Lamotrigine

Parent or patient Information Leaflet

Dr. C. P. Ravi Kumar

Consultant Paediatric Neurologist
MRCPCH, CCT in Paediatrics (U.K.)
Fellow in Paediatric Epilepsy &
Neurology (London)

Lamotrigine is a medicine used in epilepsy to control focal epilepsy, generalized tonic-clonic seizures, absence seizures (vacant spells) and few specific syndromes such as Lennox Gastuat syndrome.

Why is Lamotrigine important for my child’s treatment?

It is important that your child takes Lamotrigine regularly so that they have no Seizures or fewer seizures.

Do not stop giving Lamotrigine all of a sudden, as it may result in your child having more seizures.

What is Lamotrigine available as?

Lamotrigine is available in the preparation of Tablets, Modified-release tablets (releases medication slowly into blood after it has been consumed) in the market.

Brand names:

Tablet: Lamez, Lamictal, Lametec

Delayed release: Lamez DT

“Generic Vs Branded Drugs”

When should I give Lamotrigine ?

Twice a day; morning and evening. Ideally, 10-12 hours apart.

For example, anytime between 7 to 8 am and right after 12 hours between 7 to 8 pm. You can adjust the time slot according to your schedule.

However, there are some exceptions when your doctor may advise to give it thrice a day. Please follow your doctor’s instructions in such case.

It should ideally be given at the same time every day to establish a routine as it minimizes the chances of missing a dose.

What if I miss the dose?

Tablets & liquids: The child can be given the missed dose, if you remember to give it within a lapse of 6 hours. If you fail to give the missed dose within 6 hours, then might as well leave it. It is advisable to wait until the time of next routine dose.

Modified release preparations: If you miss a dose, you can give it any time within the next 8 hours. After this time, wait until the next routine dose.

Never give a double dose of Lamotrigine .

If your child vomits out the content within 30 minutes of taking the medicine dosage then you can give the dose again; but if your child vomits after 30 minutes of taking the dose, then just leave it be and do not give it again.

How much of the drug should be given?

Your doctor will work out the accurate amount of Lamotrigine (the dose) for your child and write the dosage in your prescription.

When you first start giving Lamotrigine to your child, you are supposed to give them a small amount and then increase the dose little by little over a course of few days or weeks. This helps your child’s body to get use to the medicine. Your doctor will clarify what steps to take.

It is mandatory to follow the instructions given by your doctor about the dosage of medication.

Ultimately, when your child is free of seizures or convulsions (fits) and has no obvious side effects, you will know that the dosage is just correct.

How should I the medicine? “Giving Medicines”

Tablets: A whole tablet must be swallowed with a glass of water, juice or milk. You may give it by crushing and mixing it in water/ juice or small serving of yogurt / Curd.

Modified Release (Controlled release): These tablets should not be crushed, as they lose their purpose. The whole tablet intact should be swallowed. If you need to crush to administer the medicine, use a standard tablet.

Could this medication have any side effects on my child? “Side effects”

We use medicines to make our children feel better, but sometimes they cause unwanted effects. Please read about side effects in a separate leaflet.

Side-effects that you must do something about – Rare

• Your child may be more sleepy than usual or even lack of Sleep

• Emotional liability, disturbing dreams.
• Behavioural change.
• Your child may feel less hungry (lose their appetite)

Your child may get these side-effects when they first start taking Lamotrigine. However, its daily use will make your child’s body to adapt and settle down within a period of week or so. Continue to give lamotrigine to your child as your doctor has directed you to.

Liver disease: It is mandatory to monitor liver enzymes regularly. If your doctor catches any evidence of liver dysfunction, it must be taken care of immediately. If your child’s health deteriorates and falls sick every few hours, suffers from stomachache, skin and eyes are pale yellow in color, feels lethargic and sleepy or increased number of seizures take them to your doctor straight away.

Other RARE, but SERIOUS side-effect you need to know about

If your child starts developing skin Rash, Stop Medications right there and SEEK IMMEDIATE MEDICAL ADVICE from your DOCTOR.

IF YOU NOTICE ANY SKIN RASH OR ULCERS IN MOUTH or GENITAL AREA, THEN STOP MEDICINE IMMEDIATELY AND RUSH TO HOSPITAL’S EMERGENCY DEPARTMENT.

Sometimes your child may experience other side-effects that are not listed above. If you notice any abnormalities with your child’s body or behavior, do not hesitate and immediately contact your doctor.

Despite this long list of side effects, Lamotrigine is a very effective anti-epileptic (anticonvulsant) medicine and has very little effect on the child’s level of alertness, behaviour and learning abilities.

Can other common medicines be given at the same time as Lamotrigine?

• Medications like ibuprofen, paracetamol, antibiotics or any of the other over the counter medicines can be given when necessary, except the ones your doctor has prohibited you from.

• Consult with your doctor before giving any other medicines to your child. This includes herbal or complementary medicines.
• Some other medicines used to treat epilepsy may affect how well Lamotrigine works or may cause side effects. If your child is experiencing more fits or seizures, or any other side effects after using other medications, talk to your doctor immediately.

Where should I keep this medicine?

• Keep the medicine in a cupboard, secured away from heat and direct sunlight. It is not a must to keep the medicine in the refrigerator though.

• Make sure the medicine is out of your child’s reach.
• Store the medication in the same box it was packed in.

For complete information please see the manufacturer’s information leaflet.

References :

1. IAP Drug Formulary Web Update 2020(3) Edition 58, https://www.iapdrugformulary.com/Home
2. Consumer Medicines Information (CMI), https://www.tga.gov.au/consumer-medicines-information-cmi
3. British National Formulary for Children (BNFC)
4. Food and Drug Administration, USA https://www.fda.gov

Disclaimer:

The medical information provided on this platform is deliberately simplified to make it conceivable for a layman. Remember the fact that, every individual has a different pathophysiology for the disease that requires individual medical attention to address the same. Content available on the internet cannot be taken as a substitute to the medical advice given by your health practitioner. Sometimes the information may not be precise and accurate, misleading at times. It is hence non-negotiable to seek medical consultation for any queries you may have.

Compiled by:

Dr. C P Ravi Kumar
Consultant Paediatric Neurologist
www.cpravikumar.com
https://www.asterbangalore.com/specialists/ravi-kumar-c-p-consultant-paediatric-neurology-56