LAMICTAL ODT
Generic Name for LAMICTAL ODT
Lamotrigine 25mg, 50mg, 100mg, and 200mg; orally-disintegrating tabs.
Legal Classification:
Rx
Pharmacological Class for LAMICTAL ODT
Phenyltriazine.
Manufacturer of LAMICTAL ODT
GlaxoSmithKline Pharmaceuticals
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Indications for LAMICTAL ODT
Maintenance treatment of bipolar disorder.
Adult dose for LAMICTAL ODT
≥18yrs: Not on enzyme-inducing antiepileptic drugs (EIAEDs, ie, phenytoin, carbamazepine, phenobarbital, primidone), or valproate: 25mg daily for 2 weeks, then 50mg daily for 2 weeks, then 100mg daily for 1 week, then to target dose of 200mg daily. Concomitant valproate: 25mg every other day for 2 weeks, then 25mg daily for 2 weeks, then 50mg daily for 1 week, then to target dose of 100mg daily. Concomitant EIAEDs and not valproate: 50mg daily for 2 weeks, then 100mg daily in divided doses for 2 weeks, then increase weekly by 100mg daily in divided doses to target dose of 400mg daily in divided doses. Discontinuing valproate: double lamotrigine dose over 2 weeks in equal weekly increments. Discontinuing EIAEDs: maintain lamotrigine dose for 1 week after discontinuing EIAEDs, then reduce lamotrigine dose by 1/2 over 2 weeks in equal weekly decrements then adjust as needed. Reevaluate periodically. Concomitant estrogen-containing oral contraceptives or hormone replacement therapy: see literature. Hepatic impairment: if moderate or severe (w/o ascites) reduce dose by 25%; if severe (w. ascites) reduce dose by 50%.
Children's dosing for LAMICTAL ODT
<18yrs: not recommended.
Also:
Precautions for LAMICTAL ODT
Discontinue at first sign of rash (unless clearly not drug related); avoid rechallenge. Avoid rapid dose increases and exceeding recommended dose (may increase risk of serious rash). History of allergy or rash to other AEDs (may increase frequency of nonserious rash). Reevaluate if fever, rash, or other hypersensitivity reaction occurs; discontinue if hypersensitivity occurs. Impaired cardiac function. Moderate or severe hepatic impairment. Significant renal impairment: consider reduced dose. Suicidal tendencies (monitor). Avoid abrupt cessation; taper over at least 2 weeks if possible. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended.
Interactions for LAMICTAL ODT
Lamotrigine levels increased by valproate. Lamotrigine levels decreased by phenytoin, carbamazepine, phenobarbital, primidone, rifampin. Monitor with other anticonvulsants. Lamotrigine levels may be decreased by oral contraceptives and increased when they are stopped (if monotherapy: adjust dose), and may affect hormonal replacement therapy or other hormonal contraceptive efficacy. May potentiate other folate inhibitors (eg, trimethoprim). Valproate may increase risk of serious rash. Increased incidence of dizziness, diplopia, ataxia, blurred vision with carbamazepine. No apparent effect on lithium levels.
Adverse Reactions for LAMICTAL ODT
GI upset, insomnia, somnolence, dizziness, back pain, fatigue, rhinitis, non-serious rash, abdominal pain, dry mouth, headache, abnormal dreams; rare: serious rash (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis), hypersensitivity, multiorgan failure, blood dyscrasias.
How is LAMICTAL ODT supplied?
Tabs 25mg, 100mg—100
150mg, 200mg—60
Chewable Dispersible tabs 2mg—30
5mg, 25mg—100
Starter kit 25mg x 35 tabs—1
25mg x 84 tabs + 100mg x 14 tabs—1
25mg x 42 tabs + 100mg x 7 tabs—1
ODT Maintenance Packs—30
ODT Titration Kit 25mg x 21 tabs + 50mg x 7 tabs—1
50mg x 42 tabs + 100mg x 14 tabs—1
25mg x 14 tabs, 50mg x 14 tabs, 100mg x 7 tabs—1
Related Disease:
Bipolar disorder