Patient Information Overview

Pronounced: LAM-ic-tal
Generic name: Lamotrigine
Category: Anticonvulsant Medication

Why is this drug prescribed?

Lamictal is prescribed to control partial seizures in people with epilepsy. It is also used to control a serious form of epilepsy known as Lennox-Gastaut syndrome. Lamictal is used in combination with other antiepileptic medications or as a replacement for a medication such as Tegretol, Dilantin, phenobarbital, or Mysoline.

Most important fact about this drug

You may develop a rash during the first 2 to 8 weeks of Lamictal therapy, particularly if you are also taking Depakene. If this happens, notify your doctor immediately. The rash could become severe and even dangerous, particularly in children. A slight possibility of this problem remains for up to 6 months.

How should you take this medication?

Take Lamictal exactly as prescribed by your doctor. Taking more than the prescribed amount can increase your risk of developing a serious rash. Do not stop taking this medication without first discussing it with your doctor. An abrupt halt could increase your seizures. Your doctor can schedule a gradual reduction in dosage.

--If you miss a dose... .

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store in a tightly closed container at room temperature. Keep dry and protect from light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Lamictal.

• More common side effects may include: Blurred vision, dizziness, double vision, headache, nausea, rash, sleepiness, uncoordinated movements, vomiting g
• Less common side effects may include: Abdominal pain, accidental injury, anxiety, constipation, depression, diarrhea, fever, "flu-like" symptoms, increased cough, inflammation of vagina, irritability, painful menstruation, sore throat, tremor
• Rare side effects may include: Absence of menstrual periods, chills, confusion, dry mouth, ear pain, emotional changes, heart palpitations, hot flashes, joint disorders, memory decrease, mind racing, muscle weakness, muscle spasm, poor concentration, ringing in ears, sleep disorder, speech disorder
• Additional side effects in children may include: Bronchitis, convulsions, ear problems, eczema, facial swelling, hemorrhage, infection, indigestion, light sensitivity, lymph node problems, nervousness, penis disorder, sinus infection, swelling, tooth problems, urinary tract infection, vertigo, vision problems

Why should this drug not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Lamictal, you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about this medication

Lamictal may cause some people to become drowsy, dizzy, or less alert. Do not drive or operate dangerous machinery or participate in any activity that requires full mental alertness until you are certain the drug does not have this kind of effect on you. Remember to be alert for development of any type of rash, especially during the first 2 to 8 weeks of treatment.

Be sure to tell your doctor about any medical problems you have before starting therapy with Lamictal. If you have kidney or liver disease, or heart problems, Lamictal should be used with caution.

Lamictal may cause vision problems. If any develop, notify your doctor immediately. Also be quick to call your doctor if you develop a fever or have any other signs of an allergic reaction. Notify your doctor, too, if your seizures get worse.

Possible food and drug interactions when taking this medication

Lamictal is often combined with other medications used to treat epilepsy, including the following:

• Carbamazepine (Tegretol)
• Phenobarbital (Donnatal, Quadrinal, others)
• Phenytoin (Dilantin)
• Primidone (Mysoline)
• Valproic acid (Depakene)

Be sure to check with your doctor before combining any other drugs with your seizure medications. Lamictal, in particular, may inhibit the action of sulfa drugs such as Bactrim, Proloprim, and Septra.

Special information if you are pregnant or breastfeeding

The effects of Lamictal during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, tell your doctor immediately. Lamictal should be used during pregnancy only if clearly needed. Lamictal appears in breast milk. Because the effects of Lamictal on an infant exposed to this medication are unknown, breastfeeding is not recommended.

Recommended dosage

ADULTS

Lamictal combined with Tegretol, Dilantin, Phenobarbital, and Mysoline:

One 50-milligram dose per day for 2 weeks, then two 50-milligram doses per day, for 2 weeks. After that, your doctor will have you take a total of 300 milligrams to 500 milligrams a day, divided into 2 doses.

Lamictal combined with Depakene alone or Depakene and any of the above medications:

One 25-milligram dose every other day for 2 weeks, then 25 milligrams once a day for 2 weeks. After that, the doctor will prescribe a total of 100 milligrams to 400 milligrams a day, taken in 1 or 2 doses.

Lamictal as a replacement for Tegretol, Dilantin, Phenobarbital, or Mysoline

While you continue to take the other drug, your doctor will add Lamictal, starting at a dose of 50 milligrams per day, then gradually increasing the daily dose. Once you've reached a dosage of 500 milligrams per day divided into 2 doses, the doctor will then begin gradually reducing the dosage of the other drug until, after 4 weeks, it has been completely eliminated.

CHILDREN 2 YEARS OF AGE AND OLDER

Lamictal can be added to other epilepsy drugs prescribed for children under 16 who have partial seizures or a serious form of epilepsy known as Lennox-Gastaut syndrome. Doses for children under 12 are based on the child's weight. Children 12 and older receive the adult dose. Doses are increased gradually from a low starting level to limit the risk of severe rash. Lamictal is not used as a replacement drug for children under 16.

Overdosage

A massive overdose of Lamictal can be fatal. If you suspect an overdose, seek medical treatment immediately.

• Symptoms of s of Lamictal overdose may include: Lack of coordination, rolling eyeballs, increased seizures, decreased level of consciousness, coma, delayed heartbeat

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Reviewed: 01/2006