Lamotrigin Actavis (Lamotrigine)

Lamotrigine is an anticonvulsant used to manage seizure disorders and mood stabilization in bipolar disorder.

• Epilepsy: reduces the frequency and severity of seizures in patients with focal or generalized epilepsy.
• Bipolar disorder: provides mood stabilization and helps prevent depressive and manic episodes.
• Adjunctive therapy in refractory seizures: used alongside other antiepileptic drugs when seizures are not controlled.

• Lamotrigine inhibits voltage‑gated sodium channels, which stabilises neuronal membranes and reduces excessive neuronal firing. It also modulates the release of excitatory neurotransmitters such as glutamate, contributing to its antiepileptic and mood‑stabilising effects.

Lamotrigine may cause a range of adverse reactions. The most frequently reported events are generally mild to moderate in intensity.

Common Side Effects

• Dizziness
• Headache
• Nausea
• Rash or skin irritation
• Blurred vision
• Insomnia

Serious or Rare Side Effects

• Stevens‑Johnson syndrome or toxic epidermal necrolysis
• Severe skin reactions such as drug rash with eosinophilia and systemic symptoms (DRESS)
• Blood dyscrasias including aplastic anemia or agranulocytosis
• Hepatic failure or severe liver injury
• Suicidal thoughts or behavior
• Severe hypersensitivity reactions

Lamotrigine requires careful clinical monitoring to minimise risks.

• Dose titration: start with a low dose and increase gradually to reduce the risk of rash.
• Monitor skin: watch for any rash or hypersensitivity signs and discontinue if severe.
• Avoid abrupt discontinuation: sudden stopping may increase seizure frequency.
• Use with caution in hepatic impairment: dose adjustments may be necessary.
• Pregnancy: discuss potential risks and benefits with a healthcare provider before use.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Lamotrigine interacts with several medicines that can alter its plasma concentrations.

Major Interactions (Avoid)

• Valproic acid: markedly increases lamotrigine levels, raising toxicity risk.
• Carbamazepine: significantly reduces lamotrigine concentrations, potentially decreasing efficacy.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: may increase lamotrigine clearance, requiring dose adjustment.
• Phenobarbital: can lower lamotrigine levels, necessitating monitoring.
• Rifampin: induces metabolism and may reduce lamotrigine exposure.