lamotrigine

Generic name: Lamotrigine
Available as: Lamictal: tablets 25mg, 50mg, 100mg, 200mg, dispersible tablets 2mg, 5mg, 25mg, 100mg.
Lamotrigine: tablets 25mg, 50mg, 100mg, 200mg, dispersible tablets 5mg, 25mg, 100mg.

Adults

Average total daily dose: Used alone: 100 – 200mg daily divided into 1 – 2 doses, up to 500mg.
With sodium valproate: 100 – 200mg daily divided into 1 – 2 doses.
With enzyme-inducing AEDs and without sodium valproate: 200 – 400mg daily divided into 1 – 2 doses, up to 700mg.
Without enzyme-inducing AEDs and without sodium valproate: 100 – 200mg daily divided into 1 – 2 doses.
Doses per day: 1 – 2
Treatment: Monotherapy and add-on therapy for focal and generalised seizures. Also used for seizures associated with Lennox-Gastaut syndrome.
Most common possible side effects include the following. Report severe reactions, such as a skin rash, to your doctor.
Serious skin rash and hypersensitivity. Risk minimised with slow introduction. Nausea, vomiting, diarrhoea, dry mouth, aggression, agitation, headache, drowsiness, dizziness, tremor, difficulty sleeping, unsteadiness, back pain, joint pain, eye movements, double vision, and blurred vision.

Children

Average total daily dose: From 2 years. ​Used alone: 1 – 10mg/kg daily divided into 1 – 2 doses, up to 15mg/kg.
With sodium valproate: 1 – 5mg/kg daily divided into 1 – 2 doses, up to 200mg.
With enzyme-inducing AEDs and without sodium valproate: 5 – 15mg/kg daily divided into 1 – 2 doses, up to 400mg.
Without enzyme-inducing AEDs and without sodium valproate: 1 – 10mg/kg daily divided into 1 – 2 doses, up to 200mg.
Doses per day: 1 – 2
Treatment: Add-on therapy for focal seizures, and primary and secondarily generalised tonic clonic seizures. Also used for seizures associated with Lennox-Gastaut syndrome. Monotherapy for typical absence seizures
Most common possible side effects include the following. Report severe reactions, such as a skin rash, to your doctor.
Serious skin rash and hypersensitivity if allergic to lamotrigine. Risk minimised with slow introduction. Nausea, vomiting, diarrhoea, headache, fatigue (tiredness), dizziness and sleep disturbance. Tremor may occur when taken with sodium valproate and may reduce as dose is changed.

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Please note:

• This information is a guide only, and lists the usual daily doses of anti-epileptic drugs (AEDs). The dose taken may be different to those listed above.
  
• Treatment of neonatal seizures (from birth to 28 days of age) is not covered.
  
• Most doses are listed as ‘mg/kg’: this means milligrams of AED per kg of the child’s weight.
  
• Children starting AED treatment at the age of 12 may start on adult doses. Some AEDs are only used for children aged 12 and over (including eslicarbazepine acetate, lacosamide, perampanel, pregabalin, retigabine and tiagabine).
  
• Some AED doses are listed as ‘twice daily’ (for example ‘5mg/kg twice daily’). This means that the dose listed is taken each time (and so the total daily dose will be double that listed).
  
• Some AED doses are listed as ‘divided into 2 (or 3) doses’ (for example ‘25 - 30mg/kg daily divided into 2 doses’). This means that the total amount listed is divided into two to give the dose taken each time.
  
• ‘Effective’ means the seizures it works for. ‘Monotherapy’ means the AED is taken on its own. ‘Add-on therapy’ means the AED is taken alongside other AEDs. ‘Tolerance’ means that a drug becomes less effective the longer you take it.
  
• Information for this page comes from sources including the British National Formulary (BNF), the British National Formulary for children (BNFC) and the electronic medicines Compendium (eMC). The side effects listed here are some of the most common possible side effects and may be worded differently in the patient information leaflet for the AED. Doctors may refer to the BNF/BNFC for starting doses and how to increase doses. For more details, and a complete list of side effects, visit www.medicines.org.uk/guides/epilepsy (opens new window).
  
• Every effort is made to ensure that all information is correct at time of publishing but information may change after publication. This information is not a substitute for advice from your doctor. Epilepsy Society is not responsible for any actions taken as a result of using this information.