Lamictal (Lamotrigine)

By Michelle Welborn, PharmD
Medically Reviewed by Cristina Perelman, Medical Director
Last Update: August 13, 2024

Lamictal (Lamotrigine) is a preparation prescribed for arresting epileptic seizures. Generic Lamictal is effective for epilepsy treatment together with a brand one.

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Table of Contents

Product Info

Indications

Lamictal is used as part of mono- and polycomponent therapy of focal and generalized seizures, including attacks of myoclonic-astatic epilepsy in adults and adolescents. Children 2-12 years of age are prescribed Lamictal as an additional remedy for suppressing convulsive syndrome.

Monotherapy is possible after achieving control over the frequency and intensity of attacks. It is shown in the therapy of typical absences.

Dosage and Instruction for Use

Monotherapy of epilepsy in adults and adolescents is carried out in the following way: in the first 2 weeks of admission – 25 mg once a day, the next 2 weeks – 50 mg of Lamictal with the same frequency of receptionю Then the dose is gradually increased until the maximum clinically significant effect is achieved. Supportive therapy is carried out with a dose of 100-200 mg per day, and in some patients, it can reach 0.5 g.

Multicomponent epiphystopic therapy, which, in addition to Lamictal, includes agents that activate hepatic enzymes, provides a daily dose of 50 mg of Lamictal in the first 2 weeks. In the next fortnight, the daily amount of the drug is doubled. A month after the start of therapy, the daily dose of Lamictal reaches 100 mg in 2 divided doses. To maintain the therapeutic effect, 200-400 mg of the drug per day is used.

Overdose

The intake of excessive dosage can cause:

  • dizziness;
  • cranialgia;
  • nausea;
  • visual disturbances;
  • impaired coordination;
  • lack of consciousness.

Symptoms of overdose are eliminated through the use of detoxification measures, including gastric lavage.

Contraindications

Lamictal is not used in persons with revealed excessive sensitivity to the components of its formula.

Side Effects

From the skin system: allergic exanthema is possible up to Stevens-Jones syndrome and Lyell’s disease. In the blood picture when taking Lamictal, there may be a decrease in the number of cells of all germs of hematopoiesis.

Undesirable reactions associated with taking the drug may occur in the field of immune defense in the form of lymphadenopathy.

Possible disturbances of vision, balance and consciousness are observed from the side of the central nervous system. An abrupt cessation of Lamictal intake threatens with withdrawal syndrome, which manifests itself in the increase in convulsive seizures.

Dyspeptic phenomena, stool and a decrease in enzymatic activity of the liver are possible in the gastrointestinal tract.

An insufficiently effective dose of Lamycatalum can provoke rhabdomyolysis, intravascular clotting of blood cells, syndrome of multiple organ failures.

Drug Interactions

Competitive metabolism of Lamotrigine with hepatic enzymes slows down its assimilation. The combined use of carbamazepine with Lamictal carries a high risk of adverse reactions. Antiepileptic drugs, hormonal contraceptives and paracetamol accelerate metabolism and excretion of Lamictal in 2 times.

Special Recommendations

The safety of Lamictal in pregnant women has not been determined due to the lack of clinical studies. Suppression of the dihydrofolate reductase enzyme suggests that the risk of congenital anomalies in the fetus is likely to develop.

Storage

To save in conditions of low humidity with a temperature optimum up to 30 °C, out the children reach.


About the Author

Michelle Welborn, PharmD

Michelle Welborn, who holds a Doctor of Pharmacy degree from Campbell University, is the President of MWelborn Group, LLC, a consulting firm specializing in regulatory guidance for companies seeking FDA Orphan Designation and marketing approval. With 15 years of experience in pharmaceuticals, she has held key roles in Medical and Regulatory Affairs at Astra-Merck and Sanofi-Aventis, and served as a Clinical Pharmacy Manager for an HMO. Her deep understanding of childhood epilepsy, rare diseases, and drug development is driven by her daughter Lilly’s battle with Dravet syndrome. Michelle is a passionate advocate, representing children with rare diseases at international conferences and serving on advisory boards, including the Charlie Foundation and Lennox-Gastaut Syndrome Foundation.


Disclaimer: The information presented is for informational purposes only and should not be considered as medical advice. It is essential to consult a qualified healthcare provider before making any healthcare or medication decisions. This content is not a substitute for professional medical advice, diagnosis, or treatment.