Lamictal

Pronunciation

Generic Name: lamotrigine (la MOE tri jeen)
Brand Names: Lamictal

What is Lamictal?

Lamictal (lamotrigine) is an anti-epileptic medication, also called an anticonvulsant.

Lamictal is used either alone or in combination with other medications to treat epileptic seizures in adults and children. Lamictal is also used to delay mood episodes in adults with bipolar disorder (manic depression).

The immediate-release form of lamotrigine (regular tablet and the orally disintegrating tablet, Lamictal ODT) can be used in children as young as 2 years old when it is given as part of a combination of seizure medications. However, this form should not be used as a single medication in a child or teenager who is younger than 16 years old.

The extended-release form of lamotrigine (Lamictal XR) is for use only in adults and children who are at least 13 years old.

Lamictal may also be used for purposes not listed in this medication guide.

Important information

Before taking Lamictal, tell your doctor if you have kidney or liver disease, a history of depression or suicidal thoughts, or if you are allergic to other seizure medications.

Lamictal may cause severe or life-threatening skin rash, especially in children and in people who take too high of a dose at the start of treatment with Lamictal. Serious skin rash may also be more likely to occur if you are taking Lamictal together with valproic acid (Depakene) or divalproex (Depakote).

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Seek emergency medical attention if you have: fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

You may have thoughts about suicide while taking this medication. Your doctor will need to check you at regular visits. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Do not stop taking Lamictal without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using Lamictal suddenly. Contact your doctor if your seizures get worse or you have them more often while taking Lamictal. Taking this medication during early pregnancy can increase the risk of the baby being born with cleft lip or cleft palate. Tell your doctor if you are pregnant or if you become pregnant during treatment.

Before taking this medicine

You should not take Lamictal if you are allergic to lamotrigine.

To make sure you can safely take Lamictal, tell your doctor if you have any of these other conditions:

  • kidney or liver disease;

  • a history of depression or suicidal thoughts or actions; or

  • if you are allergic to other seizure medications.

You may have thoughts about suicide while taking this medication. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

FDA pregnancy category C. It is not known whether Lamictal will harm an unborn baby. Taking this medication during early pregnancy can increase the risk of the baby being born with cleft lip or cleft palate. Tell your doctor if you are pregnant or plan to become pregnant while taking Lamictal. Birth control pills can make Lamictal less effective, resulting in increased seizures. Tell your doctor if you start or stop using birth control pills while you are taking lamotrigine. Your Lamictal dose may need to be changed. Tell your doctor if you plan to stop taking birth control pills. Lamotrigine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

See also: Pregnancy and breastfeeding warnings (in more detail)

How should I take Lamictal?

Take Lamictal exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Taking too much Lamictal at the start of treatment may increase your risk of a severe life-threatening skin rash. Follow the directions on your prescription label.

Your doctor may occasionally change your dose over several weeks or months to make sure you get the best results. Take only the amount prescribed by your doctor whenever your dose is changed.

To make sure you are taking the right dose of Lamictal, your blood may need to be tested often. Visit your doctor regularly.

Extended-release lamotrigine (Lamictal XR) may be used for different conditions than immediate-release Lamictal is used for. Always check your refills to make sure you have received the correct size, color, and shape of tablet. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.

If you are switching to Lamictal from another anticonvulsant medication, carefully follow your doctor's instructions about timing and dosage when switching from one drug to another.

Do not crush, chew, or break a regular Lamictal tablet. Swallow it whole.

To take the orally disintegrating tablet (Lamictal ODT), place the tablet on your tongue and move it around in your mouth. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet.

To take the chewable dispersible tablet, you may either swallow it whole with a glass of water, or chew it first and then swallow it. You may also place the tablet into 1 teaspoon of water or diluted fruit juice and allow it to disperse in the liquid for about 1 minute. Gently swirl the liquid and then swallow all of the mixture right away. Do not save it for later use.

Do not stop taking Lamictal without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using lamotrigine suddenly. You may need to use less and less before you stop the medication completely. Wear a medical alert tag or carry an ID card stating that you take Lamictal. Any medical care provider who treats you should know that you take seizure medication.

Use Lamictal regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store Lamictal at room temperature away from light and moisture.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include blurred vision, problems with coordination, increased seizures, feeling light-headed, or fainting.

What should I avoid?

Lamictal may cause blurred vision or impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Lamictal side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Lamictal: hives; fever; swollen glands; painful sores in or around your eyes or mouth; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Lamictal may cause severe or life-threatening skin rash, especially in children and in people who take too high of a dose at the start of treatment with Lamictal. Serious skin rash may also be more likely to occur if you are taking Lamictal together with valproic acid (Depakene) or divalproex (Depakote). Seek emergency medical attention if you have a fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

If you have to stop taking Lamictal because of a serious skin rash, you may not be able to take it again in the future.

Call your doctor at once if you have any of these other serious side effects:

  • the first sign of any skin rash, no matter how mild;

  • fever, swollen glands, body aches, flu symptoms, headache, neck stiffness, increased sensitivity to light;

  • easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;

  • upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);

  • chest pain, irregular heart rhythm, feeling short of breath;

  • confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

  • increased seizures or worsening of your bipolar disorder.

Less serious Lamictal side effects may include:

  • tremors, dizziness, tired feeling;

  • blurred vision, double vision;

  • loss of coordination;

  • dry mouth, mild nausea, stomach pain, upset stomach;

  • changes in your menstrual periods;

  • back pain;

  • sleep problems (insomnia); or

  • runny nose, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Lamictal?

Tell your doctor about all other medicines you use, especially:

  • hormonal forms of birth control (pills, injections, implants, or skin patches);

  • carbamazepine (Carbatrol, Equetro, Tegretol);

  • divalproex (Depakote);

  • oxcarbazepine (Trileptal);

  • phenobarbital (Solfoton);

  • primidone (Mysoline);

  • phenytoin (Dilantin);

  • rifampin (Rifadin, Rifater, Rifamate, Rimactane); or

  • valproic acid (Depakene, Stavzor).

This list is not complete and other drugs may interact with Lamictal. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about Lamictal.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 16.02. Revision Date: 2012-04-18, 3:09:41 PM.

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