LAMOTRIGINE

(Lamictal)

Standard Prescription

lamotrigine__mg PO__(frequency) (__mg/kg/24hr)

Dosages

Seizures:
Children 2-12 yrs (or <50 kg):
Wk 1 & 2: 0.15 mg/kg/dose PO BID
Wk 3 & 4: 0.3 mg/kg/dose PO BID
Increment: 0.3 mg/kg/dose PO BID every 7-14 days
Maintenance: 2.3-3.8 mg/kg/dose PO BID (4.5-7.5 mg/kg/24 hr)
Maximum: 7.5 mg/kg/dose PO BID or 200 mg/dose PO BID

With valproic acid:
Wk 1 & 2: 0.08 mg/kg/dose PO BID
Wk 3 & 4: 0.15 mg/kg/dose PO BID
Increment: 0.15 mg/kg/dose PO BID every 7-14 days
Maintenance: 0.5-2.5 mg/kg/dose PO BID
Maximum: 2.5 mg/kg/dose PO BID or 100 mg/dose PO BID

Children > 12 yrs (or >50 kg):
Wk 1 & 2: 25 mg/dose PO daily
Wk 3 & 4: 25 mg/dose PO BID
Increment: 12.5-25 mg/dose PO daily to BID every 7-14 days (25-50 mg/24 hr)
Maintenance: 100-200 mg/dose PO BID
Maximum: 300 mg/dose PO BID

With valproic acid:
Wk 1 & 2: 12.5 mg/dose PO daily
Wk 3 & 4: 12.5 mg/dose PO BID
Increment: 12.5 mg/dose PO daily to BID every 7-14 days (25-50 mg/24 hr)
Maintenance: 50-100 mg/dose PO BID
Maximum: 150 mg/dose PO BID

Bipolar Depression:
Adolescents > 12 yrs old (or >50 kg):
Monotherapy:
Wk 1 & 2: 25 mg PO once daily
Wk 3 & 4: 50 mg PO once daily
Wk 5: 100 mg PO once daily
Maintenance: 200 mg PO once daily

With valproic acid (+/- EI-AED):
Wk 1 & 2: 25 mg PO every other day
Wk 3 & 4: 25 mg PO DAILY
Wk 5: 50 mg PO DAILY
Maintenance: 100 mg PO DAILY

Without valproic acid (+ E-I AED):
Wk 1 & 2: 50 mg PO DAILY
Wk 3 & 4: 50 mg PO BID
Wk 5: 100 mg PO BID
Wk 6: 150 mg PO BID
Maintenance: up to 200 mg PO BID

Mechanism of Action

Anticonvulsant. Lamotrigine is a member of the sodium channel blocking class of antiepileptic drugs and suppresses the release of glutamate and aspartate, two of the dominant excitatory neurotransmitters in the CNS.

Forms Supplied

tablet: 25 mg,100 mg
chewable/dispersible tablet: 5 mg (Also available but not stocked at BCCH: 150 mg tablet; 2mg chewable/dispersible tablet

Comments

May worsen myoclonic seizures at higher doses and Dravet Syndrome.

Round doses down to nearest whole tablet.

Increased risk of rash with rapid titration. Must titrate dose slowly. Usually takes 12-15 weeks to achieve maintenance dose.

If withheld for > 5 half-lives, restart using initial dosing titration schedule.

Adverse effects: drowsiness, blurred vision, headache, insomnia, rash (related initial dose and titration frequency), Stevens-Johnson syndrome (SJS).

Skin rash can be serious and progress to SJS. All patients/families should be advised to seek medical attention if a rash develops at any time during treatment.

Allergic reaction usually develops within 10-14 days; however, it may appear in up to 3 months after treatment initiation.

Enzyme-inhibiting drugs (e.g. valproic acid) may increase half life; while enzyme-inducing drugs (e.g. phenytoin, carbamazepine) may decrease half life.

May interact with combination estrogen-progestin or progestin-only contraceptives (reduced lamotrigine levels and possible loss of contraceptive efficacy). Lamotrigine dosage adjustment and/or use of alternative contraceptive method may be necessary.

Effective for bipolar depression as monotherapy or adjunctive therapy (adults): open-label studies only in children and adolescents. Little to evidence of efficacy in acute mania or unipolar depression.

EI-AED = enzyme inhibiting anti-epileptic drug (e.g. carbamazepine, phenytoin, phenobarbital).

References

32, 44, 83, 94, 95, 158

Last Edited

2023-01-12 06:27:47