Lamotrigine (Oral)

Overview

Lamotrigine is a medicine given to patients looking to control certain types of seizures due to epilepsy. This includes seizures such as Lennox-Gastaut syndrome, partial seizures, and tonic-clonic seizures. Lamotrigine may be prescribed either on its own or alongside other drugs as well. Be aware that Lamotrigine is not designed to cure epilepsy in any way, but is instead used to control seizures for as long as you keep taking the medicine.

As well as this purpose, Lamotrigine is also given to patients older than 18 who are suffering from bipolar disorder (manic-depressive illness).

You can not access this medicine on your own, but can instead only get it through a prescription from your doctor. It is known to interact with a variety of other medical problems and drugs, and so is not suitable for certain patients. There are so many different forms this drug comes in, and your doctor will need to advise you on which one is most suitable for your condition. You should closely follow all prescriptions they give you, and also any other lifestyle or dietary changes you should make.

Condition(s) treated

  • Epileptic seizures

Type of medicine

  • Chewable tablet

Side effects

As well as having its intended effects, it is possible that Lamotrigine will cause some patients to experience unwanted side effects as well. These side effects can range in their severity and their need for medical assistance. DIrectly below is a list of the more serious side effects that may occur. If you experience any of these whilst taking Lamotrigine, you should contact your doctor immediately.

More common

  • Double vision

Less common

  • Uncontrolled, continuous rolling or back and forth eye movements

Rare

  • Unusual weakness or tiredness

Incidence not known

  • Shortness of breath

Below are the symptoms of overdose due to Lamotrigine. Get emergency medical help if you experience any of the following.

Instead of these more serious side effects, you may experience some less severe ones that don't require emergency medical attention. Instead, you may find that they simply pass over time as your treatment progresses and your body adjusts to the medicine.Below is a list of such side effects. However, if you do experience any of the following and find them bothersome or persistent, then you can still contact your doctor. They may be able to offer advice or ways to help reduce the side effects.

More common

  • Nausea

Less common

  • A runny nose

Though these lists are extensive, they do not necessarily include all possible side effects. If you experience any others that are not listed here, then you can still contact your doctor for advice.

Dosage

Below you can find the typical doses of Lamotrigine given to patients with both bipolar disorder or epilepsy. Be aware that the exact doses you have been prescribed may differ greatly from what is below. This is because every patient is different and your exact prescription will be based on a number of factors. This includes factors such as the extent of your condition, other medicines you are taking, as well as other medical conditions you suffer from. You should not alter your doses in any way unless told to do so by your doctor. If you have any questions about your doses, then these should first be addressed to your doctor.

For patients taking oral dosage (tablets, disintegrating tablets, or chewable dispersible tablets) to treat bipolar disorder:

  • Adults who are not taking valproic acid (Depakote®) and who are not taking primidone (Mysoline®), phenobarbital (Luminal®), carbamazepine (Tegretol®), and/or phenytoin (Dilantin®). To start, take 25mg of Lamotrigine 1 time a day for a period of two weeks. After, take a total dose of 50mg that is divided into 2 smaller doses taken every day for 2 weeks. Afterwards, your doctor may decide to gradually increase your doses further if necessary. Although, the total daily dosage is not normally more than 200mg.

For patients looking to treat epilepsy by taking oral dosage (tablets, disintegrating tablets, or chewable dispersible tablets):

  • Adults and teenagers who are not taking valproic acid (Depakote®), but are taking primidone (Mysoline®), phenobarbital (Luminal®), carbamazepine (Tegretol®), and/or phenytoin (Dilantin®). To start, take 50mg of Lamotrigine 1 time a day for a period of two weeks. After, take a total dose of 100mg that is divided into 2 smaller doses taken every day for 2 weeks. Afterwards, your doctor may decide to gradually increase your doses further if necessary. Although, the total daily dosage is not normally more than 500mg.

For patients taking extended-release tablets to treat seizures:

  • Adults and teenagers aged above 13 who are not taking valproic acid (Depakote®), but are taking primidone (Mysoline®), phenobarbital (Luminal®), carbamazepine (Tegretol®), and/or phenytoin (Dilantin®). To start, take 50mg of Lamotrigine 1 time a day for a period of two weeks. After, take 100mg once a day for 2 weeks. Afterwards, your doctor may decide to gradually increase your doses further if necessary. Although, the total daily dosage is not normally more than 600mg.

You should aim to never miss a dose of this medicine as doing so will impact upon the effectiveness of your treatment. If you do miss a dose for any reason, you should take it as soon as you remember. However, if it is almost time for your next dose then you should skip the missed one and return to your regular schedule of dosing. It is important you never double dose.

You should take Lamotrigine exactly as it is prescribed to you by your doctor. You should never take it for longer than instructed, and never take any more of it. This will enable the best treatment for you and help limit any unwanted effects.

Upon receiving this medicine, you will find a Medication Guide. You should read this fully and address any questions you have to your doctor.

You can take this medicine either with or without food and on a full or empty stomach. However, if you have been told by your doctor to take it a certain way, then you should follow their instructions.

If you have been prescribed the chewable dispersible tablet form of Lamotrigine, then you can chew and swallow them, disperse them in some liquid and swallow, or swallow them whole. If you do choose to chew them, then you should follow this with a small quantity of diluted fruit juice or water in order to help you swallow it properly. If you wish to break up the tablets, you should first cover them in just enough diluted fruit juice or water (roughly a teaspoonful). Then, wait for about a minute until they are completely dispersed and simply swirl the solution around and swallow straight away.

If you have been prescribed the disintegrating tablet, you should ensure your hands are fully dry before you handle any tablets. You should only open the blister pack containing the tablet once you are ready to actually take and use the tablet. You can remove a tablet from a blister pack by peeling the foil back and taking it out. Never push the tablet out through the foil. You should first place the tablet on your tongue and then swirl it around your mouth. You will find that it melts quickly. Once it has melted, you can swallow it or take a sip of water to help.

If you are taking the extended-release tablets, then you should not chew, crush, or break these. Instead, swallow them whole.

You should only take the exact brand of medicine prescribed to you. Other ones don't work the same.

You can take Lamotrigine with other medicines designed to help seizures. Unless your doctor tells you to stop, you should keep taking all medicines prescribed to you.

Interactions

It is possible that other drugs you are currently taking will interact with Lamotrigine.You should, therefore, tell your doctor about all prescription and nonprescription drugs you take. They can then predict if an interaction will likely occur and take necessary steps to prevent or limit the interaction. Directly below is a list of drugs with which it is usually not recommended you take at the same time as Lamotrigine. Your doctor may, therefore, decide to change one or both or the interacting drugs. However, it is possible that taking both is best for your treatment. Under such circumstances, your doctor may simply adjust one or both doses.

  • Valproic Acid

If you take any of the following medicines at the same time as Lamotrigine, then you could be at an increased risk of experiencing certain side effects. However, it may again be that taking both is best for your treatment. As such, your doctor may then need to alter one or both doses in order to limit any interaction.

  • Norgestrel
  • Etonogestrel

It is also possible that this drug will interact with certain parts of your dietary intake. Your doctor may, therefore, ask you to make restrictions on certain things you eat, smoke, or drink. You may need to consume them less frequently or in smaller quantities in order to avoid unwanted interactions.

Finally, other medical problems you suffer from may interact with this medicine. In particular, the following:

  • Thalassemia. This medicine has the potential to limit the number of red blood cells your body produces

Warnings

Before prescribing you with this medicine, your doctor will want to first ensure that it is indeed the best course of treatment for you. As apart of this decision-making process they will need to be made aware of any allergies you have. This includes those to animals, dyes, foods, and preservatives.

The studies that have taken place to date have not highlighted any pediatrics-specific problems that would make the Lamotrigine tablets, chewable tablets, or disintegrating tablets any less useful for children older than 2 suffering from seizures. However, it should be noted that efficacy and safety have yet been established for children younger than 2.

As of writing, no suitable studies have taken place on the use of extended-release Lamotrigine tablets for treating partial seizures in children aged younger than 13. As such, no efficacy and safety have been established.

As of writing, no suitable studies have taken place on how age affects the use of Lamotrigine disintegrating tablets, tablets, or chewable tablets in children who have bipolar disorder. No efficacy and safety have yet been established.

Be aware that, even though no suitable studies have taken place in the relationship between age and the usefulness of this medicine, it is not expected that Lamotrigine is any less effective in elderly patients. Just be aware that geriatric patients are more likely to have age-related heart, kidney, and liver problems. These could require an adjustment to be made in the doses that such elderly people are given.

As of writing, it is unclear as to whether suitable studies have taken place in pregnant women receiving Lamotrigine. Your doctor is best placed to advise on any increased risks.

There are currently no suitable studies that have been performed on how this medicine affects breastfeeding women or their infants. Your doctor is best placed to advise on any increased risks and to then weigh them against the benefits this medicine offers.

You will be required to attend regular appointments with your doctor whilst you take this medicine. It is important that you attend all appointments as they offer a chance for your doctor to assess how your treatment is progressing and look for unwanted effects. They may also need to adjust the doses you take of this medicine, and such appointments are especially important in the first few month of your treatment.

If, whilst taking this medicine you become pregnant, you should inform your doctor immediately. Your doctor may require you to join a pregnancy registry for patients that are taking seizure medicine.

If, whilst taking the medicine, you experience changes in your menstrual cycle, you should inform your doctor. This includes changes in your menstrual cycle via things like breakthrough bleeding or other female hormonal products or birth control pills.

Lamotrigine has the potential to increase the effects of CNS depressants or alcohol. Below is a list of examples of CNS depressants. If you do take any of the above, then you should make your doctor aware of this before taking Lamotrigine.

  • Muscle relaxants

Whilst taking Lamotrigine, you should not drive or perform other dangerous tasks until you know how the medicine fully affects you. This includes tasks that require you to react quickly and be alert. It can cause the following effects:

  • Drowsiness

One sign of you experiencing a serious unwanted effect is a skin rash. If you develop flu-like symptoms a rash, swollen, gland, fever, or if your seizures get worse, you should tell your doctor right away.

It is possible that this medicine will cause a severe allergic reaction that affects multiple organs in your body (such as your kidney or liver). If you experience any of the following symptoms, inform your doctor immediately.

  • Muscle stiffness or pain

Lamotrigine can cause some patients to become irritable, agitated, or to have other abnormal behaviors. It can cause others to be depressed or have suicidal thoughts or tendencies. If you notice any of these effects, then inform your doctor immediately.

If you display any of the following symptoms whilst taking this medicine, tell your doctor right away. They could be symptoms of a condition that is both serious and rare known as aseptic meningitis.

  • Fever

You should only stop taking this medicine if you first check with your doctor. Stopping suddenly can cause your seizures to return or to start occurring more frequently. Instead, your doctor will likely want you to gradually decrease your doses over time.

You should not take any other medicines at the same time as Lamotrigine unless they have first been discussed with your doctor. This includes prescription and nonprescription drugs, as well as any herbal or vitamin supplements.

Storage

You should store your Lamotrigine in a sealed container and keep it at room temperature, away from any direct light, moisture, or heat. You should also never allow it to freeze. Keep it safely away from children. Once you finish your treatment, or if you notice any medicine goes out of date, then you should dispose of any medicine left. Your doctor or pharmacist can advise on a safe and sensible way to do so.

Summary

If you are suffering from bipolar disorder or epilepsy, then Lamotrigine is just one medicine that may be effective in helping to control some of your symptoms. However, you should be aware that this medicine is not suitable for all patients as it can interact with a variety of things and can cause certain side effects. If you are prescribed it then you should take it exactly as described by your doctor, and you should only take the exact brand you were prescribed.

You should also be careful in attending all scheduled appointments so that your doctor can properly track your treatment and make any necessary adjustments to your dosage. If you experience any of the more worrying side effects listed above, then you should inform your doctor immediately. Similarly, if you have any other questions about this medicine or your treatment in general, then these are best addressed to your doctor.