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Lamotrigine (la MOE tri jeen) has been approved by the FDA to treat focal onset seizures, primary generalized tonic-clonic seizures, or generalized seizures of Lennox-Gastaut syndrome, used together with other anti-seizure medications (ASM) in patients 2 years and older.

Lamotrigine can be converted to the single ASM in patients 16 years and older with focal-onset seizures who were taking carbamazepine, phenytoin, phenobarbital, primidone, or valproate as a single antiseizure drug.

Your epilepsy treatment should always be discussed with your healthcare provider before use. Based on their judgment and knowledge, a drug may be prescribed for other epilepsy types not included in the indications. For more information, please see the prescribing information.

How can you take lamotrigine? (Available formulations)

Lamotrigine is available in a few different formulations to take by mouth with or without food. You can take lamotrigine as a tablet, an extended-release tablet, an orally disintegrating tablet (dissolves in the mouth and can be swallowed without water), and a chewable dispersible tablet (can be chewed or dissolved in liquid).

Who should not take lamotrigine?

If you are allergic to lamotrigine or any of the inactive ingredients, then you should not take it.

Other considerations may influence whether you should take lamotrigine. Tell your healthcare provider if you:

  • have had a rash or allergic reaction to another antiseizure medicine.
  • have or have had depression, mood problems, or suicidal thoughts or behavior.
  • have a history of heart problems or irregular heartbeats or if any of your family members have any heart problem, including genetic abnormalities.
  • have had aseptic meningitis after taking lamotrigine.
  • are taking oral contraceptives (birth control pills) or other female hormonal medicines.
  • are pregnant or plan to become pregnant.
  • are breastfeeding or plan to breastfeed.

What is important to know about taking lamotrigine?

Do not stop taking lamotrigine suddenly unless directed to do so by your healthcare provider.

As with all antiseizure medications, lamotrigine should be withdrawn gradually to minimize the risk of causing or worsening seizures or status epilepticus. You should not stop using lamotrigine suddenly unless your healthcare provider tells you to stop the medicine because of a serious side effect.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Taking lamotrigine with certain other medicines may cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider. Especially tell your healthcare provider if you take: valproate, oral contraceptives, or female hormone medicines.

Boxed Warning

Lamotrigine is approved by the FDA because it is safe and effective for most people who take it. However, there are risks associated with all medicines. Some side effects caused by lamotrigine can be very serious, and even life-threatening. It is important to be informed about these serious reactions and to be aware of their symptoms.

Risk of serious rash

Lamotrigine may cause life-threatening rashes including Stevens-Johnson syndrome and toxic epidermal necrolysis. While not all rashes are serious, there is no way to predict which ones will become life-threatening. Call your healthcare provider at the first sign of any rash, so they can decide if you should continue taking lamotrigine. Tell your healthcare provider right away if you have a skin rash, blistering or peeling of your skin, hives, or painful sores in your mouth or around your eyes. A serious skin rash can happen at any time during your treatment with lamotrigine but is more likely to happen within the first 2 to 8 weeks of treatment. Children and teenagers aged between 2 and 17 years have a higher chance of getting this serious skin rash while taking lamotrigine. The risk of getting a serious skin rash is higher if you are taking valproate, or if you do not follow the schedule of dose increases you were prescribed.

Women or those who are/plan to become pregnant
Use in pregnancy

Based on the results of pregnancy exposure registries and epidemiological studies of patients who were pregnant, a higher risk of birth defects has not been seen with patients taking lamotrigine. However, in animal studies, there were instances of developmental issues at doses below those used clinically. Having a seizure during pregnancy could harm both the pregnant individual and the baby. Tell your healthcare provider right away if you become pregnant. Do not start or stop taking seizure medication during pregnancy without your healthcare provider’s advice.

If you become pregnant while taking lamotrigine, talk to your healthcare provider about registering with the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The purpose of this registry is to collect information about the safety of antiseizure medicine during pregnancy. You can enroll in this registry by calling 1-888-233-2334.

Use during breastfeeding

Lamotrigine is present in breast milk and may cause side effects in a breastfed baby. If you breastfeed while taking lamotrigine, watch your baby closely for trouble breathing, episodes of temporarily stopping breathing, sleepiness, or poor sucking. Call your baby’s healthcare provider right away if you see any of these problems. Talk to your healthcare provider about the best way to feed your baby if you take lamotrigine. Your healthcare provider will consider the developmental and health benefits of breastfeeding along with your need for lamotrigine and the potential effect on the infant from lamotrigine or from your epilepsy.

Effect of birth control

Lamotrigine does not decrease the effectiveness of hormonal contraceptives, including birth control pills, injections, implants, skin patches, and vaginal rings. However, these medications may decrease the effectiveness of lamotrigine. Do not start or stop taking hormonal contraceptives until you have talked with your healthcare provider. Tell your healthcare provider if you have any changes in your menstrual pattern such as breakthrough bleeding. Stopping these medicines while you are taking lamotrigine may cause side effects (such as dizziness, lack of coordination, or double vision). Starting these medicines may lessen how well lamotrigine prevents seizures.

What are the side effects of lamotrigine?

Common side effects

The most common side effects that were reported in studies of lamotrigine are dizziness, sleepiness, tremor, back pain, headache, nausea, vomiting, rash, diarrhea, blurred or double vision, tiredness, fever, insomnia, lack of coordination, dry mouth, abdominal pain, stuffy nose, infections (including seasonal influenza), and sore throat.

Rare, but serious side effects
Serious reactions, including serious blood or liver problems

Rare but life-threatening reactions involving the immune system or multi-organ hypersensitivity, which can cause serious blood or liver problems have been reported with lamotrigine use. You may or may not have a rash with these types of reactions. Call your healthcare provider right away if you experience fever, frequent infections, severe muscle pain, swelling of your face, eyes, lips, or tongue, swollen lymph glands, unusual bruising or bleeding, weakness, fatigue, yellowing of your skin, or the white part of your eyes, trouble walking or seeing, seizures happening more often, or pain/tenderness in the area toward the top of your stomach (enlarged liver/spleen).

Cardiac rhythm and conduction abnormalities

In patients with known heart problems, the use of lamotrigine may lead to a fast heartbeat. Call your healthcare provider right away if you have a fast, slow, or pounding heartbeat, feel your heart skip a beat, have shortness of breath, have chest pain, or feel light-headed.

Suicidal thoughts or behaviors

Studies have found that people who take antiseizure medications including lamotrigine may have suicidal thoughts or behaviors, which occur in approximately 1 in 500 patients. If you experience any thoughts or impulses to hurt yourself, you should contact your healthcare provider immediately.

Aseptic meningitis

Aseptic meningitis, a serious inflammation of the protective membrane that covers the brain and spinal cord, has been identified as a very rare but serious side effect of lamotrigine. Contact your healthcare provider immediately if you experience headache, fever, nausea, vomiting, stiff neck, rash, unusual sensitivity to light, muscle pains, chills, confusion, or drowsiness while taking lamotrigine.