Pharm

Lamotrigine

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Lamotrigine, Lamictal

  • Indications
  1. Simple Partial Seizures
  2. Complex Partial Seizures
  3. Generalized Tonic Clonic Seizures
  • Adverse Effects
  • Dose related
  1. Dizziness
  2. Incoordination
  3. Tremor
  4. Ataxia
  5. Diplopia
  6. Headache
  7. Insomnia
  8. Somnolence
  9. Blurred vision
  10. Nausea or Vomiting
  • Adverse Effects
  • Other
  1. Serious skin rash (Incidence 0.08% in adults)
    1. Stevens Johnson Syndrome
    2. Toxic Epidermal Necrolysis
  2. Aplastic Anemia
  3. Thrombocytopenia
  4. Neutropenia
  5. Pancytopenia
  6. Aseptic Meningitis
  • Drug Interactions
  1. Valproic Acid
  2. Carbamazepine
  3. Phenytoin
  4. Phenobarbital
  5. Primidone
  6. Rifampin
  7. Oral Contraceptives
  • Dosing
  • Adults
  1. Initial: 25 mg every other day for 2 weeks
  2. Next: 25 mg orally daily for 2 weeks
  3. Target dose: 50-100 mg orally twice daily
  4. Maximum dose: 400 mg/day
  5. Precautions
    1. Slow titration over 6 weeks or more reduces the risk of Stevens-Johnson Syndrome
    2. Dosing adjustments are needed when used with agents listed under Drug Interactions
  • Monitoring
  1. Obtain labs monthly for the first 2 months and then every 3 to 12 months
  2. Complete Blood Count
  3. Liver Function Test