1. What’s lamotrigine
Lamotrigine is a medication used to deal with epilepsy. It will probably additionally assist stop low temper (despair) in adults with bipolar dysfunction.
Lamotrigine is accessible on prescription. It comes both as tablets you swallow or tablets you chew or dissolve in water to make a drink.
2. Key info
- It is regular to take lamotrigine a few times a day. You possibly can take it with or with out meals.
- The most typical unwanted side effects of lamotrigine are pores and skin rashes and complications.
- It will probably take as much as 6 weeks for lamotrigine to work. You should still have matches or seizures or really feel low throughout this time.
- Don’t cease taking lamotrigine with out speaking to your physician first.
- When you’ve got epilepsy, you are entitled to free prescriptions for your entire medicines, not simply your epilepsy ones.
3. Who can and can’t take lamotrigine
Lamotrigine will be taken by adults, and by youngsters aged 2 years and over. Lamotrigine will not be appropriate for some individuals.
To verify lamotrigine is protected for you, inform your physician if you happen to:
- have ever had an allergic response to lamotrigine or different medicines prior to now
- have liver or kidney issues
- have bipolar dysfunction and have ever had ideas of harming or killing your self
- have ever had meningitis or a rash brought on by lamotrigine
- are pregnant or making an attempt to get pregnant
- have an intolerance to or can’t digest lactose (lactose intolerance) – some manufacturers of lamotrigine comprise lactose
4. How and when to take lamotrigine
Lamotrigine is a prescription medication. It is vital to take it as suggested by your physician.
For epilepsy, the same old dose for:
- adults and older youngsters (aged 12 years and over) is 100mg to 700mg a day, taken as 1 or 2 doses
- youthful youngsters (aged 2 to 11 years) – the dose will differ relying on their weight
For bipolar dysfunction, the same old dose for adults is:
- between 200mg and 400mg a day, taken as both 1 or 2 doses
Find out how to take it
It is regular to take lamotrigine a few times a day. You possibly can take it with or with out meals. For those who take it twice a day, attempt to house your doses evenly by means of the day. For instance, very first thing within the morning and within the night.
Non-chewable or non-dispersible tablets – swallow complete with a glass of water. Don’t chew them.
Chewable or dispersible tablets – will be swallowed complete with a glass of water, chewed or blended with water or juice to make a drink.
Will my dose go up or down?
Once you begin taking lamotrigine, it is vital to extend the dose slowly as this can assist scale back or cease some unwanted side effects taking place. When you discover a dose that fits you, it’s going to often keep the identical.
How lengthy will I take it for?
When you’ve got epilepsy, it is probably that after your situation is below management you may nonetheless have to take lamotrigine for a few years.
When you’ve got bipolar dysfunction, it is probably that you’re going to take lamotrigine for a minimum of 6 months, however probably for much longer.
Don’t cease lamotrigine with out chatting with your physician first.
What if I neglect to take it?
For those who take lamotrigine and also you neglect a dose:
- as soon as a day – take the missed dose as quickly as you bear in mind. If it is lower than 12 hours till your subsequent dose is due, miss the missed dose and take your subsequent dose as regular.
- twice a day – take the missed dose as quickly as you bear in mind. If it is lower than 8 hours earlier than the subsequent dose is due, it is higher to go away out the missed dose and take your subsequent dose as regular.
- Don’t take 2 doses on the identical time. By no means take an additional dose to make up for a forgotten one.
- When you’ve got epilepsy, it is vital to take this medication frequently. Lacking doses might set off a seizure.
- For those who neglect to take your tablets for greater than 5 days in a row, communicate to your physician, as you may want to begin on a low dose once more and regularly improve to your regular dose.
- For those who neglect doses usually, it could assist to set an alarm to remind you.
- You may additionally ask your pharmacist for recommendation on different methods that will help you bear in mind to take your medication.
What if I take an excessive amount of?
Taking an excessive amount of lamotrigine may cause critical unwanted side effects.
Speedy motion required: Name 999 or go to A&E if:
You are taking an excessive amount of lamotrigine and:
- have speedy, uncontrollable eye actions
- really feel clumsy or lose your stability
- really feel a change within the rhythm of your heartbeat
- have had a match or seizure
- cross out
Don’t drive your self. Get another person to drive you or name for an ambulance. If you could go to hospital, take the lamotrigine packet or the leaflet inside it, plus any remaining medication, with you. Discover your nearest accident and emergency (A&E) division
5. Negative effects
Like all medicines, lamotrigine may cause unwanted side effects, though not everybody will get them.
Pores and skin rashes
- It’s normal to get a pores and skin rash with lamotrigine. Most pores and skin rashes aren’t critical.
- However if you happen to develop a pores and skin rash or redness, inform a health care provider right away, as this may develop right into a life-threatening pores and skin situation known as Stevens-Johnson syndrome.
- Stevens-Johnson syndrome is a uncommon facet impact of lamotrigine. It causes flu-like signs, adopted by a pink or purple rash that spreads and kinds blisters. The affected pores and skin finally dies and peels off.
- It is extra more likely to occur within the first 8 weeks of beginning lamotrigine, or when the dose is elevated too shortly.
- It will probably additionally occur if lamotrigine is stopped immediately for a couple of days after which restarted on the identical dose as earlier than, with out lowering the dose after which rising it slowly once more.
Stevens-Johnson syndrome is extra widespread in:
- individuals who developed a rash with a unique epilepsy medication prior to now
- people who find themselves allergic to an antibiotic known as trimethoprim
- individuals additionally taking a medication known as sodium valproate
To assist stop the possibility of you getting a rash that might be confused with Stevens-Johnson syndrome, it is best to not begin any new medicines, meals or merchandise through the first 3 months of remedy with lamotrigine.
It is also finest to not begin lamotrigine inside 2 weeks of a viral an infection, vaccination or rash brought on by one thing else.
Different widespread unwanted side effects
These widespread unwanted side effects might occur in additional than 1 in 100 individuals. They’re often gentle and go away by themselves. Hold taking the medication, however speak to your physician if these unwanted side effects hassle you or don’t go away:
- feeling drowsy, sleepy or dizzy
- aggression, or feeling irritable or agitated
- shaking or tremors
- problem sleeping
- feeling or being sick (nausea or vomiting)
Different critical unwanted side effects
Only a few individuals taking lamotrigine have critical issues.
Inform a health care provider right away when you’ve got a critical facet impact, together with:
- ideas of harming or killing your self – a small variety of individuals taking lamotrigine for bipolar dysfunction have had suicidal ideas, and this may occur after just a few weeks of remedy
- worsening seizures (if you happen to take lamotrigine for epilepsy)
- surprising bruising or bleeding, a excessive temperature or sore throat – these might be warning indicators of a blood dysfunction
- a stiff neck, complications, feeling or being sick, a excessive temperature and excessive sensitivity to vibrant gentle – these might be indicators of meningitis
Critical allergic response
In uncommon circumstances, it is potential to have a critical allergic response (anaphylaxis) to lamotrigine.
Speedy motion required:
- you get a pores and skin rash that will embrace itchy, pink, swollen, blistered or peeling pores and skin
- you are wheezing
- you get tightness within the chest or throat
- you might have hassle respiration or speaking
- your mouth, face, lips, tongue or throat begin swelling
You may be having a critical allergic response and might have speedy remedy in hospital.
These aren’t all of the unwanted side effects of lamotrigine.
6. How to deal with unwanted side effects of lamotrigine
What to do What’s:
- complications – ensure you relaxation and drink loads of fluids. Don’t drink an excessive amount of alcohol. Ask your pharmacist to suggest a painkiller. Speak to your physician in case your complications last more than per week or are extreme.
- feeling drowsy, sleepy or dizzy as your physique will get used to lamotrigine, these unwanted side effects ought to put on off. Don’t drive, trip a motorbike or function equipment till you are feeling extra alert. If they don’t go inside per week or two, your physician might scale back your dose or improve it extra slowly. If that doesn’t work, communicate to your physician. Chances are you’ll want to change to a unique medication.
- aggression, or feeling irritable or agitated –speak to your physician.
- shaking or tremors – speak to your physician if that is bothering you. These signs could be a signal that the dose is simply too excessive for you. It might assist to alter your dose or take your medication at a unique time of day.
- problem sleeping – speak to your physician.
- diarrhoea – drink plenty of fluids, corresponding to water or squash, to keep away from dehydration. Indicators of dehydration embrace peeing lower than regular or having darkish, strong-smelling pee. Don’t take another medicines to deal with diarrhoea with out chatting with a pharmacist or physician. Communicate to a health care provider if signs worsen or last more than per week.
- feeling or being sick – persist with easy meals and don’t eat wealthy or spicy meals. It’d assist to take your lamotrigine after a meal or snack. For those who’re being sick, take small, frequent sips of water or squash to keep away from dehydration. Communicate to a health care provider if signs worsen or last more than per week.
7. Being pregnant and breastfeeding
Lamotrigine and being pregnant
- There is no agency proof that lamotrigine is dangerous to an unborn child.
- However for security, your physician will solely advise you to take it in being pregnant if the advantages of the medication outweigh the dangers.
- It is vital for you and your child to remain effectively throughout being pregnant.
- For those who grow to be pregnant whereas taking lamotrigine, inform your physician or nurse right away. Don’t cease taking it with out speaking to your physician first.
- When you’ve got epilepsy, it is essential that it is handled throughout being pregnant as seizures can hurt you and your unborn child.
- For those who’re pregnant, or making an attempt to get pregnant, and taking lamotrigine, you are really helpful to take the next dose of folic acid, a vitamin that helps your child develop usually.
- Your physician would possibly prescribe a excessive dose of 5mg a day when you’re making an attempt to get pregnant and through the first 12 weeks of being pregnant.
Lamotrigine and breastfeeding
In case your physician or well being customer says your child is wholesome, lamotrigine will be taken when you’re breastfeeding.
It is vital to maintain taking lamotrigine to maintain you effectively. Don’t cease taking it with out speaking to your physician. Breastfeeding may even profit each you and your child.
For those who discover your child will not be feeding in addition to regular, appears unusually sleepy, or you might have another issues What’s them, speak to your pharmacist, well being customer or physician as quickly as potential.
Non-urgent recommendation: Inform your physician if you happen to’re:
- making an attempt to get pregnant
For extra info What’s how lamotrigine can have an effect on you and your child throughout being pregnant.
8. Cautions with different medicines
Some medicines and lamotrigine intrude with one another and improve the possibilities of unwanted side effects. Your physician might have to alter your dose of lamotrigine.
Examine along with your pharmacist or physician if you happen to’re taking:
- different medicines used to deal with epilepsy, corresponding to carbamazepine, felbamate, gabapentin, levetiracetam, oxcarbazepine, phenobarbital, phenytoin, pregabalin, primidone, topiramate, valproate or zonisamide
- aripiprazole, lithium, olanzapine or risperidone (used for psychological well being issues)
- bupropion, a quit smoking medication
- rifampicin, an antibiotic often given to deal with tuberculosis (TB)
- medicines used to deal with HIV
- hormonal contraceptives or hormone alternative remedy (HRT)
Mixing lamotrigine with natural cures and dietary supplements
There is perhaps an issue taking some natural cures and dietary supplements alongside lamotrigine, particularly ones that may trigger rashes, sleepiness or shaking and tremors.
Ask your pharmacist for recommendation.
9. Widespread questions What’s lamotrigine
How does lamotrigine work?
For epilepsy – mind cells usually “speak” to one another utilizing electrical alerts and chemical substances. Seizures can occur when the mind cells aren't working correctly or working quicker than regular. Lamotrigine slows down these electrical alerts to cease seizures.
For bipolar dysfunction – we don't actually understand how lamotrigine prevents low temper in individuals. It'd work in the same option to epilepsy. Typically it is known as a temper stabiliser, because it reduces temper swings.
How lengthy does it take to work?
It often takes round 6 weeks for lamotrigine to work correctly. It's because the dose must be elevated slowly to stop unwanted side effects. You should still have seizures or really feel low throughout this time.
Is it protected to take lamotrigine for a very long time?
Many individuals can take lamotrigine safely for a number of months or years. However there are some unwanted side effects that may occur over a very long time. Lengthy-term remedy with lamotrigine may cause osteoporosis and osteopenia, rising your threat of breaking a bone.
Your physician can organize for exams to test your bone energy. Common train and weight loss plan can even assist maintain your bones sturdy.
How can I come off lamotrigine?
For those who're taking lamotrigine for epilepsy, stopping it immediately may cause seizures. Coming off lamotrigine must be executed very slowly and would possibly take a couple of months.
For those who're taking lamotrigine for bipolar dysfunction, it is often protected to cease taking it with out having to scale back your dose first.
For those who get a critical facet impact, corresponding to a extreme pores and skin rash, your physician might let you know to cease taking lamotrigine right away, even when you've got epilepsy.
What occurs if I need to change to a unique medication?
For those who're switching medicines, it is essential to do it precisely as your physician tells you to. If you wish to change, you may often begin taking the brand new one at a low dose and slowly construct up the dose when you're nonetheless taking lamotrigine.
As soon as you take the right dose of the brand new medication, you need to be capable of slowly scale back your dose of lamotrigine. It will probably take a number of weeks or months till you might have stopped taking lamotrigine utterly.
Does lamotrigine trigger weight reduction?
Lamotrigine doesn't often have an effect on weight in any respect.
Will the unwanted side effects put on off?
Most unwanted side effects of lamotrigine put on off, however it could actually take a number of weeks or months. Once you begin taking lamotrigine, it is vital to extend the dose slowly as this can assist scale back or cease some unwanted side effects taking place.
Lamotrigine can even trigger some unpredictable unwanted side effects it doesn't matter what dose you're taking, and these can occur at any time. Communicate to your pharmacist or physician if you happen to're involved What's unwanted side effects.
Are there comparable medicines?
There are many medicines that can be utilized for epilepsy and bipolar dysfunction, however they work in numerous methods. They could have totally different unwanted side effects, or be taken kind of usually.
When you've got epilepsy, the selection will rely upon the kind of seizures that you've got. Your physician will talk about the very best medication for you.
When you've got low temper with bipolar dysfunction, different medicines your physician would possibly use embrace lithium or quetiapine.
Do I have to take the identical model of lamotrigine?
It isn't all the time vital to remain on the identical model. In case your epilepsy has been exhausting to manage prior to now and the model of lamotrigine you are now taking is working effectively for you, your physician might suggest you keep on the identical one.
For those who take lamotrigine for bipolar dysfunction, most individuals shouldn't have to remain on the identical model. Speak to your physician when you've got been requested to change to a unique model of lamotrigine and also you're fearful What's it.
Can I take sodium valproate with lamotrigine?
Sure, you possibly can take sodium valproate with lamotrigine. However sodium valproate can improve the quantity of lamotrigine in your blood, so your physician might prescribe a decrease dose of lamotrigine.
How does it evaluate with different medicines for epilepsy?
There are lots of totally different medicines for treating epilepsy. It isn't potential to say that one works higher than the opposite. It varies from individual to individual, and is determined by the kind of seizures and the way usually you might have them.
Different epilepsy medicines embrace:
Earlier than prescribing a medication, your physician may even keep in mind your age and gender, the medicines you are already taking and another well being issues you might have.
It is regular to attempt to deal with epilepsy utilizing a single medication. If this medication will not be working effectively otherwise you're getting unwanted side effects, your physician will usually attempt you on a unique one.
If a single medication will not be controlling your seizures, your physician might suggest taking 2 or extra epilepsy medicines on the identical time.
How does it evaluate with different medicines for bipolar dysfunction?
When you've got bipolar dysfunction, there are a number of kinds of medication to stop low temper. It isn't potential to say that one works higher than one other, and varies from individual to individual.
Lithium is often used for treating low temper in bipolar dysfunction, in addition to a medication known as quetiapine (an antipsychotic medication). You possibly can take lamotrigine by itself, or generally along with lithium or quetiapine, relying on what your physician recommends.
Your physician or specialist will discover the medicines that work finest for you.
Can I get epilepsy medicines free of charge?
When you've got epilepsy, you are entitled to free prescriptions for your entire medicines, not simply your epilepsy ones. To assert your free prescriptions, you may want a medical exemption certificates.
The applying type for the medical exemption certificates is known as FP92A. You will get this out of your physician's surgical procedure. You may have to fill within the type, then your physician will signal it and ship it off.
Can I take lamotrigine earlier than surgical procedure?
Inform your surgeon that you simply take lamotrigine. Take your medication as regular on the day of your surgical procedure, except your physician or surgeon advises you to not.
Will it have an effect on my contraception?
The mixed capsule, patch and vaginal ring can decrease the quantity of lamotrigine in your blood, so that you would possibly need to use a unique kind of contraception as a substitute.
For those who resolve to take the mixed capsule, chances are you'll want to alter your dose of lamotrigine, however this is determined by what different epilepsy medicines you take.
Lamotrigine would possibly cease the mixed capsule working. Look out for bleeding or recognizing between your intervals (breakthrough bleeding), which is perhaps an indication the capsule will not be working. Speak to your physician if this occurs.
You possibly can take the progesterone-only contraceptive capsule, however lamotrigine would possibly improve the quantity of progesterone in your blood and trigger you to have extra unwanted side effects. Communicate to your physician if you happen to're fearful.
Lamotrigine doesn't have an effect on these contraceptives:
Will it have an effect on my fertility?
There is no agency proof that lamotrigine impacts feminine fertility. For some males with epilepsy, epilepsy medicines can scale back their ranges of testosterone. It doesn't have an effect on everybody, however it might make you much less fertile. Communicate to your physician when you've got any issues.
Can I drink alcohol with it?
Sure, you possibly can drink alcohol with lamotrigine. However it could make you are feeling sleepy or drained, and alcohol and hangovers can deliver on seizures in some individuals with epilepsy. In the course of the first few days of taking lamotrigine, it is best to cease consuming alcohol till you see how the medication impacts you.
For those who do drink, attempt to not have greater than the really helpful tips of as much as 14 items of alcohol per week. A regular glass of wine (175ml) is 2 items. A pint of lager or beer is often 2 to three items of alcohol.
Is there any meals or drink I have to keep away from?
No. You possibly can eat and drink usually whereas taking lamotrigine.
Can I drive or trip a motorbike with it?
-Chances are you'll really feel sleepy, drained or dizzy whenever you first begin taking lamotrigine or the dose is elevated.
-If this occurs to you, don't drive, trip a motorbike or function equipment till you are feeling extra alert.
-It will probably additionally have an effect on your imaginative and prescient. Don't drive or trip a motorbike in case your imaginative and prescient is affected.
-When you've got epilepsy, you are not allowed to drive till you might have had no seizures for 1 12 months otherwise you solely have seizures when you're asleep.
-You are not allowed to drive for six months after altering your epilepsy medication.
-Driving guidelines if you happen to change or withdraw your medication, Epilepsy Motion
-Epilepsy and driving info, GOV.UK
- Don’t cease taking lamotrigine with out speaking to your physician first.
- Inform your physician or pharmacist if you happen to’re taking another medicines, together with natural medicines, nutritional vitamins or dietary supplements.
- Bipolar dysfunction
- Epilepsy and being pregnant