Lamitrin 50mg Tablet 10pcs

Uses of Lamitrin 50mg Tablet

• Epilepsy/Seizures
• Bipolar disorder

How does Lamitrin 50mg Tablet work?

Lamitrin (antiepileptic medication) controls seizures or fits by decreasing the abnormal and excessive activity of the nerve cells in the brain.

Side Effects of Lamitrin 50mg Tablet

Adults: Common side effects include dizziness, headache, double vision, difficulty with coordination, nausea, blurred vision, drowsiness, throat inflammation, and skin rash.

Children: Frequently observed side effects are vomiting, diarrhea, infections, fever, abdominal pain, and tremors.

Quick Suggestions:

• Take your medication regularly as directed by your doctor as missing doses can trigger seizures.
• Do not change the brand of your medicine and make sure that you have a sufficient amount of medicine present with you.
• Some healthy tips to prevent seizures:
• It may cause headaches. Drink plenty of water and take a suitable painkiller. Inform your doctor if it does not go away.
• It may cause a skin rash. Inform your doctor immediately if you notice a rash, itching, and peeling of skin.
• Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
• Do not stop taking the medication suddenly without talking to your doctor as it may increase the frequency of seizures.

Indication of Lamitrin 50mg Tablet

Epilepsy (Adjunctive Therapy for Patients Aged 2 Years and Older)

• Partial-onset seizures
• Primary generalized tonic-clonic seizures
• Generalized seizures of Lennox-Gastaut syndrome

Epilepsy (Monotherapy for Patients Aged 16 Years and Older)

Bipolar Disorder (Patients Aged 18 Years and Older)

Pharmacology

Lamotrigine's exact mechanism of action is not fully understood but involves:

• Inhibiting voltage-sensitive sodium channels
• Stabilizing neuronal membranes
• Reducing the release of excitatory neurotransmitters like glutamate

Lamotrigine also exhibits weak binding to various receptors including serotonin, adenosine, adrenergic, dopamine, GABA, histamine, opioid, and muscarinic receptors.

Dosage & Administration of Lamitrin 50mg Tablet

Epilepsy (Adults and Children Over 12 Years):

Table 1: Escalation Regimen for Patients Older than 12 Years with Epilepsy

• Weeks 1 & 2:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 25 mg/day
  • With Valproate: 25 mg every other day
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 50 mg/day
• Weeks 3 & 4:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 50 mg/day
  • With Valproate: 25 mg/day
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 100 mg/day (in 2 divided doses)
• Week 5 Onwards to Maintenance:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: Increase by 50 mg/day every 1-2 weeks
  • With Valproate: Increase by 25-50 mg/day every 1-2 weeks
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): Increase by 100 mg/day every 1-2 weeks
• Usual Maintenance Dose:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 225-375 mg/day (in 2 divided doses)
  • With Valproate: 100-200 mg/day alone, 100-400 mg/day with other drugs that induce glucuronidation (in 1 or 2 divided doses)
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 300-500 mg/day (in 2 divided doses)

Epilepsy (Children Aged 2 to 12 Years):

Table 2: Escalation Regimen for Patients Aged 2 to 12 Years with Epilepsy

• Weeks 1 & 2:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
  • With Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 0.6 mg/kg/day (in 2 divided doses)
• Weeks 3 & 4:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 0.6 mg/kg/day (in 2 divided doses)
  • With Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 1.2 mg/kg/day (in 2 divided doses)
• Week 5 Onwards to Maintenance:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: Increase every 1-2 weeks by 0.6 mg/kg/day
  • With Valproate: Increase every 1-2 weeks by 0.3 mg/kg/day
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): Increase every 1-2 weeks by 1.2 mg/kg/day
• Usual Maintenance Dose:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 4.5-7.5 mg/kg/day (max 300 mg/day in 2 divided doses)
  • With Valproate: 1-3 mg/kg/day alone, 1-5 mg/kg/day with other drugs that induce glucuronidation (max 200 mg/day in 1 or 2 divided doses)
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 5-15 mg/kg/day (max 400 mg/day in 2 divided doses)

Table 3: Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

• Weeks 1 & 2:
  • Weight 6.7 kg to 14 kg: 2 mg every other day
  • Weight 14.1 kg to 27 kg: 2 mg every day
  • Weight 27.1 kg to 34 kg: 4 mg every day
  • Weight 34.1 kg to 40 kg: 5 mg every day
• Weeks 3 & 4:
  • Weight 6.7 kg to 14 kg: 2 mg every day
  • Weight 14.1 kg to 27 kg: 4 mg every day
  • Weight 27.1 kg to 34 kg: 8 mg every day
  • Weight 34.1 kg to 40 kg: 10 mg every day

Bipolar Disorder (Adults):

Table 4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder

• Weeks 1 & 2:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 25 mg daily
  • With Valproate: 25 mg every other day
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 50 mg daily
• Weeks 3 & 4:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 50 mg daily
  • With Valproate: 25 mg daily
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 100 mg daily (in divided doses)
• Week 5:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 100 mg daily
  • With Valproate: 50 mg daily
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 200 mg daily (in divided doses)
• Week 6:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 200 mg daily
  • With Valproate: 100 mg daily
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 300 mg daily (in divided doses)
• Week 7:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 200 mg daily
  • With Valproate: 100 mg daily
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): Up to 400 mg daily (in divided doses)

Use in Special Populations

• Pediatric Use:
  • Epilepsy: The safety and effectiveness of Lamitrin as adjunctive treatment for partial-onset seizures have not been established in children aged 1 to 24 months.
  • Bipolar Disorder: The safety and effectiveness for maintenance treatment of bipolar disorder have not been established in children aged 10 to 17 years.

Overdose EffectsInt

Overdose can result in symptoms such as lack of coordination (ataxia), involuntary eye movement (nystagmus), seizures (including tonic-clonic seizures), decreased consciousness, coma, and delays in intraventricular conduction.

Interaction

• Increased Concentrations: Valproate
• Decreased Concentrations: Carbamazepine, Phenytoin, Phenobarbital, Primidone, Rifampin, Estrogen-containing oral contraceptives, Protease inhibitors (lopinavir/ritonavir, atazanavir/ritonavir)

Contraindications

Hypersensitivity.

Pregnancy & Lactation

• Pregnancy: Classified as Category C. Lamotrigine is secreted in breast milk, so there is potential for adverse reactions in nursing infants. A decision should be made whether to discontinue breastfeeding or discontinue the medication, considering the drug's importance to the mother.

Precautions & Warnings

• Discontinue immediately if a rash appears.
• Monitor for conditions like neutropenia, thrombocytopenia, and pancytopenia. Watch for signs of anemia, unexpected infections, or bleeding.
• Monitor for signs of suicidal thoughts or behaviors.
• Be vigilant for symptoms of meningitis.

Storage Conditions

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