lamotrigine, Lamictal, Lamictal CD, Lamictal ODT, Lamictal XR (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

Other important side effects include:

  • increased risk of developing aseptic meningitis and
  • reduced white blood cells, red blood cells, and platelets.

Multiorgan failure, including fatal liver disease rarely has been observed during lamotrigine treatment.

As a general rule, anti-seizure medications should not be abruptly stopped because of the possibility of increasing the frequency of seizures. In most cases, the dose of lamotrigine should be gradually lowered over a period of at least two weeks. Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need for the drugs. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS:

  • Tablets: 25, 100, 150, and 200 mg.
  • Tablets, chewable (CD): 2, 5, and 25 mg.
  • Tablets, orally disintegrating (ODT): 25, 50, 100, and 200 mg.
  • Tablets, extended release (XR): 25, 50, 100, 200, 250, and300 mg.

STORAGE: Tablets should be stored at room temperature, between 15 C - 30 C (59 F - 86 F).

DOSING: The dose of immediate release lamotrigine for seizures in patients not taking valproic acid (Depakote, Depakote ER, Depakene, Depacon, Stavzor), but taking seizure medications that reduce lamotrigine blood levels (for example, phenobarbitol, phenytoin [Dilantin, Dilantin-125], carbamazepine [Tegretol], primidone) is 50 mg once daily for two weeks, followed by 100 mg daily given in two divided doses for two weeks. Thereafter, the dose is increased by 100 mg daily every 1-2 weeks up to the usual maintenance dose of 300 to 500 mg daily given as a divided dose.

In patients who are taking valproic acid in which it increases blood levels of lamotrigine, the initial dose of lamotrigine is 25 mg every other day for two weeks, then 25 mg once daily for two weeks. After 4 weeks the dose is slowly increased by 25 to 50 mg per day every one to two weeks until a dose of 100 to 400 mg once daily or divided twice daily is reached. The maintenance dose when using extended release tablets is 200 to 600 mg once daily.

Medically Reviewed by a Doctor on 12/31/2014


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