Lamotrigin Al (Lamotrigine)

Lamotrigine is an anticonvulsant that acts on seizure activity and mood regulation.

• Epilepsy (partial seizures): Reduces the frequency of partial seizures in adults and children.
• Epilepsy (generalized tonic‑clonic seizures): Prevents occurrence of generalized tonic‑clonic seizures.
• Epilepsy (secondary generalized seizures): Decreases risk of seizure generalisation.
• Bipolar disorder (maintenance therapy): Helps maintain mood stability and prevents recurrence of depressive or manic episodes.

• Lamotrigine inhibits voltage‑gated sodium channels, stabilising neuronal membranes and diminishing the release of excitatory neurotransmitters such as glutamate. This reduction in neuronal hyper‑excitability underlies its antiepileptic and mood‑stabilising effects.

Lamotrigine may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Dizziness: Light‑headed sensation, often transient.
• Headache: Mild to moderate cranial pain.
• Nausea: Stomach upset, sometimes with mild vomiting.
• Rash: Skin redness or itching, usually limited.
• Blurred vision: Temporary visual disturbances.
• Insomnia: Difficulty falling or staying asleep.

Serious or Rare Side Effects

• Stevens‑Johnson syndrome: Severe skin reaction requiring immediate medical attention.
• Toxic epidermal necrolysis: Life‑threatening skin detachment.
• Blood dyscrasias: Aplastic anaemia or agranulocytosis.
• Hepatic failure: Marked liver enzyme elevation or liver injury.
• Suicidal thoughts: Emergence of depressive or suicidal ideation.
• Severe rash with mucosal involvement: Requires urgent evaluation.

When prescribing Lamotrigin Al, clinicians should consider several safety measures.

• Dose titration: Initiate at a low dose and increase gradually as directed.
• Renal impairment: Adjust dose in patients with reduced renal function.
• Hepatic impairment: Use caution in liver disease and monitor function.
• Concomitant valproate: May increase lamotrigine levels, raising toxicity risk.
• Pregnancy: Discuss potential risks with the prescriber; data are limited.
• Store at ambient temperature: Keep below 25°C in the original pack, protect from moisture.

Lamotrigin Al interacts with several medicines that can alter its plasma concentration.

Major Interactions (Avoid)

• Valproic acid: Increases lamotrigine levels, heightening toxicity risk.
• Carbamazepine: Decreases lamotrigine levels, potentially reducing efficacy.
• Phenobarbital: Lowers lamotrigine concentrations, may require dose increase.
• Phenytoin: Reduces lamotrigine exposure, risking seizure breakthrough.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: May lower lamotrigine levels; monitor seizure control.
• Serotonergic agents: Potential for serotonin syndrome; observe for symptoms.
• Other antiepileptics: May necessitate dose adjustments based on therapeutic response.