Logo

Indications - Lamotrigine is indicated for: Epilepsy-combination therapy in patients aged 2 years and older: partial-onset seizures primary generalized tonic-clonic seizures generalized seizures of Lennox-Gastaut syndrome Epilepsy-monotherapy in patients aged 16 years and older. Adults with Bipolar Disorder.

Dosage & Administration - Epilepsy- Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy Weeks 1 & 2: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day In patients taking Valproate: 25 mg every other day In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day Weeks 3 & 4: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day In patients taking Valproate: 25 mg every day In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses) Week 5 onward to maintenance: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks Usual maintenance dose: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses) In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses) In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses) Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy Weeks 1 & 2: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses) Weeks 3 & 4: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses) In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses) Week 5 onward to maintenance: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day Usual maintenance dose: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses) In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses) In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses) Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy Weeks 1 & 2: If the patients weight is 6.7 kg to 14 kg: 2 mg every other day If the patients weight is 14.1 kg to 27 kg: 2 mg every day If the patients weight is 27.1 kg to 34 kg: 4 mg every day If the patients weight is 34.1 kg to 40 kg: 5 mg every day Weeks 3 & 4: If the patients weight is 6.7 kg to 14 kg: 2 mg every day If the patients weight is 14.1 kg to 27 kg: 4 mg every day If the patients weight is 27.1 kg to 34 kg: 8 mg every day If the patients weight is 34.1 kg to 40 kg: 10 mg every day Bipolar disorder- Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder Weeks 1 & 2: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily In patients taking Valproate: 25 mg every other day In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily Weeks 3 & 4: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily In patients taking Valproate: 25 mg daily In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses) Week 5: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily In patients taking Valproate: 50 mg daily In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses) Week 6: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily In patients taking Valproate: 100 mg daily In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses) Week 7: In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily In patients taking Valproate: 100 mg daily In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)

Side Effects - Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.

Contraindications - Data not found

Others - Pregnancy & Lactation Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. Precautions & Warnings Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.