Lamitrin ER Indications
Epilepsy (Adjunctive Therapy) - Patients aged 2 years and older:
- Partial-onset seizures
- Primary generalized tonic-clonic seizures
- Generalized seizures of Lennox-Gastaut syndrome
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Epilepsy:
Bipolar Disorder:
Lamitrin ER 100mg Tablet may cause excessive drowsiness when taken with alcohol.
Lamitrin ER 100mg Tablet may be unsafe during pregnancy. Animal studies have shown harmful effects on the developing baby. Your doctor will consider the benefits and potential risks before prescribing it.
Lamitrin ER 100mg Tablet is probably safe during breastfeeding. Limited human data suggest it does not pose a significant risk to the baby. Monitor the baby for rash, sleepiness, or poor sucking, and get periodic platelet count and liver function tests.
Lamitrin ER 100mg Tablet may cause dizziness and double vision, affecting your ability to drive.
Lamitrin ER 100mg Tablet should be used with caution in patients with kidney disease. Dose adjustment may be necessary. Consult your doctor.
Lamitrin ER 100mg Tablet should be used with caution in patients with liver disease. Dose adjustment may be necessary. Consult your doctor.
Epilepsy (fits), and Bipolar disorder.
Seek emergency medical treatment or contact the doctor in case of an overdose.
If you miss a dose of Lamotrigine, take the missed dose as soon as you remember. If it’s almost time for your next dose, skip the missed dose. Do not double your dose to make up for the missed dose.
Lamotrigine is an anticonvulsant that is used to control seizures and is also used in bipolar disorders. Take this medicine at the same time regularly. Do not stop taking this medicine suddenly without informing your doctor as it may cause withdrawal symptoms like seizures.
The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, and stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.
Lamotrigine likely acts by inhibiting sodium currents by selectively binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.
Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates a weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
Epilepsy - Adults and Children Older than 12 Years
Weeks 1 & 2:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 25 mg daily
- With Valproate: 25 mg every other day
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): 50 mg daily
Weeks 3 & 4:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 50 mg daily
- With Valproate: 25 mg daily
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): 100 mg daily (in 2 divided doses)
Week 5 Onward to Maintenance:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: Increase by 50 mg/day every 1-2 weeks to 225-375 mg/day (in 2 divided doses)
- With Valproate: Increase by 25-50 mg/day every 1-2 weeks to 100-200 mg/day with Valproate alone, or 100-400 mg/day with Valproate and enzyme-inducing drugs (in 1-2 divided doses)
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): Increase by 100 mg/day every 1-2 weeks to 300-500 mg/day (in 2 divided doses)
Weeks 1 & 2:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 0.3 mg/kg/day (in 1-2 divided doses)
- With Valproate: 0.15 mg/kg/day (in 1-2 divided doses)
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): 0.6 mg/kg/day (in 2 divided doses)
Weeks 3 & 4:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 0.6 mg/kg/day (in 2 divided doses)
- With Valproate: 0.3 mg/kg/day (in 1-2 divided doses)
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): 1.2 mg/kg/day (in 2 divided doses)
Week 5 Onward to Maintenance:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: Increase by 0.6 mg/kg/day every 1-2 weeks to 4.5-7.5 mg/kg/day (max 300 mg/day in 2 divided doses)
- With Valproate: Increase by 0.3 mg/kg/day every 1-2 weeks to 1-3 mg/kg/day with Valproate alone, or 1-5 mg/kg/day (max 200 mg/day in 1-2 divided doses)
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): Increase by 1.2 mg/kg/day every 1-2 weeks to 5-15 mg/kg/day (max 400 mg/day in 2 divided doses)
Bipolar Disorder - Adults
Weeks 1 & 2:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 25 mg daily
- With Valproate: 25 mg every other day
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): 50 mg daily
Weeks 3 & 4:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 50 mg daily
- With Valproate: 25 mg daily
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): 100 mg daily (in divided doses)
Week 5:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 100 mg daily
- With Valproate: 50 mg daily
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): 200 mg daily (in divided doses)
Week 6:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 200 mg daily
- With Valproate: 100 mg daily
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): 300 mg daily (in divided doses)
Week 7:
- No Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 200 mg daily
- With Valproate: 100 mg daily
- With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (No Valproate): Up to 400 mg daily (in divided doses)
Store in a cool and dry place away from sunlight
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