What are the common side effects of Lamotrigine 100mg. How to manage headaches caused by Lamotrigine. What to do if experiencing drowsiness or dizziness while taking Lamotrigine. How to cope with aggression or irritability as a side effect of Lamotrigine. What are the serious side effects of Lamotrigine that require immediate medical attention.

Understanding Lamotrigine: Uses and Mechanism of Action

Lamotrigine is a widely prescribed medication primarily used to treat epilepsy and bipolar disorder. As an anticonvulsant and mood stabilizer, it works by modulating the activity of certain neurotransmitters in the brain. But how exactly does it function?

Lamotrigine’s primary mechanism of action involves inhibiting voltage-sensitive sodium channels, which helps to stabilize neuronal membranes and prevent the release of excitatory neurotransmitters. This action is particularly effective in controlling seizures and mood swings associated with bipolar disorder.

• Treats epilepsy by reducing the frequency and severity of seizures
• Manages bipolar disorder by stabilizing mood and preventing manic episodes
• May also be used off-label for other conditions such as neuropathic pain

While Lamotrigine is generally well-tolerated, it’s crucial to be aware of potential side effects, especially when starting the medication or adjusting the dosage.

Common Side Effects of Lamotrigine 100mg: What to Expect

When prescribed Lamotrigine 100mg, patients may experience a range of common side effects. It’s important to note that these effects often subside as the body adjusts to the medication. What are the most frequently reported side effects?

• Headaches
• Drowsiness and dizziness
• Irritability or agitation
• Tremors or shaking
• Insomnia
• Gastrointestinal issues (diarrhea, nausea, vomiting)
• Mild skin rash

These side effects typically affect more than 1 in 10 people taking Lamotrigine. However, their intensity and duration can vary from person to person. How can patients manage these common side effects effectively?

Managing Headaches Caused by Lamotrigine

Headaches are a frequent complaint among Lamotrigine users. To alleviate this discomfort:

• Ensure proper rest and hydration
• Limit alcohol consumption
• Consider over-the-counter painkillers (consult with a pharmacist)

If headaches persist for more than a week or become severe, it’s essential to consult your doctor. They may need to adjust your dosage or explore alternative treatments.

Coping with Drowsiness and Dizziness

Feeling drowsy or dizzy is common when starting Lamotrigine or increasing the dose. How can patients safely manage these side effects?

• Avoid driving or operating machinery until the symptoms subside
• Allow time for the body to adjust to the medication
• Discuss with your doctor about potentially adjusting the dosage or timing of administration

If these symptoms persist beyond a few weeks, your healthcare provider may consider modifying your treatment plan.

Mood-Related Side Effects: Aggression and Irritability

Some patients may experience changes in mood or behavior while taking Lamotrigine. Why do these mood-related side effects occur, and how can they be addressed?

Lamotrigine affects neurotransmitter activity in the brain, which can occasionally lead to mood fluctuations. If you notice increased aggression, irritability, or agitation:

• Keep a mood journal to track changes and potential triggers
• Practice stress-reduction techniques such as meditation or deep breathing exercises
• Communicate openly with your healthcare provider about these changes

Your doctor may recommend adjusting your dosage or complementing your treatment with additional therapies to manage these mood-related side effects effectively.

Gastrointestinal Side Effects: Nausea, Vomiting, and Diarrhea

Digestive issues are not uncommon when taking Lamotrigine. How can patients alleviate these uncomfortable symptoms?

Managing Nausea and Vomiting

To minimize nausea and reduce the risk of vomiting:

• Take Lamotrigine with food or immediately after meals
• Opt for smaller, more frequent meals throughout the day
• Avoid rich, spicy, or fatty foods that may exacerbate symptoms
• Stay hydrated by sipping water or clear fluids

If symptoms persist or worsen, consult your healthcare provider. They may recommend anti-nausea medications or adjust your Lamotrigine regimen.

Dealing with Diarrhea

For those experiencing diarrhea as a side effect:

• Increase fluid intake to prevent dehydration
• Consider a temporary BRAT diet (Bananas, Rice, Applesauce, Toast)
• Avoid caffeine and high-fiber foods until symptoms improve

If diarrhea continues for more than a week or is accompanied by severe abdominal pain, seek medical advice promptly.

Sleep Disturbances: Insomnia and Its Management

Lamotrigine can sometimes affect sleep patterns, leading to insomnia in some patients. How can those struggling with sleep issues improve their rest while on this medication?

• Establish a consistent sleep schedule
• Create a relaxing bedtime routine
• Avoid screens and stimulating activities before bed
• Consider natural sleep aids like chamomile tea or melatonin (after consulting with your doctor)

If sleep disturbances significantly impact your quality of life, discuss with your healthcare provider. They may suggest adjusting the timing of your Lamotrigine dose or prescribe temporary sleep aids.

Skin Reactions: From Mild Rashes to Serious Concerns

Skin reactions are a notable side effect of Lamotrigine, ranging from mild rashes to potentially severe conditions. How can patients differentiate between benign skin reactions and those requiring immediate medical attention?

Mild Skin Rashes

Mild rashes are relatively common and often resolve on their own. However, any skin reaction should be reported to your doctor. They may advise:

• Monitoring the rash closely for any changes
• Using over-the-counter antihistamines to relieve itching
• Applying cool compresses to affected areas

Serious Skin Reactions: Stevens-Johnson Syndrome

Stevens-Johnson Syndrome (SJS) is a rare but serious side effect of Lamotrigine. What are the warning signs patients should be aware of?

• Flu-like symptoms followed by a red or purple rash
• Blistering of the skin, mouth, nose, or genitals
• Peeling or shedding of large areas of skin
• Fever and general malaise

If any of these symptoms occur, seek immediate medical attention. Early recognition and treatment of SJS are crucial for preventing complications.

Serious Side Effects Requiring Immediate Medical Attention

While most side effects of Lamotrigine are manageable, some require prompt medical intervention. What are the red flags patients should watch for?

• Severe skin reactions (as mentioned above)
• Worsening of seizures or new types of seizures
• Unexplained bruising or bleeding
• Persistent fever or sore throat
• Severe muscle pain or weakness
• Yellowing of the skin or eyes (jaundice)
• Thoughts of self-harm or suicide

If any of these serious side effects occur, it’s crucial to seek immediate medical attention or contact emergency services.

Special Considerations: Pregnancy, Breastfeeding, and Interactions

Lamotrigine use requires special consideration in certain populations. What should patients be aware of regarding pregnancy, breastfeeding, and potential drug interactions?

Lamotrigine and Pregnancy

The use of Lamotrigine during pregnancy is a complex decision that requires careful consideration. While the medication may pose some risks to the developing fetus, untreated epilepsy or bipolar disorder can also be harmful. Patients should:

• Discuss the risks and benefits with their healthcare provider before conception
• Not discontinue Lamotrigine abruptly if pregnancy occurs
• Be monitored closely throughout pregnancy for potential dosage adjustments

Breastfeeding Considerations

Lamotrigine does pass into breast milk, but the effects on nursing infants are not fully understood. Mothers who wish to breastfeed while taking Lamotrigine should:

• Consult with their pediatrician and neurologist
• Monitor their infant for potential side effects such as drowsiness or poor feeding
• Consider alternative feeding methods if concerns arise

Potential Drug Interactions

Lamotrigine can interact with various medications, potentially altering its effectiveness or increasing the risk of side effects. Some notable interactions include:

• Other antiepileptic drugs (e.g., valproic acid, carbamazepine)
• Hormonal contraceptives
• Certain antibiotics
• Folate supplements

Patients should always inform their healthcare providers about all medications, supplements, and herbal products they are taking to prevent potential interactions.

Dosage Adjustments and Long-Term Management

Successful treatment with Lamotrigine often involves careful dosage adjustments and ongoing monitoring. How can patients work with their healthcare providers to optimize their treatment plan?

Gradual Dose Titration

To minimize the risk of side effects, especially skin reactions, Lamotrigine is typically started at a low dose and gradually increased. This process, known as titration, may take several weeks. Patients should:

• Follow their prescribed titration schedule closely
• Not adjust their dose without consulting their doctor
• Report any side effects promptly during the titration period

Regular Monitoring and Follow-ups

Long-term use of Lamotrigine requires ongoing monitoring to ensure its effectiveness and safety. This may involve:

• Regular blood tests to check liver function and medication levels
• Periodic neurological examinations
• Mood assessments for patients with bipolar disorder

Patients should maintain open communication with their healthcare providers and attend all scheduled follow-up appointments.

Lifestyle Considerations

Certain lifestyle factors can impact the effectiveness of Lamotrigine and the occurrence of side effects. Patients may benefit from:

• Maintaining a consistent sleep schedule
• Avoiding excessive alcohol consumption
• Managing stress through relaxation techniques or therapy
• Staying physically active, with their doctor’s approval

By adopting these lifestyle modifications, patients may experience improved treatment outcomes and fewer side effects.

Patient Education and Support Resources

Empowering patients with knowledge and support is crucial for successful Lamotrigine treatment. What resources are available to help patients navigate their treatment journey?

Educational Materials

Patients can benefit from various educational resources, including:

• Medication guides provided by pharmacies
• Patient information leaflets from reputable health organizations
• Online resources from epilepsy and bipolar disorder foundations

Support Groups

Connecting with others who have similar experiences can be invaluable. Patients may consider:

• Local support groups for epilepsy or bipolar disorder
• Online forums and communities focused on Lamotrigine use
• Peer counseling programs offered by patient advocacy organizations

Healthcare Team Communication

Maintaining open lines of communication with healthcare providers is essential. Patients should:

• Keep a log of side effects or concerns to discuss during appointments
• Ask questions about their treatment plan and medication management
• Inform their healthcare team of any changes in their health or lifestyle

By utilizing these resources and maintaining active involvement in their care, patients can optimize their Lamotrigine treatment experience and manage side effects more effectively.

Side effects of lamotrigine – NHS

Like all medicines, lamotrigine can cause side effects, although not everyone gets them.

Most side effects of lamotrigine wear off, but it can take several weeks or months.

When you start taking lamotrigine, it’s important to increase the dose slowly as this will help reduce or stop some side effects happening.

Lamotrigine can also cause some unpredictable side effects no matter what dose you take, and these can happen at any time.

Speak to your pharmacist or doctor if you’re concerned about side effects.

Common side effects

These common side effects of lamotrigine may happen in more than 1 in 10 people. There are things you can do to help you cope:

Headaches

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Talk to your doctor if your headaches last longer than a week or are severe.

Feeling drowsy, sleepy or dizzy

As your body gets used to lamotrigine, these side effects should wear off. Do not drive, ride a bike or operate machinery until you feel more alert.

If they do not go within a week or two, your doctor may reduce your dose or increase it more slowly. If that does not work, speak to your doctor. You may need to switch to a different medicine.

Aggression, or feeling irritable or agitated

Talk to your doctor.

Shaking or tremors

Talk to your doctor if this is bothering you. These symptoms can be a sign that the dose is too high for you. It may help to change your dose or take your medicine at a different time of day.

Difficulty sleeping

Talk to your doctor.

Diarrhoea

Drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor. Speak to a doctor if symptoms get worse or last longer than a week.

If you take contraceptive pills and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet to find out what to do.

Feeling or being sick (nausea or vomiting)

Stick to simple meals and do not eat rich or spicy food. It might help to take your lamotrigine after a meal or snack. If you’re being sick, take small, frequent sips of water or squash to avoid dehydration.

Speak to a doctor if symptoms get worse or last longer than a week.

If you take contraceptive pills and you’re being sick, your contraception may not protect you from pregnancy. Check the pill packet to find out what to do.

Mild skin rash

If you get a mild rash speak to your doctor for advice as your treatment may need to be changed.

Also see our serious side effects information.

If this advice does not help and you are bothered by any of these side effects, keep taking the medicine but tell your doctor or pharmacist.

Serious side effects

Skin rashes

It’s common to get a skin rash with lamotrigine. Most skin rashes are not serious.

Stevens-Johnson syndrome is a rare side effect of lamotrigine.

It causes flu-like symptoms, followed by a red or purple rash that spreads and forms blisters. The affected skin eventually dies and peels off.

It’s more likely to happen in the first 8 weeks of starting lamotrigine, or when the dose is increased too quickly.

It can also happen if lamotrigine is stopped suddenly for a few days and then restarted at the same dose as before, without reducing the dose and then increasing it slowly again.

Stevens-Johnson syndrome is more common in:

• children
• people who have developed a rash before with a different epilepsy medicine
• people who are allergic to an antibiotic called trimethoprim
• people also taking a medicine called sodium valproate

To help reduce the chance of you getting a rash that could be confused with Stevens-Johnson syndrome, it’s best to not try any new medicines or food during the first 3 months of treatment with lamotrigine.

Immediate action required: Go to A&E now if:

• you get a severe rash with flushing, blisters or ulcers – these can be signs of Stevens-Johnson syndrome

Find your nearest A&E

Other serious side effects

Very few people taking lamotrigine have any serious problems as any serious reaction is quite rare.

Tell a doctor or call 111 straight away if you have a serious side effect, including:

• worsening fits or seizures (if you take lamotrigine for epilepsy)
• unexpected bruising or bleeding, a high temperature or sore throat – these could be signs of a blood disorder

Immediate action required: Go to A&E or call 999 now if:

• you have thoughts of harming or killing yourself – a small number of people taking lamotrigine for bipolar disorder have had suicidal thoughts, and this can happen after only a few weeks of treatment
• you have a stiff neck, headaches, feel or are being sick, a high temperature and extreme sensitivity to bright light – these could be signs of meningitis

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to lamotrigine.

Immediate action required: Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
• your throat feels tight or you’re struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who’s unwell may also have a rash that’s swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

Long-term side effects

Long-term treatment with lamotrigine can cause osteoporosis and osteopenia, increasing your risk of breaking a bone.

Your doctor can arrange for tests to check your bone strength.

Regular exercise and a good diet can also help keep your bones strong.

Other side effects

These are not all the side effects of lamotrigine. For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 20 May 2022

Next review due: 25 May 2025

Stevens-Johnson syndrome – NHS

Stevens-Johnson syndrome is a rare but serious skin reaction that’s usually caused by taking certain medicines. It needs to be treated immediately in hospital.

Severe Stevens-Johnson syndrome is sometimes called toxic epidermal necrolysis.

Causes of Stevens-Johnson syndrome

Stevens-Johnson syndrome is often caused by your body reacting to certain medicines, particularly some types of:

• epilepsy medicines
• antibiotics
• anti-inflammatory painkillers

Medicines commonly linked to Stevens-Johnson syndrome

• allopurinol
• carbamazepine
• lamotrigine
• nevirapine
• oxicam anti-inflammatories, such as meloxicam and piroxicam
• phenobarbital
• phenytoin
• sulfamethoxazole and other sulfa antibiotics
• sulfasalazine

In children, Stevens-Johnson syndrome can sometimes be caused by infections like cold or flu, cold sores and glandular fever.

Who is at higher risk

You’re more likely to get Stevens-Johnson syndrome if:

• you’ve had it before after taking a certain medicine – you’re more likely to get it again if you take that medicine again or other similar medicines
• you have a weakened immune system – for example, from having a condition like HIV or AIDS, or treatments like chemotherapy
• a close family member has had Stevens-Johnson syndrome – sometimes your genes can mean you’re at higher risk of getting it

Important

Stevens-Johnson syndrome is rare and the risk of getting it is low, even if you’re taking a medicine that can cause it.

Symptoms of Stevens-Johnson syndrome

Stevens-Johnson syndrome can start with flu-like symptoms, such as a high temperature, sore throat, cough and joint pain.

A rash appears a few days later. It’s made up of circular patches that are darker in the middle and lighter around the outside.

Credit:

BSIP SA / Alamy Stock Photo https://www.alamy.com/stock-photo-stevens-johnson-syndrome-49184570.html?pv=1&stamp=2&imageid=135F5C14-A57D-467D-88E5-EEC0BEFD47C2&p=163945&n=0&orientation=0&pn=1&searchtype=0&IsFromSearch=1&srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d2%26resultview%3dsortbyPopular%26npgs%3d0%26qt%3dCT0FBP%26qt_raw%3dCT0FBP%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d1%26nu%3d%26t%3d%26edoptin%3d%26customgeoip%3d%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d

The rash usually starts on the upper body before quickly spreading to the face, arms, legs and other areas of the body, such as the genitals. It’s not usually itchy.

Blisters then appear on your skin, which burst to leave painful sores. The skin often peels very easily.

Credit:

DR M.A. ANSARY / SCIENCE PHOTO LIBRARY

https://www.sciencephoto.com/media/262594/view

You can also get blisters and sores:

• on your lips and in your mouth and throat – this can make swallowing painful
• in the tube that carries pee out of your body – this can cause pain when peeing
• on your eyes – this can cause eye pain, pain when looking at bright lights and problems with your sight

Immediate action required: Call 999 or go to A&E if you or your child:

• has a circular rash that’s darker in the middle and lighter around the outside after having an infection or starting a new medicine
• has a rash and the skin is itchy, red, swollen, blistered or peeling
• is wheezing
• has tightness in the chest or throat
• is having trouble breathing or talking
• has a swollen mouth, face, lips, tongue or throat

These may be signs of a serious reaction like Stevens-Johnson syndrome and may need immediate treatment in hospital.

Treatments for Stevens-Johnson syndrome

Stevens-Johnson syndrome is treated in hospital, often in an intensive care unit.

Without treatment, the symptoms can become life-threatening.

If it’s thought Stevens-Johnson syndrome is being caused by a medicine you’re taking, the medicine will be stopped.

You’ll have treatment to relieve your symptoms, which may include:

• fluids into a vein to prevent dehydration
• creams and dressings to moisturise and protect the skin
• strong painkillers to help ease any pain
• medicines to control inflammation and prevent infection

Recovering from Stevens-Johnson syndrome

It may take several weeks or months for you to fully recover from Stevens-Johnson syndrome. It’s likely you’ll feel very tired for a few weeks after leaving hospital.

Your skin will usually take about 2 or 3 weeks to heal, but it can sometimes take longer if you get a skin infection.

If your symptoms were caused by a reaction to a medicine, you’ll need to avoid taking that medicine (and possibly other similar ones) for the rest of your life. Your doctor will be able to discuss this with you.

Complications of Stevens-Johnson syndrome

Stevens-Johnson syndrome can cause serious complications including:

• skin problems like a skin infection, changes in skin colour and scarring
• problems with organs, such as the lungs, liver and kidneys
• eye problems, such as long-term inflammation or sight problems
• problems with the vagina or penis caused by scarring

Page last reviewed: 21 June 2022
Next review due: 21 June 2025

Lamotrigine instructions for use: indications, contraindications, side effects – description of Lamotrigine tab.

100 mg: 10, 20, 25, 30, 40, 50, 60, 75, 90, 100, 125, 150, 250, 300 or 500 pcs. (46102)

Active substance Lamotrigine (Lamotriginum) | Compendium – drug reference book

• Pharmacological properties
• Indications Lamotrigine
• Application of Lamotrigine
• Contraindications
• Side effects
• Special instructions
• Interactions
• Overdose
• Diagnosis
• Recommended alternatives
• Trade names

Medicinal products containing the active substance Lamotrigine

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anticonvulsant. Lamotrigine causes a voltage-dependent block of sodium channels of presynaptic membranes of neurons in the phase of slow inactivation and blocks the excessive release of glutamate (an amino acid that plays a major role in the development of an epileptic seizure).

After oral administration, it is rapidly and completely absorbed in the gastrointestinal tract. Cmax _{max in plasma is reached approximately 2.5 hours after oral administration. Lamotrigine is extensively metabolized in the body. On average, T ½ in adults is 29 hours. T ½ in children is less than in adults.}

• epilepsy in adults and children over 12 years of age: as adjunctive or monotherapy for partial and generalized seizures, including tonic-clonic convulsions and seizures associated with Lennox-Gastaut syndrome;
• epilepsy in children under 12 years of age: as adjunctive therapy for partial and generalized seizures, including tonic-clonic seizures and seizures associated with Lennox-Gastaut syndrome.

For adults and children over 12 years of age who are not receiving sodium valproate, the initial dose of lamotrigine monotherapy is 25 mg once a day for 2 weeks, then 50 mg once a day for 2 weeks, then the dose is increased by 50-100 mg every 1-2 weeks until optimal therapeutic effect is achieved. In the future, the maintenance dose averages 100-200 mg / day in 2 divided doses. Some patients require a dose of 500 mg/day.

For patients receiving sodium valproate, the initial dose of lamotrigine is 25 mg every other day for 2 weeks, then 25 mg daily for the next 2 weeks, after which the dose is increased by a maximum of 25–50 mg/day every 1–2 weeks until optimal therapeutic effect is achieved. In the future, the maintenance dose is 100-200 mg / day in 1-2 doses.

For patients taking antiepileptic drugs that induce liver enzymes, with or without other antiepileptic drugs (with the exception of sodium valproate), the initial dose of lamotrigine is 50 mg once a day for 2 weeks, then 100 mg / day in 2 divided doses for 2 weeks. Then the dose is increased by a maximum of 100 mg every 1-2 weeks until the optimal therapeutic effect is achieved. The usual maintenance dose is 200-400 mg/day in 2 divided doses. Some patients may need a dose of 700 mg/day to achieve the desired effect.

For patients taking antiepileptic drugs for which there is no known interaction with lamotrigine, the same dose escalation regimen is recommended as for patients taking lamotrigine with sodium valproate.

For children aged 2 to 12 years receiving sodium valproate with or without other antiepileptic drugs, lamotrigine is given at an initial dose of 0.2 mg/kg once daily for 2 weeks; then – 0.5 mg / kg 1 time per day for 2 weeks. Then the dose is increased by 0.5–1 mg/kg every 1–2 weeks until the optimal therapeutic effect is achieved. In the future, it is used in a maintenance dose of 1 to 5 mg / kg / day in 1-2 doses. The maximum daily dose is 200 mg.

For children taking antiepileptic drugs that induce liver enzymes, with or without other antiepileptic drugs (with the exception of sodium valproate), the initial dose of lamotrigine is 2 mg/kg/day in 2 divided doses for 2 weeks, then 5 mg/kg/day in 2 divided doses for 2 weeks. Then the dose is increased by a maximum of 2-3 mg / kg every 1-2 weeks until the optimal therapeutic effect is achieved. The average maintenance dose is 5-15 mg / kg / day in 2 divided doses. The maximum daily dose is 400 mg.

For children taking antiepileptic drugs for which there is no known interaction with lamotrigine, the same dose escalation regimen is recommended as for patients taking lamotrigine with sodium valproate.

hypersensitivity to lamotrigine.

allergic reactions (skin rash, usually maculopapular, which occurs more often during the first 4 weeks of treatment and disappears after discontinuation of the drug; in rare cases – Stevens-Johnson syndrome, toxic epidermal necrolysis), headache, dizziness, nausea, insomnia or drowsiness, increased fatigue, irritability and aggressiveness, agitation, confusion, diplopia , a veil before the eyes, transient changes in laboratory tests.

It is not recommended to prescribe lamotrigine to children under 2 years of age, elderly patients. Caution should be exercised when prescribing lamotrigine to patients with renal or hepatic impairment.

Lamotrigine is a weak inhibitor of dihydrofolate reductase, so long-term use may interfere with folate metabolism. When using lamotrigine during the year, no significant changes in hemoglobin content, the number of erythrocytes and the concentration of folate in erythrocytes were detected.

Abrupt withdrawal of lamotrigine may increase seizures, so it should be discontinued gradually over 2 weeks. There is insufficient information on the safety of the use of lamotrigine during pregnancy and lactation. When deciding whether to prescribe it during pregnancy, it is necessary to compare the intended benefit to the mother and the potential risk to the fetus. Preliminary data indicate that lamotrigine passes into breast milk at a concentration of 40-45% of the concentration in maternal plasma. A small number of infants whose mothers received lamotrigine did not experience any side effects.

anticonvulsants, which are inducers of microsomal liver enzymes (phenytoin, carbamazepine, phenobarbital), accelerate the metabolism of lamotrigine. With the simultaneous appointment of lamotrigine and carbamazepine or phenytoin in adults, T _½ lamotrigine decreases to about 14 hours. In children, this figure decreases to an average of 7 hours. There are reports that dizziness, diplopia, ataxia, visual disturbances, and nausea occurred when using lamotrigine during carbamazepine therapy. These phenomena, as a rule, disappear with a decrease in the dose of carbamazepine. Sodium valproate, which inhibits liver enzymes, causes a slowdown in the metabolism of lamotrigine, resulting in T _½ it lengthens up to 70 hours in adults and up to 45–55 hours in children. Lamotrigine does not significantly affect the plasma concentrations of concomitantly administered anticonvulsants. It has been established that lamotrigine does not affect protein binding of other anticonvulsants.