ADD THIS DRUG TO MY LIST

Select the drug indication to add to your list

LAMICTAL
Mood disorders
Seizure disorders
Compare To Related Drugs
View/Edit/Compare Drugs In My List

Only 4 drugs may be compared at once

Drug Name:

LAMICTAL Rx

Generic Name and Formulations:
Lamotrigine 25mg, 100mg, 150mg, 200mg; scored tabs.

Company:
GlaxoSmithKline

Therapeutic Use:

Indications for LAMICTAL:

Maintenance treatment of bipolar I disorder to delay the time to occurrence of mood episodes (depression, mania, hypomania, mixed episodes) in patients treated for acute mood episodes with standard therapy.

Limitations Of use:

Not recommended for treatment of acute manic or mixed episodes. Not established for acute treatment of mood episodes.

Adult:

≥18yrs: Not on enzyme-inducing antiepileptic drugs (EIAEDs, eg, phenytoin, carbamazepine, phenobarbital, primidone), or valproate: 25mg daily for 2 weeks, then 50mg daily for 2 weeks, then 100mg daily for 1 week, then to target dose of 200mg daily. Concomitant valproate: 25mg every other day for 2 weeks, then 25mg daily for 2 weeks, then 50mg daily for 1 week, then to target dose of 100mg daily. Concomitant EIAEDs and not valproate: 50mg daily for 2 weeks, then 100mg daily in divided doses for 2 weeks, then increase weekly by 100mg daily in divided doses to target dose of 400mg daily in divided doses. Discontinuing valproate: double lamotrigine dose over 2 weeks in equal weekly increments. Discontinuing EIAEDs: maintain lamotrigine dose for 1 week after discontinuing EIAEDs, then reduce lamotrigine dose by ½ over 2 weeks in equal weekly decrements then adjust as needed. Reevaluate periodically. Concomitant estrogen-containing oral contraceptives, hormone replacement therapy, lopinavir/ritonavir, or atazanavir/ritonavir: see full labeling. Hepatic impairment: if moderate or severe (w/o ascites) reduce dose by 25%; if severe (w. ascites) reduce dose by 50%.

Children:

<18yrs: not established.

Warnings/Precautions:

Discontinue at first sign of rash (unless clearly not drug related); avoid rechallenge. Avoid rapid dose increases and exceeding recommended dose (may increase risk of serious rash). History of allergy or rash to other AEDs (may increase frequency of nonserious rash). Reevaluate if fever, rash, or other hypersensitivity reaction occurs; discontinue if hypersensitivity occurs. Impaired cardiac function. Moderate or severe hepatic impairment. Significant renal impairment: consider reduced dose. Suicidal tendencies (monitor). Increased risk of aseptic meningitis; evaluate and treat if signs/symptoms develop. Possible ophthalmologic effects after prolonged use. Avoid abrupt cessation; taper over at least 2 weeks if possible. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended.

Interactions:

Concomitant OCT2 substrates with narrow therapeutic index (eg, dofetilide): not recommended. Lamotrigine levels increased by valproate. Lamotrigine levels decreased by phenytoin, carbamazepine, phenobarbital, primidone, rifampin, lopinavir/ritonavir, or atazanavir/ritonavir. Monitor with other anticonvulsants. Lamotrigine levels may be decreased by oral contraceptives and increased when they are stopped (if monotherapy: adjust dose), and may affect hormonal replacement therapy or other hormonal contraceptive efficacy. May potentiate other folate inhibitors. Valproate may increase risk of serious rash. Increased incidence of dizziness, diplopia, ataxia, blurred vision with carbamazepine. No apparent effect on lithium levels. May cause false (+) results for PCP.

See Also:

LAMICTAL CHEWABLE DISPERSIBLE TABS

LAMICTAL ODT

Pharmacological Class:

Phenyltriazine.

Adverse Reactions:

Nausea, diarrhea, insomnia, somnolence, back pain, fatigue, rhinitis, non-serious rash, abdominal pain, dry mouth, headache, dizziness, abnormal dreams; rare: serious rash (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis), hypersensitivity, multiorgan failure, blood dyscrasias.

Note:

Register pregnant patients exposed to lamotrigine by calling (800) 336-2176.

How Supplied:

Tabs 25mg, 100mg—100; 150mg, 200mg—60; Chewable Dispersible tabs 2mg—30; 5mg, 25mg—100; Starter kit 25mg x 35 tabs—1; 25mg x 84 tabs + 100mg x 14 tabs—1; 25mg x 42 tabs + 100mg x 7 tabs—1; ODT Maintenance Packs—30; ODT Titration Kit 25mg x 21 tabs + 50mg x 7 tabs—1; 50mg x 42 tabs + 100mg x 14 tabs—1; 25mg x 14 tabs, 50mg x 14 tabs, 100mg x 7 tabs—1

Indications for LAMICTAL:

Adjunct in partial seizures, Lennox-Gastaut syndrome, or primary generalized tonic-clonic seizures in adults and children (≥2yrs). Conversion to monotherapy in adults (≥16yrs) with partial seizures who are on carbamazepine, phenytoin, phenobarbital, primidone, or valproate as a single antiepileptic drug (AED).

Adult:

Chew tabs: give only whole tabs, round dose down to nearest whole tab (may be swallowed whole, chewed, or mixed in water or diluted fruit juice). ODT: dissolve on tongue and swallow with or without water. Adding to antiepileptic drug (AED) regimens that include valproate: initially 25mg every other day for 2 weeks, then 25mg once daily for 2 weeks; may increase by 25–50mg/day at 1–2 week intervals; usual maintenance 100–400mg/day in 1 or 2 divided doses. Adding to valproate only: usual maintenance 100–200mg/day. Adding to AED regimens other than carbamazepine, phenytoin, phenobarbital, primidone, or valproate: initially 25mg once daily for 2 weeks; then 50mg once daily for 2 weeks; may increase by 50mg/day at 1–2 week intervals; usual maintenance 225–375mg/day in 2 divided doses. Adding to AED regimens without valproate: initially 50mg per day for 2 weeks, then 100mg daily in 2 divided doses for 2 weeks; may increase by 100mg/day at 1–2 week intervals; usual maintenance 300–500mg/day in 2 divided doses. Converting from one AED (not valproate) to lamotrigine monotherapy (first titrate lamotrigine, then withdraw AED): initially 50mg per day for 2 weeks, then 100mg daily in 2 divided doses for 2 weeks; may increase by 100mg/day at 1–2 week intervals to 500mg/day in 2 divided doses. Then reduce AED dose by 20% per week for 4 weeks. Converting from valproate to lamotrigine monotherapy: see full labeling. Concomitant estrogen-containing oral contraceptives, hormone replacement therapy, lopinavir/ritonavir, or atazanavir/ritonavir: see full labeling. Hepatic impairment: if moderate or severe (w/o ascites) reduce dose by 25%; if severe (w. ascites) reduce dose by 50%.

Children:

Chew tabs: give only whole tabs, round dose down to nearest whole tab (may be swallowed whole, chewed, or mixed in water or diluted fruit juice). ODT: dissolve on tongue and swallow with or without water. <2yrs: not recommended. 2–12yrs: Adding to AED regimens that include valproate: initially 0.15mg/kg per day in 1 or 2 divided doses for 2 weeks, then 0.3mg/kg per day in 1 or 2 divided doses for 2 weeks; may increase by 0.3mg/kg per day at 1–2 week intervals in 1 or 2 divided doses; usual maintenance 1–5mg/kg per day; max 200mg/day in 1 or 2 divided doses. Adding to valproate only: usual maintenance 1–3mg/kg per day. Adding to AED regimens other than carbamazepine, phenytoin, phenobarbital, primidone, or valproate: initially 0.3mg/kg per day in 1 or 2 divided doses for 2 weeks, then 0.6mg/kg per day in 2 divided doses for 2 weeks; may increase by 0.6mg/kg per day at 1–2 week intervals; usual maintenance 4.5–7.5mg/kg per day; max 300mg/day in 2 divided doses. Adding to AED regimens without valproate: initially 0.6mg/kg per day in 2 divided doses for 2 weeks, then 1.2mg/kg per day in 2 divided doses for 2 weeks; may increase by 1.2mg/kg per day at 1–2 week intervals; usual maintenance 5–15mg/kg per day; max 400mg/day in 2 divided doses. Patients <30kg: may need higher (≤50%) maintenance dose.

Warnings/Precautions:

Discontinue at first sign of rash (unless clearly not drug related); avoid rechallenge. Avoid rapid dose increases and exceeding recommended dose (may increase risk of serious rash). History of allergy or rash to other AEDs (may increase frequency of nonserious rash). Reevaluate if fever, rash, or other hypersensitivity reaction occurs; discontinue if hypersensitivity occurs. Impaired cardiac function. Moderate or severe hepatic impairment. Significant renal impairment: consider reduced dose. Suicidal tendencies (monitor). Increased risk of aseptic meningitis; evaluate and treat if signs/symptoms develop. Possible ophthalmologic effects after prolonged use. Avoid abrupt cessation; taper over at least 2 weeks if possible. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended.

Interactions:

Concomitant OCT2 substrates with narrow therapeutic index (eg, dofetilide): not recommended. Lamotrigine levels increased by valproate. Lamotrigine levels decreased by phenytoin, carbamazepine, phenobarbital, primidone, rifampin, lopinavir/ritonavir, or atazanavir/ritonavir. Monitor with other anticonvulsants. Lamotrigine levels may be decreased by oral contraceptives and increased when they are stopped (if monotherapy: adjust dose), and may affect hormonal replacement therapy or other hormonal contraceptive efficacy. May potentiate other folate inhibitors. Valproate may increase risk of serious rash. Increased incidence of dizziness, diplopia, ataxia, blurred vision with carbamazepine. No apparent effect on lithium levels. May cause false (+) results for PCP.

See Also:

LAMICTAL CHEWABLE DISPERSIBLE TABS

LAMICTAL ODT

LAMICTAL XR

Pharmacological Class:

Phenyltriazine.

Adverse Reactions:

Adults (adjunctive): dizziness, ataxia, somnolence, headache, diplopia, blurred vision, nausea, vomiting. Adults (monotherapy): vomiting, coordination abnormalities, dyspepsia, nausea, dizziness, rhinitis, anxiety, insomnia, infection, pain, weight loss, chest pain, dysmenorrhea, nystagmus, lymphadenopathy. Children (adjunctive): infection, vomiting, fever, somnolence, accidental injury, dizziness, diarrhea, abdominal pain, nausea, ataxia, tremor, asthenia, bronchitis, flu syndrome, diplopia. Rare: rash (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis, or benign), hypersensitivity, multiorgan failure, blood dyscrasias. XR: also, cerebellar coordination/balance disorder, asthenic conditions, vertigo.

Note:

Register pregnant patients exposed to lamotrigine by calling (800) 336-2176.

How Supplied:

Tabs 25mg, 100mg—100; 150mg, 200mg—60; Chewable Dispersible tabs 2mg—30; 5mg, 25mg—100; Starter kit 25mg x 35 tabs—1; 25mg x 84 tabs + 100mg x 14 tabs—1; 25mg x 42 tabs + 100mg x 7 tabs—1; ODT Maintenance Packs—30; ODT Titration Kit 25mg x 21 tabs + 50mg x 7 tabs—1; 50mg x 42 tabs + 100mg x 14 tabs—1; 25mg x 14 tabs, 50mg x 14 tabs, 100mg x 7 tabs—1; XR tabs—30; XR Titration Kit 25mg x 21 tabs + 50mg x 7 tabs—1; 50mg x 14 tabs + 100mg x 14 tabs + 200mg x 7 tabs—1; 25mg x 14 tabs + 50mg x 14 tabs + 100mg x 7 tabs—1

Sign Up for Free e-newsletters

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs