Lamotrigine: What is it? Uses, Side Effects, Dosage, Administration, Warnings and Precautions

It is a prescription medicine. It comes in four forms to be taken orally:

  • Common tablets.
  • Extended-release tablets
  • Chewable tablets.
  • Tablets that disintegrate orally (can dissolve in the tongue).

Uso de la Lamotrigina

It is used to treat certain types of seizures in people with epilepsy. It can be used in combination with other anticonvulsant medications. Or it can be used only when passing other anticonvulsant medications.

It is also used for the long-term treatment of a mood disorder called bipolar disorder. With this condition, a person has extreme emotional highs and lows.

How does it work?

Lamotrigine belongs to a class of medications called anticonvulsants or antiepileptic drugs.

In people with epilepsy, this medication reduces the release of a substance in your brain known as glutamate. This action prevents the neurons in your brain from becoming too active. As a result, you may have fewer seizures.

For people with bipolar disorder, this medication can affect specific brain receptors that help control their mood. This could decrease the number of episodes of air you have.

Side effects

Lamotrigine may cause drowsiness. Do not drive, use heavy machinery, or do other dangerous activities until you know how this medicine affects you.

 

Although it is relatively rare, a healthcare professional should evaluate any skin rash that develops while taking Lamotrigine, as life-threatening rashes may occur.

Common side effects:

  • Dizziness.
  • Drowsiness.
  • Headache.
  • Double vision.
  • Blurry vision.
  • Nausea and vomiting.
  • Diarrhea.
  • Stomach ache.
  • Problems with balance and coordination.
  • Problems to sleep.
  • Back pain.
  • Nasal congestion.
  • Sore throat.
  • Dry mouth.
  • Fever.
  • Eruption.
  • Temblor.
  • Anxiety.

If these effects are mild, they may disappear in a few days or a couple of weeks. If they are more severe or do not go away, talk to your doctor or pharmacist.

Serious side effects:

Severe skin rashes called Stevens-Johnson syndrome and toxic epidermal necrolysis. Symptoms may include:

  • Blistering or peeling skin
  • Urticaria.
  • Eruption.
  • Painful sores in the mouth or around the eyes.

Multiorgasmic hypersensitivity is also called drug reaction with Eosinophilia and systemic symptoms (DRESS). Symptoms may include:

  • Fever.
  • Eruption.
  • Inflamed lymphatic glands
  • Severe muscle pain.
  • Frequent infections
  • Swelling of your face, eyes, lips or tongue.
  • Bruising or unusual bleeding
  • Weakness or tiredness
  • Yellowing of the skin or the whites of your eyes.

Low blood cell counts: symptoms may include:

  • Fatigue.
  • Weakness.
  • Frequent infections or an infection that does not go away.
  • Unexplained bruises.
  • Nasal hemorrhages.
  • Bleeding of the gums.

Changes in mood or behavior: Symptoms may include:

  • Thoughts about committing suicide.
  • Try to hurt yourself or kill yourself.
  • Depression or anxiety that is new or worsens
  • Restlessness.
  • Panic attacks.
  • Problems to sleep.
  • Anger.
  • Aggressive or violent behavior.
  • The bad mood that is new or worse.
  • Behavior or dangerous impulses.

Aseptic meningitis:  inflammation of the membrane that covers the brain and spinal cord. Symptoms may include:

  • Headache.
  • Fever.
  • Nausea and vomiting.
  • Neck stiffness.
  • Eruption.
  • Be more sensitive to light than usual.
  • Muscle pains.
  • Cold.
  • Confusion.
  • Drowsiness.

Interaction with other medications

Lamotrigine may interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a medication works. This can be harmful or prevent the drug from working well.

Tell your doctor about all the medications, vitamins, or herbs you are taking. Talk to your doctor or pharmacist to find out how this medication might interact with something else you are taking.

Examples of medications that can cause interactions with Lamotrigine are:

Anticonvulsant medications

Taking certain anticonvulsant medications with Lamotrigine can reduce the anticonvulsant level in your body. This can affect the effectiveness of the drug. Examples of these medications include:

On the other hand, Valproate can raise the level of Lamotrigine in your body. This can cause an increase in side effects that can be dangerous.

Medications for cardiac arrhythmia

Dofetilide is used to treat cardiac arrhythmias. When used with Lamotrigine, the levels of Dofetilide in your body may increase. This can cause fatal arrhythmias.

Drugs against HIV

Certain medications used to treat HIV can affect the effectiveness of Lamotrigine. Examples of these medications include:

  • Lopinavir.
  • Ritonavir.
  • Atazanavir.

Oral contraceptives

Taking Lamotrigine with combined oral contraceptives (those containing estrogen and progesterone) can affect its effectiveness.

Medicines for tuberculosis

Rifampin is used to treat tuberculosis. When mixed with Lamotrigine, it can reduce the effectiveness of the latter drug in your body.

Interactions with food

Medicines can interact with certain foods. In some cases, this can be harmful, and your doctor may advise you to avoid certain foods. In the case of Lamotrigine, there are no specific foods that you should exclude from your diet when you ingest it.

Warnings

Allergies

This medicine can cause a severe allergic reaction. Symptoms may include:

  • Eruption.
  • Difficulty breathing.
  • Swelling of the face, throat, and tongue.
  • Urticaria.
  • Itch.
  • Painful sores in the mouth.

Do not retake this medication if you have ever had an allergic reaction. Retaking it could be fatal (cause death).

Warnings for people with certain health conditions

For people with liver disease: This medicine is processed by your liver. If your liver is not working well, a more significant amount of the medication can remain in your body longer. This puts you at risk of increased side effects.

For people with kidney disease: This medicine is eliminated from the body by the kidneys. If your kidneys do not work well, more of the medication may stay in your body longer.

This puts you at risk of increasing side effects. If your kidney problems are severe, your doctor may stop using this medication or may not prescribe it at all.

Warnings for other groups

Pregnant women: Research in animals has shown adverse effects for the fetus when the mother takes the drug.

There have not been enough studies on humans to determine how the drug could affect the fetus. Talk to your doctor if you are pregnant or plan to be pregnant.

If you become pregnant while taking this medication, call your doctor immediately.

For breastfeeding women: This medicine is present in breast milk and can cause serious side effects in a breastfed child. Tell your doctor if you are breastfeeding your child.

Ask about the best way to feed him while taking this medication.

If you are breastfeeding while taking Lamotrigine, watch your child closely. Look for symptoms such as shortness of breath, extreme drowsiness, or poor suction. Call your doctor right away if you have any of these symptoms.

For children: It is unknown if Lamotrigine is safe and effective for treating seizures in children under two years of age.

It is also unknown if this medication is safe and effective for children under 13 years of age or if it works to treat bipolar disorder in children under 18 years of age.

How to drink?

Take Lamotrigine precisely as prescribed. Your healthcare provider can change your dose. Do not change your dose without consulting before.

Do not stop taking Lamotrigine without talking to your doctor. Stopping the drug suddenly can cause serious problems. For example, if you have epilepsy and stop taking it, you may have seizures that you do not control.

If you miss a dose, take it as soon as you remember it. If it is almost time for your next dose, skip oblivion. Take the following amount at your usual time. Do not take two at the same time.

You may not feel the full effect of Lamotrigine for several weeks.

If you have epilepsy, tell your health care provider if your seizures get worse or if you have some new type of seizure.

Swallow the tablets whole. If you have problems swallowing them, tell your health care provider to prescribe another presentation of Lamotrigine.

Note: Lamotrigine ODT should be placed on the tongue and moved around the mouth. The tablet will disintegrate quickly, can be swallowed with or without water, and can be taken with or without food.

The chewable dispersible tablets can be swallowed whole, chewed, mixed in water, or diluted with fruit juice. To separate the tablets, add them to a small amount of liquid (1 teaspoon, enough to cover the medication) in a glass or spoon.

Wait at least 1 minute or until the tablets break entirely, mix the solution, and take all the contents immediately.

If you receive Lamotrigine in a blister pack, examine the blister before use. Do not use them if the blisters are broken, torn, or missing.

Dose

The dose, the form, and its frequency will depend on:

  • Age.
  • The condition that is being treated.
  • How severe the condition is
  • Other medical conditions that you have.
  • How it reacts to the first dose

The dose of Lamotrigine for seizures in patients who do not take Valproic acid (Depakote, Depakote ER, Depakene, Depacon, Stavzor) but who take medications for attacks that reduce blood Lamotrigine levels (Phenobarbital, Phenytoin, Carbamazepine, Primidone ) It is:

  • 50 mg once a day for two weeks, followed by 100 mg a day administered in two divided doses for two weeks.
  • Subsequently, the dose is increased by 100 mg daily every 1-2 weeks until the usual maintenance dose of 300 to 500 mg per day is administered as a divided dose.

In patients taking Valproic acid, the initial dose of Lamotrigine is:

  • 25 mg every other day for two weeks, then 25 mg once a day for two weeks. After four weeks, the amount slowly increases from 25 to 50 mg per day, one or two weeks until a dose of 100 to 400 mg is reached once a day or divided twice a day.
  • The maintenance dose is 200 to 600 mg once a day.
  • The amount to treat bipolar disorder is 100 to 400 mg per day.