Lamitrin Tablet

Lamitrin Tablet 25 mg Introduction

Lamitrin Tablet 25 mg is an anticonvulsant drug, used to treat seizure disorders and mood disorders such as bipolar disorder. It works by decreasing the abnormal electrical activity in the brain and balancing the production of certain neurotransmitters. It is available as a tablet, capsule, chewable tablet or oral solution.

Uses for Lamitrin Tablet 25 mg

Lamitrin Tablet 25 mg is used to treat a variety of seizures, such as:

Generalized tonic-clonic seizures (grand mal): This seizure involves the body stiffening and shaking.
Partial seizures (focal seizures): These seizures involve part of the body or a specific behavior.
Focal aware seizures with alteration of consciousness: These seizures consist of a brief alteration in consciousness.

Lamitrin Tablet 25 mg is also used to treat bipolar disorder to reduce episodes of mania, depression, and suicidal thoughts. Lamitrin Tablet 25 mg may also be used to treat migraine headaches and pain associated with nerve damage.

Brand Name	Lamitrin
Type	Tablet
Weight	25 mg
Generic	Lamotrigine
Manufacturer	ACI Limited
Available in	English বাংলা

Mechanism of Action

Lamitrin Tablet 25 mg works by inhibiting sodium and calcium channels in the brain which helps decrease abnormal electrical activity in the brain. It also increases the production of gamma-aminobutyric acid (GABA), which stimulates the release of serotonin, a nerve chemical that helps control mood. This helps reduce seizures and stabilize mood.

How Long Does It Take to Work?

The effects of lamotrigine vary from person to person and depend on the condition being treated. For seizure disorders, it often takes several weeks before the drug reaches the therapeutic level and begins to suppress seizures. For bipolar disorders, it may take several weeks before symptoms show any improvement.

Absorption

Lamitrin Tablet 25 mg is well absorbed after oral administration and has a bioavailability of 60%. The time to reach peak concentration is 2-4 hours.

Route of Elimination

Lamitrin Tablet 25 mg is metabolized by the liver and is excreted in the urine.

Dosage

Epilepsy-
Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

Weeks 1 & 2:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
In patients taking Valproate: 25 mg every other day
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day

Weeks 3 & 4:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
In patients taking Valproate: 25 mg every day
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)

Week 5 onward to maintenance:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks

Usual maintenance dose:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)

Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

Weeks 1 & 2:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)

Weeks 3 & 4:
In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)

In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)

Week 5 onward to maintenance:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day

Usual maintenance dose:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)

Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

Weeks 1 & 2:

If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
If the patients weight is 14.1 kg to 27 kg: 2 mg every day
If the patients weight is 27.1 kg to 34 kg: 4 mg every day
If the patients weight is 34.1 kg to 40 kg: 5 mg every day

Weeks 3 & 4:

If the patients weight is 6.7 kg to 14 kg: 2 mg every day
If the patients weight is 14.1 kg to 27 kg: 4 mg every day
If the patients weight is 27.1 kg to 34 kg: 8 mg every day
If the patients weight is 34.1 kg to 40 kg: 10 mg every day

Bipolar disorder-

Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
Weeks 1 & 2:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
In patients taking Valproate: 25 mg every other day
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily

Weeks 3 & 4:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
In patients taking Valproate: 25 mg daily
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)

Week 5:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
In patients taking Valproate: 50 mg daily
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)

Week 6:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
In patients taking Valproate: 100 mg daily
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)

Week 7:

In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
In patients taking Valproate: 100 mg daily
In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)

The recommended starting dose of lamotrigine for seizure disorders is 25-50 milligrams (mg) per day. The daily dosage can be increased by 25-50 mg every week or two until the desired effect is reached. The recommended maintenance dose for seizure disorders is 50-250 mg per day.

For bipolar disorder, the starting dose is 25-50 mg per day, and the maintenance dose is 100-200 mg per day. The maximum recommended dose is 400 mg per day.

For migraine headaches, the starting dose is 25 mg per day, and the maintenance dose is 100-200 mg per day. The maximum recommended dose is 400 mg per day.

For nerve pain, the starting dose is 25-50 mg per day, and the maintenance dose is 100-200 mg per day. The maximum recommended dose is 400 mg per day.

Administration

Lamitrin Tablet 25 mg can be taken with or without food. It should be taken at the same time each day to maintain a consistent level of the drug in the blood. Capsules should be swallowed whole and not broken, chewed, or split.

Side Effect

Common side effects of lamotrigine include:

dizziness
drowsiness
nausea
vomiting
headache
blurred vision
weight changes
tremors

More serious side effects may include:

rash or blisters
fever
itching
jaundice
hallucinations
aggression
suicidal thoughts

Toxicity

Lamitrin Tablet 25 mg is generally considered safe if taken as prescribed. However, overdose can lead to serious complications, such as decreased consciousness, coma, and even death. It is important to seek medical attention immediately if you suspect an overdose.

Precaution

Before taking lamotrigine, tell your doctor if you are pregnant or breastfeeding. Lamitrin Tablet 25 mg may cause fetal harm if taken during pregnancy. It is important to talk to your doctor before taking this medication and to monitor the fetus for any potential risks.

Interaction

Lamitrin Tablet 25 mg may interact with certain medications, including birth control pills, sedatives, antidepressants, and certain anticonvulsants. It is important to tell your doctor about any medications you are taking prior to starting this medication.

Disease Interaction

Lamitrin Tablet 25 mg may interact with certain diseases, including kidney or liver disease, diabetes, bipolar disorder, and depression. Talk to your doctor before taking this medication if you have any of these conditions.

Drug Interaction

Lamitrin Tablet 25 mg may interact with certain drugs such as birth control pills, sedatives, antidepressants, and certain anticonvulsants. Tell your doctor about any drugs you are taking prior to starting this medication.

Food Interactions

Lamitrin Tablet 25 mg may interact with certain foods, including grapefruit or grapefruit juice. Talk to your doctor before taking this medication if you regularly eat grapefruit or other citrus fruit.

Pregnancy Use

Lamitrin Tablet 25 mg is classified as a Category C pregnancy drug. This means that it may cause fetal harm if taken during pregnancy, and should not be taken during pregnancy unless the benefits outweigh the risks. Talk to your doctor before taking this medication if you are pregnant or planning to become pregnant.

Lactation Use

Lamitrin Tablet 25 mg passes into breast milk and may cause serious side effects in a nursing infant. Talk to your doctor about the risks and benefits of taking this medication while breastfeeding.

Acute Overdose

If an overdose of lamotrigine is suspected, seek medical attention immediately. Symptoms may include decreased consciousness, loss of coordination, and seizures.

Contraindication

Lamitrin Tablet 25 mg is contraindicated in people who are allergic to it or any of its components. It is also contraindicated in people who have liver disease, diabetes, or bipolar disorder.

Use Directions

Take lamotrigine exactly as prescribed by your doctor. Do not take more or less of it, and do not take it more often than prescribed. Take it at the same time each day to maintain a consistent level in your bloodstream. Do not stop taking it abruptly as this may cause seizures.

Storage Conditions

Store lamotrigine at room temperature away from moisture and heat. Do not store it in the bathroom. Keep all medications away from children and pets.

Volume of Distribution

Lamitrin Tablet 25 mg has an apparent volume of distribution of 0.8-1.1 L/kg.

Half Life

The half-life of lamotrigine is 18-42 hours.

Clearance

Lamitrin Tablet 25 mg is metabolized by the liver and is eliminated mainly though the kidneys. The apparent clearance of lamotrigine is 0.27-0.62 L/hr/kg.

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