Lamictal (lamotrigine)

Generic name: lamotrigine (la MOE tri jeen)
Brand name: Lamictal, Lamictal ODT, Lamictal XR
Drug class: Triazine anticonvulsants

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

Lamictal is used alone or 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).

Immediate-release Lamictal can be used in children as young as 2 years old for seizure treatment as an add-on treatment to other seizure medication. However, this form should not be used as a single medication in a child or teenager who is younger than 16 years old.

Extended-release Lamictal XR is for use only in adults and children who are at least 13 years old.

Warnings

Lamictal may cause a severe or life-threatening skin rash, especially in children and in people who take a very high starting dose, or those who also take valproic acid (Depakene) or divalproex (Depakote). Seek emergency medical attention if you have a skin rash, hives, blistering, peeling, or sores in your mouth or around your eyes.

Call your doctor at once if you have signs of other serious side effects, including: fever, swollen glands, severe muscle pain, bruising or unusual bleeding, yellowing of your skin or eyes, headache, neck stiffness, vomiting, confusion, or increased sensitivity to light.

Some people have thoughts about suicide while taking lamotrigine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

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 this medicine suddenly. Contact your doctor if your seizures get worse or you have them more often while taking this medicine. 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.

Lamictal may cause a severe or life-threatening skin rash, especially in children and in people who take a very high starting dose, or those who also take valproic acid (Depakene) or divalproex (Depakote).

Tell your doctor if you have ever had:

  • a rash or allergic reaction after taking another seizure medication;
  • kidney or liver disease;
  • heart problems such as heart block or irregular heartbeats;
  • depression, suicidal thoughts or actions; or
  • meningitis (inflammation of the tissue that covers the brain and spinal cord) after taking Lamictal.

Some people have thoughts about suicide while taking lamotrigine. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking seizure medication during pregnancy without your doctor's advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of lamotrigine on the baby.

Birth control pills can make lamotrigine less effective, resulting in increased seizures. Tell your doctor if you start or stop using birth control pills. Your lamotrigine dose may need to be changed.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

How should I take Lamictal?

Take Lamictal exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Taking too much Lamictal at the start of treatment may increase your risk of a severe life-threatening skin rash.

You may need frequent blood tests to help your doctor make sure you are taking the right dose.

Extended-release and immediate-release Lamictal may be used for different conditions. Always check your refills to make sure you have received the correct size, color, and shape of tablet. Avoid medication errors by using only the form and strength your doctor prescribes.

If you switch to Lamictal from another seizure medicine, carefully follow your doctor's instructions about the timing and dosage of your medicine.

Lamictal tablets should be swallowed whole. Do not crush, chew, or break it.

Lamictal chewable dispersible tablets may be swallowed whole, chewed, or mixed with water or diluted fruit juice.

Read and carefully follow any Instructions for Use provided with the orally disintegrating or dispersible tablets. Ask your doctor or pharmacist if you do not understand these instructions.

Do not stop using this medicine suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.

In case of emergency, wear or carry medical identification to let others know you use seizure medication.

Lamotrigine may affect a drug-screening urine test and you may have false results. Tell the laboratory staff that you use lamotrigine.

Store at room temperature away from light and moisture.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Get your prescription refilled before you run out of medicine completely.

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 to avoid

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Lamictal side effects

Get emergency medical help if you have signs of an allergic reaction to Lamictal (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

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

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.

Call your doctor at once if you have:

  • fast, slow, or pounding heartbeats or fluttering in your chest;
  • chest pain, shortness of breath;
  • fever, swollen glands, weakness, severe muscle pain;
  • any skin rash, especially with blistering or peeling;
  • painful sores in your mouth or around your eyes;
  • headache, neck stiffness, increased sensitivity to light, nausea, vomiting, confusion, drowsiness;
  • jaundice (yellowing of the skin or eyes); or
  • pale skin, cold hands and feet, easy bruising, unusual bleeding.

Common Lamictal side effects may include:

  • headache, dizziness;
  • blurred vision, double vision;
  • tremor, loss of coordination;
  • dry mouth, nausea, vomiting, stomach pain, diarrhea;
  • fever, sore throat, runny nose;
  • drowsiness, tired feeling;
  • back pain; or
  • sleep problems (insomnia).

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.

What other drugs will affect Lamictal?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Tell your doctor if you take any of the following medication, as these drugs may affect Lamictal;

  • anti-epileptic medications including valproic acid, divalproex sodium, carbamazepine, phenytoin, phenobarbital, or primidone;
  • antibiotics, such as rifampin;
  • birth control pills called oral contraceptives; or
  • human immunodeficiency virus (HIV) medications including lopinavir/ritonavir or atazanavir/lopinavir

Other drugs may interact with lamotrigine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.