Lamictal

The active ingredient in Lamictal is lamotrigine. Although the exact mechanism is unknown, it is suggested that Lamictal works by stabilizing abnormal electrical activity in the brain, hence its use as an antiepileptic drug. Stabilizing electrical activity can also help restore the balance of neurotransmitters in the nervous system, which helps relieve symptoms of mood disorders.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Lamictal. However, the following is a synopsis of the general guidelines for the use of Lamictal:

• Lamictal is typically started at a lower dose and is gradually increased over time to minimize side effects by giving your body time to adjust to the medication. Use as prescribed and do not discontinue or exceed the recommended dose without consulting your doctor. Stopping the drug can have serious consequences. If you have epilepsy, stopping can lead to uncontrollable seizures.
• For patients 2 years and older, Lamictal is often an adjunctive (add-on) to other antiepileptics for controlling seizures. For patients 16 years and older with partial onset seizures, Lamictal may be used as a monotherapy. The use of Lamictal may need to be reevaluated if there is a change in seizure control or if there is a worsening of side effects.
• If there are changes to your medications, your maintenance dose of Lamictal may need to be adjusted. For example, starting or stopping birth control pills with estrogen may require a dose adjustment. Consult your healthcare provider before making any changes to your medications.
• Lamictal is not affected by food so you can take it without regard to meals.
• Take Lamictal tablets whole. Do not break, crush, or chew them.
• Dispersible tablets or oral disintegrating tablets (ODT) should be placed on the tongue to dissolve completely. Remnants can be swallowed with or without water.
• Lamictal tablets for oral suspension can be mixed in a small amount of water or juice. Tablets should be added to a teaspoon of liquid, left for about a minute, mixed, and taken immediately.
• There are no chewable tablets for Lamictal but the tablets for oral suspension can be chewed if this method of administration is preferred.
• If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take double doses to make up for a missed one.

The most common side effects of Lamictal seen in clinical trials as compared to placebo for epilepsy include:

• Dizziness
• Headache
• Double vision
• Blurred vision
• Loss of muscle coordination
• Nausea and vomiting
• Drowsiness
• Stuffy or runny nose
• Sore throat

Other side effects more commonly seen in children with epilepsy include:

• Infection
• Fever
• Diarrhea
• Stomach pain
• Tremor

The most common side effects of Lamictal seen in clinical trials as compared to placebo for bipolar disorder include:

• Nausea and vomiting
• Dry mouth
• Trouble sleeping
• Back pain
• Drowsiness
• Fatigue
• Stuffy or runny nose
• Stomach pain

Some individuals may experience serious side effects while using Lamictal. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Suicidal thoughts (any depressive symptoms, mood changes, or behavioral changes noted by patients, their families, or caregivers should be reported immediately to the healthcare provider).
• Skin rash, especially if it is associated with blistering and fever.
• Symptoms of an abnormal heartbeat such as a fluttering, racing, or pounding feeling in the chest alongside shortness of breath or chest pain.
• Symptoms of hemophagocytic lymphohistiocytosis such as swelling of lymph nodes, fever, or rash.
• Symptoms of aseptic meningitis such as headache, fever, nausea, vomiting, and a stiff neck.
• Symptoms of disorders affecting blood cells such as unexpected infection, bleeding, fatigue, or pallor.
• Symptoms of liver damage such as yellowing of the skin and eyes or right-sided abdominal pain.

These are not all of the possible side effects of Lamictal. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Lamictal, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• Heart disease or heart problems such as irregular heartbeats
• Liver disease
• Kidney disease
• Depression, mood problems, or suicidal thoughts
• Because it can cause drowsiness, do not drive or operate heavy machinery until you know how Lamictal affects you.
• Lamictal can affect the efficacy of birth control pills. Any breakthrough bleeding or spotting between menstrual periods should be promptly reported to your doctor.

Boxed Warning

• Lamictal can cause serious skin rashes that can be life-threatening. These include Stevens-Johnson Syndrome and toxic epidermal necrolysis. There is an increased risk of serious rashes like these in children or if the dose of lamotrigine exceeds the recommended amounts. If you experience a skin reaction, discontinue use and seek medical attention.

Do not use Lamictal if you have:

• A known hypersensitivity or allergic reaction to lamotrigine or any of the other ingredients in Lamictal. This includes rash, swelling of the face or lips, difficulty breathing, or hives.

Because Lamictal is started at a low dose that is gradually increased over time, it can take several weeks to see the beneficial effects of lamotrigine.

When Lamictal is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, there is a risk for drug interactions. There may be changes in how Lamictal or your other medications work or an increased risk for side effects. Make sure that you tell your healthcare professional about anything that you are taking, including:

• Valproate or valproic acid
• Carbamazepine
• Phenytoin
• Phenobarbital
• Primidone
• Rifampin
• Estrogen-containing oral contraceptives with ethinyl estradiol
• Lopinavir
• Ritonavir
• Atazanavir
• Risperidone
• Dofetilide

Lamictal is available in various dosage forms. Regular tablets are scored and come in the following strengths:

• 25 mg
• 100 mg
• 150 mg
• 200 mg

Dispersible tablets or oral disintegrating tablets (ODT) come in the following strengths:

• 25 mg
• 50 mg
• 100 mg
• 200 mg

Tablets for oral suspension come in the following strengths:

• 2 mg
• 5 mg
• 25 mg

Lamictal is also available as an extended-release formulation known as Lamictal XR. This formulation is longer acting so it can be taken once daily. Depending on the situation, it may be a more appropriate choice for certain patients. Discuss with your doctor before making any medication changes.

Lamictal should be stored at room temperature away from moisture and heat and out of reach of children.

Lamictal is manufactured by the pharmaceutical company GlaxoSmithKline.

Yes, a generic version of the brand name Lamictal is available.

Do not stop taking Lamictal without consulting your healthcare provider first. Abruptly stopping this medication can cause serious problems and a gradual taper is preferred. Consult your healthcare provider before starting, stopping, or changing medications while taking Lamictal.

Lamictal may cause harm to your unborn child. Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Women who must take Lamictal during pregnancy are encouraged to enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The registry collects information related to the use of antiepileptic drugs in expectant mothers.

Lamictal can pass into the breastmilk and may cause harm to the nursing infant. Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.