Lamotrigine Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Lamotrigine Tablet (generic name lamotrigine) is a prescription antiepileptic medicine from the triazine (phenyltriazine) class. It is used together with other medicines to treat certain seizure types and to help stabilize mood in people with bipolar I disorder. It comes in several forms, including standard tablets, chewable dispersible tablets, orally disintegrating tablets, extended-release tablets, and an oral liquid.

What is Lamotrigine Tablet

Lamotrigine is a prescription medicine belonging to the phenyltriazine class of antiepileptic drugs. It is chemically different from other anticonvulsants. Doctors prescribe it to help control certain seizure types and to help stabilize mood in bipolar disorder. It comes as standard tablets, chewable dispersible tablets, orally disintegrating tablets, extended-release tablets, and an oral liquid.

Lamotrigine Tablet uses

• Used together with other medicines to treat certain seizure types (partial-onset seizures, primary generalized tonic-clonic seizures, and the generalized seizures of Lennox-Gastaut syndrome) in people aged 2 years and older
• Used alone when switching from another seizure medicine in people aged 16 years and older with partial-onset seizures
• Used long-term to help delay the return of mood episodes (depression, mania, hypomania, mixed episodes) in adults with bipolar I disorder who have already been treated for a mood episode with standard therapy
• Extended-release tablets are used with other medicines for primary generalized tonic-clonic seizures and partial-onset seizures in people aged 13 years and older, or alone when switching from one other partial-onset seizure medicine

Benefits of Lamotrigine Tablet

• Can reduce how often seizures happen when added to other seizure medicines
• Can help control certain hard-to-treat seizure types, including those from Lennox-Gastaut syndrome
• Can lengthen the time between mood episodes in people with bipolar I disorder

How Lamotrigine Tablet works

Lamotrigine is thought to calm overactive electrical signals in the brain. It acts on channels in nerve cells to stabilize them and reduce the release of certain brain chemicals (like glutamate) that can trigger seizures. This helps control epileptic seizures and may also help stabilize mood in bipolar disorder, though exactly how it helps mood is not fully known.

Lamotrigine Tablet dosage

This medicine can be taken with or without food. Standard tablets should be swallowed whole with water and not chewed or crushed. Chewable dispersible tablets may be swallowed whole, chewed, or mixed in a small amount of water or diluted fruit juice; if chewed, follow with a small amount of water or diluted fruit juice to help swallowing; if dispersed in liquid, wait about a minute until fully broken up, then swirl and take the whole amount right away.

Orally disintegrating tablets are placed on the tongue and allowed to dissolve; they can be swallowed with or without water and taken with or without food; check the blister pack before use and do not use if blisters are torn, broken, or missing. Extended-release tablets must be swallowed whole and should not be chewed, crushed, or divided.

If prescribed twice a day, doses should be spaced evenly through the day, such as morning and evening. If a dose is missed, take it as soon as remembered unless the next dose is due soon, in which case skip the missed dose; do not take two doses at the same time.

It may take several weeks to feel the full effect of this medicine. Do not stop taking this medicine suddenly without talking to your healthcare provider, as this can cause serious problems including seizures that do not stop.

Use exactly as prescribed by your doctor or pharmacist.

Available forms and strengths

• Tablets
• Chewable dispersible tablets
• Orally disintegrating tablets (ODT)
• Extended-release tablets
• Oral suspension/liquid

Side effects of Lamotrigine Tablet

Common

• Dizziness
• Tremor
• Headache
• Skin rash
• Blurred or double vision
• Fever
• Lack of coordination (ataxia)
• Abdominal pain
• Infections, including seasonal flu
• Sleepiness/drowsiness
• Back pain
• Nausea, vomiting
• Diarrhea
• Tiredness
• Insomnia
• Dry mouth
• Stuffy nose
• Sore throat
• Irritability or agitation
• Anxiety

Serious

• Serious skin rashes such as Stevens-Johnson syndrome or toxic epidermal necrolysis, with blistering, peeling skin, or painful sores in the mouth or around the eyes
• Fever, swollen lymph glands, or flu-like symptoms that may signal a serious allergic reaction affecting organs (DRESS/multi-organ hypersensitivity)
• Signs of liver problems such as yellowing of the skin or eyes, dark urine, or pain in the upper stomach area
• Signs of blood problems such as unusual bruising or bleeding, looking pale, or feeling very tired
• Aseptic meningitis with headache, fever, nausea, vomiting, stiff neck, rash, or sensitivity to light
• Fast, slow, or pounding heartbeat, chest pain, shortness of breath, or feeling lightheaded
• Thoughts of suicide or self-harm, or new/worsening depression, anxiety, agitation, or unusual behavior changes
• Hemophagocytic lymphohistiocytosis (HLH), a rare life-threatening immune condition with fever, rash, and organ dysfunction
• Seizures happening more often or for the first time
• Swelling of the face, eyes, lips, or tongue

Warnings and precautions

• Lamotrigine can cause a serious skin rash that may require hospitalization or can be fatal; the risk is higher in the first 2 to 8 weeks of treatment, in children and teens, and if the starting dose is too high or increased too fast, or if taken with valproate.
• A genetic variant called HLA-B*1502, found mainly in people of Han Chinese and Thai origin, may raise the risk of serious skin reactions.
• This medicine can cause other serious allergic or organ-related reactions, affecting the liver, blood cells, or other organs, sometimes without a rash.
• In people with existing heart problems, this medicine may cause a fast heartbeat or other heart rhythm problems.
• Like other antiseizure medicines, this drug may raise the risk of suicidal thoughts or actions in a small number of people.
• Do not stop this medicine suddenly without talking to a healthcare provider, as this can cause serious problems including seizures that do not stop.
• This medicine may cause aseptic meningitis, a serious inflammation of the lining around the brain and spinal cord.
• Starting or stopping birth control pills or other hormone medicines while on this drug can change how well it works or increase side effects; do not start or stop these without medical advice.
• Lamotrigine may harm an unborn baby, so it should only be used during pregnancy if the benefits outweigh the risks, and pregnant women taking it should consider joining a pregnancy safety registry.
• Lamotrigine passes into breast milk and can affect a nursing baby, so breastfeeding is generally not recommended while taking this medicine, and any breastfed infant should be watched closely for problems.
• People with kidney problems may process this medicine more slowly, so caution and possibly a lower dose is needed.
• People with liver problems, especially moderate to severe impairment, usually need a reduced dose of this medicine.
• This medicine can increase the effects of alcohol and other drugs that cause drowsiness, so caution is advised with regular alcohol use.
• This medicine can cause dizziness, drowsiness, poor coordination, and blurred vision, so avoid driving or operating machinery until you know how it affects you.

Storage

• Store at room temperature, generally between 68°F and 77°F (20°C to 25°C), with brief excursions to 59-86°F (15-30°C) allowed
• Keep tablets in a dry place and protect from light
• Oral liquid should be shaken well before each use and any unused liquid should be thrown away 90 days after first opening the bottle
• Keep this medicine and all medicines out of the reach and sight of children

When to see a doctor

• Get medical help right away if you develop a new skin rash, blistering or peeling skin, hives, or painful sores in the mouth or around the eyes, since these may be early signs of a dangerous skin reaction.
• Seek immediate help for fever, frequent infections, severe muscle pain, swelling of the face/eyes/lips/tongue, swollen lymph glands, unusual bruising or bleeding, looking pale, weakness, fatigue, yellowing of the skin or eyes, trouble walking or seeing, new or worsening seizures, or pain near the top of the stomach.
• Get help right away for a fast, slow, or pounding heartbeat, a skipped heartbeat, shortness of breath, chest pain, or feeling lightheaded.
• Contact a healthcare provider immediately if you have thoughts about suicide or dying, attempt self-harm, or notice new or worsening depression, anxiety, agitation, irritability, aggression, or unusual mood or behavior changes.
• Seek medical attention right away for headache, fever, nausea, vomiting, stiff neck, rash, unusual sensitivity to light, muscle pains, chills, confusion, or drowsiness, which could indicate meningitis.
• If you take too much of this medicine, contact a healthcare provider, a poison control center, or go to the nearest emergency room right away.

Alternatives

• Sodium Valproate
• Oxcarbazepine
• Carbamazepine