Lamotrigine

Brand names of lamotrigine

  • Lamictal

An anticonvulsant, lamotrigine is used as an anti-epileptic in the treatment of seizures in both adults and in children who are over two years old. It can be used alone or combined with other medications for seizures and is also used to delay mood attacks and bipolar ailment in adults.

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Things you need to tell your physician before taking lamotrigine

Before you begin taking lamotrigine ensure that your doctor knows all the medications you are allergic to including lamotrigine and the various ingredients that are used in the kind of lamotrigine tablets you will be taking. The medicine guide is easily available with the doctor or pharmacist for checking on ingredients.

Convey to the doctor the names of all prescribed or non prescribed medications you are taking or might take in the future which includes herbal remedies, vitamins and nutritional supplements.

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It is necessary to have a talk with your doctor before you begin with lamotrigine if you are taking female hormonal medications either as hormonal contraceptives like birth control pills, patches, rings, injections, implants or as intrauterine devices or if you are undergoing treatment for hormone replacement known as HRT (hormone replacement therapy). If you have any other bleeding besides the regular menstrual period because of the hormonal treatment then tell the doctor so. The doctor will be able to advise you about stopping the other medications with lamotrigine only once he has full information.

Tell your doctor if you suffer from certain medical conditions like autoimmune disease. This is a condition where the body swells and loses some of its functions as it attacks its own organs. Lupus is one such disorder where different organs are attacked causing various symptoms. Any blood, kidney or liver disease you might have had should also be mentioned to the doctor.

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Tell the doctor if you are pregnant or are planning to get pregnant and also if you are breast feeding before you begin with lamotrigine and in case you do get pregnant while you are on the medication tell the doctor immediately. If your surgeon or the dentist advises any surgical proceedings then tell both, the surgeon and the dentist, that you are taking lamotrigine.

Lamotrigine is known to cause drowsiness in some patients. So till you know how the medication affects you do not drive a vehicle or operate any machinery.

During clinical trials of lamotrigine, as an antiepileptic to treat various conditions, 1 out of 500 adults and small children (aged 5 or older) became suicidal. Suicidal thoughts and behaviour was seen as early as one week after they started on lamotrigine. So lamotrigine could affect your mental health unexpectedly too and you could turn suicidal while you are being treated for epilepsy, mental illness or other conditions. Therefore there is a risk in taking lamotrigine but there could be a bigger risk to your mental health if the disorder is left untreated. So it is best to discuss with your doctor, before you begin on lamotrigine, whether the risk of taking the antiepileptic is bigger or not taking the medication is more risky.

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The following are serious symptoms that may result from taking lamotrigine and your family or caregiver should also be aware of them so that if you cannot call the doctor yourself they should immediately call the doctor. Report if these symptoms occur, panic attacks, agitation and restlessness, anxiety, depression, any new or worsening irritability, any difficulty in falling asleep, dangerous impulsive, aggressive, angry or violent behaviour or any manic, frenzied and overly excited behaviour. If there are thoughts and talks about ending life or harming one self, withdrawals from friends and family, preoccupation with death and dying, giving away of prized possessions and any other atypical behavioural changes then report them to the doctor.

Usage

Lamotrigine is taken to control fits that result from epilepsy. Mostly this medication is given in combination with other anticonvulsants.

How to use lamotrigine

Lamotrigine is available as a tablet, an extended release tablet or long acting tablet and as a tablet that disintegrates in the mouth and can then be swallowed without water and also as a chewable dispersible tablet which can either be chewed or dissolved in the water. The tablets are taken in the mouth along with the food or also without food.

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The extended release tablets are taken only one in a day. The other three forms of the tablets, plain tablets, orally dissolving tablets or chewable dispersible tablets are all taken once or twice a day according to the doctor's instructions. It is possible that at the beginning of the treatment you may be advised by the doctor to take a tablet only every other day. The directions on the prescription label should be followed precisely and any part that is not understood can be explained to you by your doctor or pharmacist.

The brand names for lamotrigine are similar to the brand names for other medicines. Each time you fill up your prescription ensure that you are getting lamotrigine and not any other similarly named medication. Talk to the pharmacist to ensure he is giving you the right medication. The prescription your doctor gives you should be legible and readable. Once you receive your tablets of lamotrigine compare them to the pictures in the patient information sheet provided by the manufacturer. Talk to the pharmacist if you realize you have been given the wrong medication. Unless you are certain that the medication you have is the right one and the one that the doctor prescribed, do not take it.

In case your tablets have come in a blister pack, check the packet to see if any of the blisters are torn, broken or have no tablets. Do not start your medication from that pack if you should find any of these problems.

The tablets and the extended-release tablets should be swallowed whole and should not be split, chewed or crushed. The chewable dispersal tablets may be swallowed, chewed or dissolved in any liquid. To wash down the chewed medication you can take a small amount of water or juice. To dissolve the tablet in liquid you need to take about a teaspoon of water or juice in a glass. The tablet is placed in the glass and after a minute it will dissolve. Swirl it a bit and drink the entire contents at once. A single tablet should not be divided to be used for two doses. The orally disintegrating tablets are placed in the mouth and moved around a bit in the mouth. Once they dissolve simply swallow it down or take water if you like.

If you are switching medicines from one that is being used to treat your seizures to lamotrigine then the doctor will probably ask you to decrease the dose of that medication and increase lamotrigine dosages very gradually. Follow the directions correctly and when in doubt then ask the pharmacist or doctor to tell you exactly how much of each of these medicines you should take.

The full benefit of lamotrigine will be seen after several weeks. Do not stop taking them even if you feel well. Do not stop taking them without consulting the doctor even if you have any side effects. Inform the doctor and he could recommend a decrease in dose over a period of time. If you stop the medicine abruptly you could have seizures. If for some reason the doctor has stopped your medication then do not start lamotrigine again on your own but consult the doctor if you feel you need the medication.

How lamotrigine works

Lamotrigine controls the number of seizures and their severity when it acts on the central nervous system. Lamotrigine probably suppresses the actions of that part of the brain where the neurons that cause seizures are stimulated and so the neurons remain inactive.

Side effects

Serious
  • sore throat
  • weakness
  • lethargy, or seizures may be a sign of a potentially fatal blood reaction
  • red or purple point like rash on the skin
  • fever
  • confusion
  • blistering or peeling skin lesion
  • swollen glands
Common
Less common

Possible interactions

Herbal medicines like St. John's wort, ma huang and kola may stimulate the central nervous system quite unacceptably and this could worsen the side effects of lamotrigine. Since ginseng works partly as an MAO inhibitor, combining it with lamotrigine is not recommended. Valerian and kava kava could increase the drowsiness. Drinking alcohol while on this medication should also be totally shunned as it could add to the drowsiness. Also exposure to the sun is not recommended as excessive heat may worsen any muscular coordination problems that taking lamotrigine may have effected.

Discontinuation

Lamotrigine should not be stopped suddenly as that could lead to seizures. So you need to begin on another anti-seizure medication, in consultation with your doctor, before you are taken off lamotrigine.

Storage instructions

Lamotrigine can be stored safely at room temperature of 77°F (25°C). Do not store in the bathroom as it should be stored away from light, heat and moisture. Keep the medication out of reach of children and pets.

The medication should be properly discarded once it is not needed or it has reached the expiry limit. Your area waste disposal company or your pharmacist could instruct you on the safe disposal of the medication. You should not flush the medication or throw it in the drain unless recommended to do so.

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