Lamotrigine drug information

Drug/brand names

• Lamotrigine
• Lamictal

Formulation

Tablets are available as 25mg, 50mg, 100mg and 200mg strengths.

Dispersible/chewable tablets are available as 2mg, 5mg, 25mg and 100mg strengths.

Uses

Lamotrigine is used to reduce seizure frequency and severity in people who have epilepsy.

Lamotrigine is used alone or alongside other epilepsy medication for focal (partial) and generalised (eg tonic clonic, absence) seizures as well as for seizures associated with Lennox-Gastaut syndromes. Lamotrigine is also used for depression associated with bipolar disorder and within neuropathic pain.

Side effects

(The list of side effects is not exhaustive, please refer to product literature for full list)

Side effects are more likely with higher doses of medication, and may improve when the dose is reduced.

Common side effects are:

• Sleepiness
• Nausea, vomiting, diarrhoea or a dry mouth
• General aches, including joint pain and back ache.
• Headache
• Insomnia
• Tremor
• Dizziness
• Aggression or irritability
• Rash – this may appear like sunburn, or could be a milder irritation. If this happens you must speak to your doctor or epilepsy nurse as soon

Rare side effects include:

• Severe rash or rash associated with fever, facial swelling or headaches which must be reported to a doctor immediately. If this happens please stop taking lamotrigine.
• Lamotrigine can cause blood disorders, patients should immediately report any signs of infection such as fever and sore throat or any unusual bruising or bleeding.
• All antiepileptic medication can cause feelings of depression, or severe mood changes. If you experience any of these please contact your specialist.
• Confusion and hallucinations.
• Lamotrigine can worsen Parkinson’s Disease.

If you have any concerns about side-effects, please do contact your GP or the epilepsy nurse on the number at the bottom of the leaflet.

Contraception

Use of the combined contraceptive pill can increase how quickly lamotrigine is cleared from your body and can lead to an increased risk of seizure; the dose of lamotrigine may need to be altered. For this reason usually non-hormonal methods are advised to reduce this risk (for example, a barrier method or intrauterine implant). Your doctor or epilepsy nurse will be able to advice you about this.

Lamotrigine may slightly reduce the effectiveness of progesterone only oral contraceptive pill so you may need to change the type of pill to protect you from pregnancy. Your doctor will advise you if this is the case.

Lamotrigine does not affect the contraceptive injection in the same way.

Pregnancy and Breast Feeding

Possible risks to your baby from lamotrigine include cleft palate and heart defects but trials have shown that these risks are likely to be low. If you are planning a pregnancy you should discuss your medication with your GP before you conceive, and request further pre-conception counselling with the epilepsy team. We recommend you take folic acid (5mg oral daily) from at least twelve weeks prior to conception until the end of week 12 of pregnancy. If you are already pregnant it is too late to make these changes.

The dose of lamotrigine usually has to be increased during pregnancy. The changes to your dosage would be made in the epilepsy pregnancy clinic and blood levels of lamotrigine will be checked during pregnancy.

Lamotrigine passes in uncertain levels into breast milk, therefore there is a risk it may pass in significant levels to the infant. These levels of lamotrigine are not known to cause harm to the infant already exposed to lamotrigine during pregnancy. It is recommended that infants should be monitored for adverse effects including sedation, feeding difficulties, inadequate weight gain, rash and failure to reach developmental milestones. The infant may also require blood tests to check levels of the drug in their blood.

Drug interactions

Other antiepileptic drugs may influence the dose of lamotrigine that you are given. You will need to be monitored carefully if you need to take lamotrigine with other antiepileptics and some other medication. This may involve monitoring the level of lamotrigine in your blood.

Always remind your doctor or pharmacist that you take lamotrigine, any new medication will need to be considered carefully.

Medications such as paracetamol and aspirin can be taken with lamotrigine.

Other useful information

• Try to take lamotrigine at the same time each day. Do not stop taking the medication unless a doctor tells you to do so.
• Keep a record of your seizures when you start any new medication. This will help determine future drug dosage changes.
• If you forget to take a dose, take it as soon as you remember. Do not take two doses at once.
• Store lamotrigine as directed by the manufacturers information, it does not usually require any special storage conditions.
• Note lamotrigine tablets contain lactose (however the dispersible tablets do not).
• It is recommended that people taking lamotrigine should avoid alcohol. This is because both can cause drowsiness and if the two are taken together, severe drowsiness can result.
• Note dispersible tablets are suitable for use via enteral feeding tube if this route is applicable.

If you experience any of these side effects, please contact the epilepsy nurse (contact details are at the end of the leaflet) or your GP.

Contact details

If you have any questions or concerns, please contact the Epilepsy Nurse Specialist on 01223 217992.

The information on this leaflet is not exhaustive. Please refer to the patient information leaflet prepared by the manufacturer of your drug which can be found in the medicine packaging.