are given twice daily.

Drug Class and Mechanism

Lamictal is an oral drug that is used for treating seizures. It is chemically unrelated to other anti-seizure drugs. The precise mechanism by which lamictal exerts its anti-seizure action is not known.

Missed Dose

Try to take each dose at the scheduled time. If you miss a dose, take it as soon as remembered; do not take it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Storage

Store this medication at room temperature at 77 degrees F (25 degrees C) away from heat, light, and moisture. Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Do not store in the bathroom. Keep this and all medications out of the reach of children.

Warnings/Precautions

Rarely, serious (sometimes fatal) skin rashes have occurred while using this medication. These rashes (e.g., Stevens-Johnson syndrome) are more common in children (less than 16 years old) than in adults. Therefore, lamictal should only be used in children who have partial seizures or seizures, associated with Lennox-Gastaut syndrome. Immediately notify your doctor if you develop any type of rash. If this medication is the cause of the rash, the drug must be stopped.

Even after stopping this medication, it is still possible for the rash to cause permanent or life-threatening scarring along with other problems. The possibility of a rash may be increased by using too much of this medication when treatment begins, increasing the dose beyond what your doctor prescribes during treatment, or taking valproic acid with lamictal. Most life-threatening rashes have occurred within 2 to 8 weeks of starting this medication.

However, such serious rashes have also occurred after 6 months of use. Tell your doctor if you have: other illnesses, heart problems, liver problems, kidney problems, allergies (especially drug allergies). Sunscreen and/or protective clothing is recommended to protect against a possible severe rash, triggered by sunlight. Use caution operating machinery or engaging in activities, requiring alertness. Limit alcohol intake while taking this drug. This medication should be used only if clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This drug is excreted into breast milk. Due to possible risks to nursing infants, breast-feeding while using this drug is not recommended. Consult your doctor.

Possible Side Effects

Headache, fatigue, drowsiness, dizziness, blurred vision, weakness, clumsiness may occur the first several days as your body adjusts to the medication. If any of these effects continue or become bothersome, inform your doctor. If you develop a rash, stop using this drug and seek immediate medical attention. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, hives, fever, swollen glands, swelling of the lips or tongue, painful sores in the mouth or around the eyes, severe dizziness, trouble breathing. If you notice other effects, not listed above, contact your doctor or pharmacist.

More Information

Laboratory tests may be done periodically while taking this medication to monitor the effects. See your doctor regularly.