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Lamotrigine- 25 Tablets
Lamotrigine- 50 Tablets
Lamotrigine- 100 Tablets
Lamotrigine- 5 DT
Composition
Lamotrigine- 25 Tablets
Each uncoated scored tablet contains Lamotrigine 25 mg
Lamotrigine- 50 Tablets
Each uncoated scored tablet contains Lamotrigine 50 mg
Lamotrigine- 100 Tablets
Each uncoated scored tablet contains Lamotrigine 100 mg
Lamotrigine- 5 DT
Each dispersible tablet contains Lamotrigine 5 mg
Indications
Lamotrigine is indicated as monotherapy as well as an adjunctive
therapy in the treatment of partial seizures in adults with
epilepsy.
Lamotrigine is also indicated as adjunctive therapy in the
generalized seizures of Lennox-Gestaut syndrome in paediatric and
adult patients.
Dosage and Administration
Monotherapy with Lamotrigine in patients 3 16 years of age:
Lamotrigine is to be titrated to the targeted dose of 50 mg/day
while maintaining the dose of the EIAEDs at a fixed level. The
EIAEDs is then gradually withdrawn over a period of 4 weeks.
Recommended maintenance dose of Lamotrigine as Monotherapy is 500
mg/day given in two divided doses.
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Dose recommendation for Lamotrigine (mg/day) for adults (over
12 year). |
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Week 1&2
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Week 1&2 |
Usual
Maintenance dose |
| With enzyme-inducing
antiepileptic drugs (EIAEDS*) & No valproic acid (VPA) |
50 mg/day
(once a day) |
100 mg/day
(two divided doses) |
300-500 mg/day
(two divided doses). To achieve maintenance, doses may be
increased by 100 mg/day every 1 to 2 weeks. |
EIAEDS* &
valproic acid (VPA) |
25 mg every other
day. |
25 mg (once a day) |
100-400 mg/day
(two divided doses). To achieve maintenance, doses may be
increased by 25-50 mg/day every 1 to 2 weeks. |
*
e.g. phenytoin, carbamazepine, phenobarbitone and primidone
Note: In patients taking AEDs where the pharmacokinetic
interaction with lamotrigine is currently not known, the dose
escalation as recommended for lamotrigine with concurrent
valproate should be used, thereafter, the dose should be increased
until optimal response is achieved.
Because of a risk of rash the initial dose and subsequent dose
escalation should not be exceeded.
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RECOMMENDED DOSE
ESCALATION FOR LAMOTRIGINE (Lamotrigine) FOR CHILDREN AGED
2-12 YEARS (TOTAL DAILY DOSE IN MG/KG BODY WEIGHT/DAY) ON
COMBINED DRUG THERAPY |
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Week 1&2 |
Week 1&2 |
Usual
Maintenance dose |
| With AED regimen containing VPA |
0.15 mg/kg/day
(1 or 2 divided doses) |
0.3 mg/kg/day
(1 or 2 divided doses) |
1-5 mg/kg/day
(maximum 200 mg/day in 1 or 2 divided doses).
To achieve maintenance, doses may be increased by 0.5-1 mg
every 1 to 2 weeks. |
| Added to EIAEDs and without VPA |
0.6 mg/ kg/day
(two divided doses) |
1.2 mg/ kg/day
(two divided doses) |
5-15 mg/kg (in two
divided doses).
To achieve maintenance, doses may be increased by 2-3 mg/kg 1
to 2 weeks to a maximum of 400 mg/day. |
Lamotrigine as adjunctive therapy
Lamotrigine therapy should be initiated slowly to avoid the
occurrence of rash and should be gradually decreased when it is to
be discontinued to prevent rebound seizures. Lamotrigine tablets
should be swallowed with water.
Discontinuation Strategy:
For patients receiving lamotrigine in combination with other AEDs,
a re-evaluation of all AEDs in the regimen should be considered if
a change in seizure control or an appearance of worsening of
adverse experiences is observed.
If a decision is made to discontinue therapy with lamotrigine, a
step-wise reduction of dose over at least 2 weeks (approximately
50% per week) is recommended unless safety concerns require a more
rapid withdrawal.
Discontinuing an EIAED should prolong the half-life of lamotrigine;
discontinuing VPA should shorten the half-life of lamotrigine.
Contraindications
1. In children below 2 years of age
2. Hypersensitivity to lamotrigine.
Presentation
Lamotrigine- 25 Blister pack of 10 tablets
Lamotrigine- 50 Blister pack of 10 tablets
Lamotrigine- 100 Blister pack of 10 tablets
Lamotrigine- 5 DT Blister pack of 10 tablets
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