LAMICTAL XR

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Generic Name for LAMICTAL XR Lamotrigine 25mg, 50mg, 100mg, and 200mg, ext-rel tabs. Legal Classification: Rx Pharmacological Class for LAMICTAL XR Phenyltriazine. Manufacturer of LAMICTAL XR GlaxoSmithKline Pharmaceuticals

Indications for LAMICTAL XR

Adjunct in primary generalized tonic-clonic seizures or partial onset seizures with or without secondary generalization in patients ≥13 years of age.

Adult dose for LAMICTAL XR

Swallow whole. Take once daily. ≥13yrs: adding to antiepileptic drug (AED) regimens that include valproate: initially 25mg every other day for 2 weeks, then 25mg once daily for 2 weeks, then 50mg once daily for 1 week, then 100mg once daily for 1 week, then 150mg once daily for 1 week; followed by maintenance range 200–250mg/day. For patients not taking carbamazepine, phenytoin, phenobarbital, primidone, or valproate: initially 25mg once daily for 2 weeks, then 50mg once daily for 2 weeks, then 100mg once daily for 1 week, then 150mg once daily for 1 week, then 200mg once daily for 1 week; followed by maintenance range 300–400mg/day. Adding to AED regimens without valproate: initially 50mg once daily for 2 weeks, then 100mg once daily for 2 weeks, then 200mg once daily for 1 week, then 300mg once daily for 1 week, then 400mg once daily for 1 week; followed by maintenance range 400–600mg/day. Converting from lamotrigine immediate-release tabs: give initial dose to equal total daily dose of immediate-release; monitor and adjust as needed. 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 XR

<13yrs: not recommended.

Also:

Precautions for LAMICTAL XR

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 XR

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 XR

Adults (adjunctive): dizziness, ataxia, somnolence, headache, diplopia, blurred vision, nausea, vomiting. Adults (monotherapy): vomiting, coordination abnormalities, dyspepsia, nausea, dizziness, rhinitis, anxiety, insomnia, pain, weight loss, chest pain, dysmenorrhea, nystagmus, lymphadenopathy. Children (adjunctive): infection, vomiting, fever, dizziness, GI upset, ataxia, tremor, asthenia, bronchitis, flu syndrome, diplopia. Rare: rash (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis, or benign), hypersensitivity, multiorgan failure, blood dyscrasias. XR: also, cerebellar coordination/balance disorder, asthenic conditions, vertigo.

How is LAMICTAL XR 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
XR tabs—30
XR Titration Kit 25mg x 21 tabs + 50mg x 7 tabs—1
50mg x 14 tabs + 100mg x 14 tabs + 200mg x 7 tabs—1
25mg x 14 tabs + 50mg x 14 tabs + 100mg x 7 tabs—1

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