Home :: Drugs :: Lamotrigine

Lamotrigine - Learn about Lamotrigine Side Effects and Precautions

Lamotrigine Information

The pharmacology action of Lamotrigine is that it proposed mechanism suggests inhibition of voltage-sensitive sodium channels, thereby stabilizing neuronal membranes, that modulates presynaptic transmitter release of excitatory amino acids (eg, glutamate, aspartate).

Lamotrigine is used in treatment of bipolar I disorder to delay the time to occurrence of mood episodes in patients treated for acute mood episodes with standard therapy. May be useful in adults with generalized tonic-clonic, absence, atypical absence, and myoclonic seizures.

Interaction and Contraindication of Lamotrigine

Interaction of Lamotrigine - Acetaminophen, carbamazepine, hydantoins (eg, phenytoin), oral contraceptives, oxcarbazepine, phenobarbital, primidone, progestins, rifamycins (eg, rifampin), succinimides (eg, methsuximide):  Lamotrigine plasma levels may be reduced by these agents, decreasing the therapeutic effect.
Carbamazepine:  The risk of carbamazepine toxicity may be increased.
Folate Inhibitors:  Lamotrigine is an inhibitor of dihydrofolate reductase. Use caution with other agents that inhibit folate metabolism.
Valproic acid:  Plasma levels may be reduced by lamotrigine, decreasing the therapeutic effect. Valproate increases lamotrigine levels.

Contraindication of Lamotrigine - Use in patients who require low-galactose diet.

Side Effects o f Lamotrigine

Here are the list of some common side effects ofLamotrigine :

• Dizziness (38%); headache (29%); ataxia (22%); somnolence (14%); insomnia (10%); abnormal coordination (7%); incoordination, xerostomia (6%); anxiety (5%); asthenia (at least 5%); tremor, depression (4%); convulsions, irritability, speech disorder (3%); concentration disturbance, seizure exacerbation (2%).
• Diplopia (28%); blurred vision (16%); nystagmus (at least 5%); abnormal vision (3%).
• Nausea (19%); vomiting (9%); dyspepsia (7%); abdominal pain, diarrhea (6%); constipation (5%); tooth disorder (3%); anorexia (2%).
• Rhinitis (14%); pharyngitis (10%); increased cough (8%); sinusitis (at least 5%).
• Back pain, fatigue (8%); flu syndrome (7%); fever (6%); lymphadenopathy, infection, pain, weight decrease (at least 5%); neck pain, arthralgia (2%).

Precaution and Warning while taking Lamotrigine

The precaution and warnings of Lamotrigine drug is as follows:

• Instruct patient, family, or caregiver to continue other medications for seizures or bipolar disorder unless advised to do otherwise by health care provider.
• Advise patient, family, or caregiver that medication will be started at a low dose and gradually increased as tolerated until max benefit has been obtained.
• Instruct patient, family, or caregiver to take exactly as prescribed and not to change the dose or discontinue therapy unless advised by health care provider.
• Advise patient to swallow tablet whole. Chewing the tablet may leave a bitter taste.
• Instruct patient, family, or caregiver in proper use of chewable dispersible tablets.
• Advise patient, family, or caregiver that each dose may be taken without regard to meals but to take with food if stomach upset occurs.
• Instruct patient, family, or caregiver that if a dose is missed to skip that dose and not to double up on the next dose.
• Instruct patient, family, or caregiver to discontinue therapy and contact health care provider immediately if any of the following occur: skin rash, hives, fever, swollen lymph glands, painful sores in the mouth or around the eyes, or swelling of the lips or tongue.
• Advise patient, family, or caregiver that if medication needs to be discontinued it will be slowly withdrawn over a period of 2 wk or more unless safety concerns (eg, rash) require a more rapid withdrawal.
• Caution patient that drug may cause dizziness or drowsiness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined.
• Advise women to notify health care provider if pregnant, planning to become pregnant, or breastfeeding.
• Caution patient, family, or caregiver that if medication is stopped for any reason to notify health care provider and not to restart the medication without instruction from health care provider because a dosage adjustment may be necessary if the medication is restarted.
• Instruct patient, family, or caregiver to contact health care provider if seizures get worse, if new types of seizures occur, or if bipolar symptoms do not improve or they worsen.
• Advise patient, family, or caregiver to contact health care provider if bothersome side effects occur.

How to store Lamotrigine

• Tablets and chewable dispersible tablets are interchangeable on mg for mg basis.
• Dosing regimen is dependent on age of patient, condition being treated, and concurrent use of other antiepileptic or antipsychotic drugs.
• Administer prescribed dose without regard to meals. Administer with food if GI upset occurs.
• Tablets should be administered whole. Chewing tablet may leave a bitter taste.