Lamictal

What is it?

An anticonvulsant, triazine preparation available as yellow tablets in 4 different strengths containing 25mg, 50mg, 100mg or 200mg of 1amotrigine marked with name and strength. Also, LAMICTAL DISPERSIBLE, white tablets for chewing in 4 different strengths containing 2mg (marked LTG), 5mg, 25mg or 100mg of lamotrigine, marked with strength and name.

Medical Uses

Seizures of various categories, either as monotherapy or with other drugs; Lennox-Gastaut syndrome.

Dosage

Adults, monotherapy, starting dose of 25mg as single dos each day for 2 weeks, followed by 50mg once daily for further 2 weeks. if necessary, dose is further increased on a weekly or fortnightly basis by increments of 50 to 100mg until control is achieved - generally in order of 100 to 200mg each day as one dose or divided into 2 daily doses. Extreme cases may require up to 500mg each day. Additional therapy with enzyme inducers, except sodium valproate: 50mg once each day to start for 2 weeks followed by 50mg twice each day for 2 weeks. If necessary, dose is increased by a maximum increment of 100mg on a weekly or fortnightly basis until condition is controlled - generally in order of 200 to 400mg each day in two divided doses. Extreme cases may require 700mg each day in divided doses. With sodium valproate: 25mg every second day at first for 2 weeks followed by 25mg once daily for 2 weeks. Dose then increased by 25 to 50mg increments on weekly or fortnightly basis until control is achieved - usually in order of 100 to 200mg each day either as single or 2 divided doses. Children additional therapywith enzyme inducers, not valproate: aged 2 to 12 years, at first, 0.6mg per kg of body weight each day in 2 divided doses for 2 weeks followed by 1.2mg per kg of body weight each day for 2 weeks. Then, increase by 1.2mg per kg of body weight on weekly or fortnightly basis until control is achieved - usually in order of 5 to 15mg per kg of body weight in 2 divided doses each day. With sodium valproate, aged 2 to 12 years, start with 0.15mg per kg of body weight each day as single dose for 2 weeks, followed by 0.3mg per kg of body weight once each day for 2 weeks. Then, increase by maximum increments of 0.3mg per kg of body weight on weekly or fortnightly basis until control is achieved - usually in order of 1 to 5mg per kg of body weight, either as single or 2 divided doses. Special cure: elderly, pregnancy, breastfeeding; Monitor liver, kidney and clotting in patients developing fever, flu, rash, drowsiness or deterioration of seizure control; Also, watch for bruising, anaemia, infections or other signs of failure of bone marrow. Withdraw gradually over 2 weeks.

Avoid Use

Children under 2 years, significant liver disease.

Possible Drug and Food Interactions

Sodium valproate, primidone, phenobarbitone, phenytoin, carbamazepine.

Known Side Effects

Dizziness, insomnia, confusion, double or blurred vision, irritability, aggression, headache, agitation, weariness, tremor, gastrointestinal upsets, loss of co-ordination, rash, Stevens-Johnson syndrome, angioneurotic oedema (condition in which there is widespread swelling), bone marrow suppression, aplastic anaemia, pancytopenia (marked decline in all blood cells), skin death. Patients should report any occurrence of skin changes/rash.