Lamitrin 25mg Tablet 10pcs

Uses of Lamitrin 25

• Epilepsy/Seizures
• Bipolar disorder

How does Lamitrin 25 work?

It acts by inhibiting sodium currents (which is out of control in epileptic patients) via suppression of the release of glutamate (an excitatory brain chemical).

Side Effects of Lamitrin 25

• Nausea
• Vomiting
• Sleepiness
• Dizziness
• Blurred vision
• Double vision
• Back pain
• Dryness in mouth
• Insomnia (difficulty in sleeping)
• Abdominal pain
• Impaired coordination
• Nasal congestion (stuffy nose)
• Infection

Quick Suggestions:

Indication of Lamitrin 25

Lamitrin 25 belongs to a group of medicines called anti-epileptics. It is used to treat two conditions, epilepsy and bipolar disorder.

Mechanism of Action for Lamotrigine

1. Inhibition of Sodium Channels:

• Lamotrigine's primary mechanism resembles that of phenytoin and carbamazepine, involving the inhibition of voltage-sensitive sodium channels.
• By stabilizing neuronal membranes, it modulates the release of presynaptic excitatory neurotransmitters.
• Specifically, lamotrigine likely inhibits sodium currents through selective binding to inactive sodium channels, reducing the release of the excitatory amino acid, glutamate.

2. Application in Bipolar Disorder:

• The anticonvulsant mechanism of lamotrigine is thought to be the same as its mechanism for managing bipolar disorder, involving the stabilization of neuronal membranes and modulation of neurotransmitter release.

3. Binding Properties and Receptor Interaction:

• Serotonin Receptor: Weak inhibitory effect on the serotonin 5-HT3 receptor.
• Adenosine Receptors: Weak binding to Adenosine A1/A2 receptors.
• Adrenergic Receptors: Weak binding to α1/α2/β adrenergic receptors.
• Dopamine Receptors: Weak binding to dopamine D1/D2 receptors.
• GABA Receptors: Weak binding to GABA A/B receptors.
• Histamine Receptor: Weak binding to histamine H1 receptors.
• Opioid Receptors: Weak inhibitory effects at sigma opioid receptors and weak binding to the κ-opioid receptor (KOR).
• Muscarinic Receptors: Weak binding to mACh receptors.
• Serotonin Receptors: Weak binding to serotonin 5-HT2 receptors.

4. Inhibition of Calcium Currents:

• An in vivo study has shown that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may contribute to its anticonvulsant effects.

This diverse receptor interaction and channel inhibition contribute to lamotrigine's efficacy in treating epilepsy, bipolar disorder, and possibly some neuropathic pain states.

Dosage & Administration of Lamitrin 25

Adult Dose

Oral Epilepsy:

• Initial Dose: 25 mg once daily for 2 weeks.
• Second Phase: 50 mg once daily for 2 weeks.
• Maintenance Dose: Increase by 50-100 mg every 1-2 weeks to a usual dose of 100-200 mg daily, as a single dose or in 2 divided doses. Some patients may require up to 500 mg daily.

Adjunct in Epilepsy: With Valproate:

• Initial Dose: 25 mg on alternate days for 2 weeks.
• Second Phase: 25 mg once daily for 2 weeks.
• Maintenance Dose: Increase by 25-50 mg every 1-2 weeks to a usual dose of 100-200 mg daily in 1-2 divided doses.

With Enzyme-Inducing Antiepileptics (excluding Valproate):

• Initial Dose: 50 mg once daily for 2 weeks.
• Second Phase: 50 mg twice daily for 2 weeks.
• Maintenance Dose: Increase by 100 mg every 1-2 weeks to a usual dose of 200-400 mg daily in 2 divided doses; some patients may require up to 700 mg daily.

With Oxcarbazepine (excluding enzyme-inducing or -inhibiting antiepileptics):

• Initial Dose: 25 mg once daily for 2 weeks.
• Second Phase: 50 mg once daily for 2 weeks.
• Maintenance Dose: Increase by 50-100 mg every 1-2 weeks to a usual dose of 100-200 mg daily in 1-2 divided doses; some patients may require up to 500 mg daily.

Bipolar Disorder: Monotherapy:

• Initial Dose: 25 mg once daily for 2 weeks.
• Second Phase: 50 mg once daily for 2 weeks.
• Maintenance Dose: Double the daily dose weekly to a usual dose of 200 mg daily. Maximum dose is 200 mg/day.

With Valproate:

• Initial Dose: 25 mg every other day for 2 weeks.
• Second Phase: 25 mg once daily for 2 weeks.
• Maintenance Dose: Double the daily dose weekly to a usual dose of 100 mg daily.

With Enzyme-Inducing Antiepileptics (excluding Valproate):

• Initial Dose: 50 mg once daily for 2 weeks.
• Second Phase: 100 mg daily in 2 divided doses for 2 weeks.
• Maintenance Dose: Increase by 100 mg weekly to a usual dose of 400 mg daily in 2 divided doses.

Hepatic Impairment:

• Moderate Impairment (Child-Pugh category B): Reduce dose by about 50%.
• Severe Impairment (Child-Pugh category C): Reduce dose by about 75%.

Lamitrin 25 Child Dose

Oral Epilepsy (Children >12 years):

• Initial Dose: 25 mg once daily for 2 weeks.
• Second Phase: 50 mg once daily for 2 weeks.
• Maintenance Dose: Increase by 50-100 mg every 1-2 weeks to a usual dose of 100-200 mg daily, as a single dose or in 2 divided doses. Some patients may require up to 500 mg daily.

Adjunct in Epilepsy (Children): With Valproate:

• Initial Dose: 0.15 mg/kg once daily for 2 weeks.
• Second Phase: 0.3 mg/kg once daily for 2 weeks.
• Maintenance Dose: Increase by 0.3 mg/kg every 1-2 weeks to a usual dose of 1-5 mg/kg once daily or in 2 divided doses.

Lamitrin 25 is not recommended for children under 12 years for the treatment of epilepsy.

Renal Dose of Lamitrin 25

Renal Impairment:

• Use caution and consider dose reduction in significant renal impairment.

Interaction

1. Enhanced Metabolism:

• Metabolism of Lamitrin 25 is enhanced by enzyme-inducing drugs such as:
  • Phenytoin
  • Carbamazepine
  • Phenobarbitone
  • Primidone
  • Rifampicin
  • Ethinyloestradiol/levonorgestrel combination

2. Reduced Metabolism:

• The metabolism of Lamitrin 25 is reduced by sodium valproate.

Contraindications

Hypersensitivity.

Pregnancy & Lactation

Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Precautions for Lamitrin 25 (Lamotrigine)

1. Hepatic or Renal Impairment:

• Closely monitor patients with liver or kidney impairment.

2. Monitoring:

• Monitor children’s body weight.
• Advise patients to report any hypersensitivity reactions.
• Avoid abrupt withdrawal unless severe skin reactions develop.

3. Driving and Operating Machinery:

• May impair the ability to drive or operate machinery. Use with caution.

4. Pregnancy and Lactation:

• Pregnancy: Consult your doctor before use.
• Lactation: Distributed into human breast milk; use with caution.

5. Serious Risks:

• Serious skin rashes
• Blood dyscrasias
• Suicidal behavior
• Aseptic meningitis
• These can occur in both adult and pediatric populations.

Storage:

Keep out of reach of children, Store in a dry place, below 25°C temperature, and protected from light.