Lamitrin ER 50mg Tablet 10pcs

Uses of Lamitrin ER 50

Lamitrin ER 50 Tablet manages:

• Epilepsy
• Bipolar I disorder

How does Lamitrin ER 50 work?

It works by acting on ion channels in the brain and decreases the repetitive firing of brain cells.

Side Effects of Lamitrin ER 50

Common Side Effects:

• Dizziness, headache
• Sleepiness or lack of sleep
• Shaking, lack of coordination
• Back pain, tiredness
• Nausea, vomiting, stomach pain
• Diarrhea, dry mouth
• Rash
• Blurred or double vision
• Fever, stuffy nose, sore throat
• Infections (including seasonal flu)

Uncommon Side Effects:

• Unusual hair loss or thinning (alopecia)
• Skin rashes or sunburn after exposure to sun or artificial light (photosensitivity)

Rare Side Effects:

• Conjunctivitis (itchy eyes with discharge, crusty eyelids)
• Meningitis (symptoms include fever, nausea, vomiting, headache, stiff neck, and extreme sensitivity to bright light)
• Nystagmus (rapid and uncontrollable eye movements)
• Stevens-Johnson syndrome (a life-threatening skin reaction)

Serious Side Effects: Stop taking Lamitrin ER 50mg Tablet and contact your doctor immediately if you experience any of the following:

• Serious skin reaction (skin rash, blistering or peeling, hives, painful sores in your mouth or around your eyes)
• Blood or liver problems (fever, frequent infections, severe muscle pain, swollen face, eyes, lips, tongue or lymph nodes, unusual bruising or bleeding, paleness, weakness, fatigue, yellow skin or eyes, trouble walking or seeing, seizures for the first time or happening more often, pain or tenderness in the upper stomach area)
• Heartbeat problems (fast, slow, or pounding heartbeat, feeling your heart skip a beat, breathlessness, chest pain, lightheadedness)
• Suicidal thoughts or behavior (new or worsening depression, anxiety or irritability, agitation or restlessness, aggression, anger or violence, acting on dangerous impulses, panic attacks, trouble sleeping, extremely increased activity and talking, other unusual changes in behavior or mood)
• Aseptic meningitis (headache, fever, nausea, vomiting, stiff neck, rash, unusual light sensitivity, muscle pains, chills, confusion, drowsiness)

How to Manage Side Effects

Nausea:

• Take Lamitrin ER 50 Tablet with or just after meals. Stick to simple meals. Avoid oily or spicy foods. If symptoms persist, contact your doctor.

Vomiting:

• Get adequate rest. Drink lots of fluids, especially water. Have small sips if you feel sick. Eat when you feel like it—no need to eat or avoid specific foods. If symptoms persist, contact your doctor.

Diarrhea:

• Drink fluids such as water or fruit juices to stay hydrated. If symptoms persist, contact your doctor.

Dry Mouth:

• Sip water regularly and other sugar-free liquids. Avoid alcohol-containing mouthwashes. Limit caffeine intake. Avoid smoking or using tobacco products. If symptoms persist, contact your doctor.

Headache:

• Drink plenty of water and get adequate rest. Stay relaxed and stress-free. Take medication for headaches after consulting your doctor. If symptoms persist, contact your doctor.

Dizziness:

• Lie down until dizziness improves, then get up gradually. Move slowly and carefully. Get adequate rest. Drink plenty of water and other fluids. Avoid coffee, cigarettes, alcohol, and drugs. If symptoms persist, contact your doctor.

Skin Rash:

• Avoid hot showers to prevent further irritation. Do not scratch the affected area. Use protective clothing when outdoors. Regularly moisturize your skin. If symptoms persist, contact your doctor.

Blurred Vision:

• Avoid driving or going outside alone if you have blurred vision. Close your eyes for some time until your vision clears. Call your doctor if blurred vision persists for a long period.

Dosage & Administration

Epilepsy-
 

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

Weeks 1 & 2:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 25 mg every day
• In patients taking Valproate: 25 mg every other day
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: 50 mg/day

Weeks 3 & 4:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 50 mg/day
• In patients taking Valproate: 25 mg every day
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)

Week 5 onward to maintenance:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: Increase by 50 mg/day every 1 to 2 weeks
• In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks

Usual maintenance dose:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 225 to 375 mg/day (in 2 divided doses)
• In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)

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

Weeks 1 & 2:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
• In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)

Weeks 3 & 4:
In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 0.6 mg/kg/day (in 2 divided doses)

• In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)

Week 5 onward to maintenance:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
• In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day

Usual maintenance dose:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
• In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)

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

Weeks 1 & 2:

• If the patient's weight is 6.7 kg to 14 kg: 2 mg every other day
• If the patient's weight is 14.1 kg to 27 kg: 2 mg every day
• If the patient's weight is 27.1 kg to 34 kg: 4 mg every day
• If the patient's weight is 34.1 kg to 40 kg: 5 mg every day

Weeks 3 & 4:

• If the patient's weight is 6.7 kg to 14 kg: 2 mg every day
• If the patient's weight is 14.1 kg to 27 kg: 4 mg every day
• If the patient's weight is 27.1 kg to 34 kg: 8 mg every day
• If the patient's weight is 34.1 kg to 40 kg: 10 mg every day

Bipolar disorder-

Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
Weeks 1 & 2:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 25 mg daily
• In patients taking Valproate: 25 mg every other day
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: 50 mg daily

Weeks 3 & 4:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 50 mg daily
• In patients taking Valproate: 25 mg daily
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: 100 mg daily (in divided doses)

Week 5:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 100 mg daily
• In patients taking Valproate: 50 mg daily
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: 200 mg daily (in divided doses)

Week 6:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 200 mg daily
• In patients taking Valproate: 100 mg daily
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: 300 mg daily (in divided doses)

Week 7:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 200 mg daily
• In patients taking Valproate: 100 mg daily
• In patients taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)

Pharmacology

Lamotrigine's specific mechanism of action is unknown, however it is thought to involve cellular actions that contribute to its efficacy in a variety of situations. Lamotrigine's activities are similar to those of phenytoin and carbamazepine, in that it inhibits voltage-sensitive sodium channels, stabilizes neuronal membranes, and modulates presynaptic excitatory neurotransmitter release.

Lamotrigine suppresses the release of the excitatory amino acid glutamate by blocking sodium currents by selectively binding to the inactive sodium channel.

Lamotrigine's mechanism of action in lowering anticonvulsant activity is most likely the same as it is in bipolar disorder treatment. Studies on lamotrigine have discovered that it binds to sodium channels in a similar way to local anesthetics, which could explain why it has been shown to help those with neuropathic pain.

Lamotrigine can connect to a variety of receptors.

Interaction

Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir, Olanzapine, Phenobarbital/primidone, Phenytoin, Pregabalin, and others interact with Lamotrigine.

Contraindications

Dizziness, tremors, headache, rash, blurred vision, fever, lack of coordination, abdominal discomfort, infections, sleepiness, back pain, vomiting, diarrhea, weariness, sleeplessness, dry mouth, stuffy nose, and sore throat are all common Lamotrigine side effects.

Pregnancy & Lactation

Pregnancy Classification C. Human milk contains lamotrigine, which is expelled. Because Lamotrigine has the potential to produce major adverse reactions in nursing infants, a decision should be made whether to stop breastfeeding or stop taking the medicine, taking into account the drug's importance to the mother.

Precautions & Warnings

Both adults and children can develop serious skin rashes, blood dyscrasias, suicidal behavior, and aseptic meningitis.

Storage Conditions:

Keep away from light and heat in a dry location. Keep out of children's reach.