Lamitrin 50mg Tablet 10pcs

✔️ Uses of Lamitrin 50mg Tablet

• Epilepsy/Seizures
• Bipolar disorder

✔️ How does Lamitrin 50mg Tablet work?

Lamitrin (antiepileptic medication) controls seizures or fits by decreasing the abnormal and excessive activity of the nerve cells in the brain.

✔️ Side Effects of Lamitrin 50mg Tablet

Adults: Common side effects include dizziness, headache, double vision, difficulty with coordination, nausea, blurred vision, drowsiness, throat inflammation, and skin rash.

Children: Frequently observed side effects are vomiting, diarrhea, infections, fever, abdominal pain, and tremors.

✔️ Quick Suggestions:

• Take your medication regularly as directed by your doctor as missing doses can trigger seizures.
• Do not change the brand of your medicine and make sure that you have a sufficient amount of medicine present with you.
• Some healthy tips to prevent seizures:
• It may cause headaches. Drink plenty of water and take a suitable painkiller. Inform your doctor if it does not go away.
• It may cause a skin rash. Inform your doctor immediately if you notice a rash, itching, and peeling of skin.
• Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
• Do not stop taking the medication suddenly without talking to your doctor as it may increase the frequency of seizures.

✔️ Indication of Lamitrin 50mg Tablet

Epilepsy (Adjunctive Therapy for Patients Aged 2 Years and Older)

• Partial-onset seizures
• Primary generalized tonic-clonic seizures
• Generalized seizures of Lennox-Gastaut syndrome

Epilepsy (Monotherapy for Patients Aged 16 Years and Older)

Bipolar Disorder (Patients Aged 18 Years and Older)

✔️ Pharmacology

Lamotrigine's exact mechanism of action is not fully understood but involves:

• Inhibiting voltage-sensitive sodium channels
• Stabilizing neuronal membranes
• Reducing the release of excitatory neurotransmitters like glutamate

Lamotrigine also exhibits weak binding to various receptors including serotonin, adenosine, adrenergic, dopamine, GABA, histamine, opioid, and muscarinic receptors.

✔️ Dosage & Administration of Lamitrin 50mg Tablet

Epilepsy (Adults and Children Over 12 Years):

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

• Weeks 1 & 2:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 25 mg/day
  • With Valproate: 25 mg every other day
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 50 mg/day
• Weeks 3 & 4:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 50 mg/day
  • With Valproate: 25 mg/day
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 100 mg/day (in 2 divided doses)
• Week 5 Onwards to Maintenance:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: Increase by 50 mg/day every 1-2 weeks
  • With Valproate: Increase by 25-50 mg/day every 1-2 weeks
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): Increase by 100 mg/day every 1-2 weeks
• Usual Maintenance Dose:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 225-375 mg/day (in 2 divided doses)
  • With Valproate: 100-200 mg/day alone, 100-400 mg/day with other drugs that induce glucuronidation (in 1 or 2 divided doses)
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 300-500 mg/day (in 2 divided doses)

Epilepsy (Children Aged 2 to 12 Years):

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

• Weeks 1 & 2:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
  • With Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 0.6 mg/kg/day (in 2 divided doses)
• Weeks 3 & 4:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 0.6 mg/kg/day (in 2 divided doses)
  • With Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 1.2 mg/kg/day (in 2 divided doses)
• Week 5 Onwards to Maintenance:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: Increase every 1-2 weeks by 0.6 mg/kg/day
  • With Valproate: Increase every 1-2 weeks by 0.3 mg/kg/day
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): Increase every 1-2 weeks by 1.2 mg/kg/day
• Usual Maintenance Dose:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 4.5-7.5 mg/kg/day (max 300 mg/day in 2 divided doses)
  • With Valproate: 1-3 mg/kg/day alone, 1-5 mg/kg/day with other drugs that induce glucuronidation (max 200 mg/day in 1 or 2 divided doses)
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 5-15 mg/kg/day (max 400 mg/day in 2 divided doses)

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

• Weeks 1 & 2:
  • Weight 6.7 kg to 14 kg: 2 mg every other day
  • Weight 14.1 kg to 27 kg: 2 mg every day
  • Weight 27.1 kg to 34 kg: 4 mg every day
  • Weight 34.1 kg to 40 kg: 5 mg every day
• Weeks 3 & 4:
  • Weight 6.7 kg to 14 kg: 2 mg every day
  • Weight 14.1 kg to 27 kg: 4 mg every day
  • Weight 27.1 kg to 34 kg: 8 mg every day
  • Weight 34.1 kg to 40 kg: 10 mg every day

Bipolar Disorder (Adults):

Table 4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder

• Weeks 1 & 2:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 25 mg daily
  • With Valproate: 25 mg every other day
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 50 mg daily
• Weeks 3 & 4:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 50 mg daily
  • With Valproate: 25 mg daily
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 100 mg daily (in divided doses)
• Week 5:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 100 mg daily
  • With Valproate: 50 mg daily
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 200 mg daily (in divided doses)
• Week 6:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 200 mg daily
  • With Valproate: 100 mg daily
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): 300 mg daily (in divided doses)
• Week 7:
  • Without Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate: 200 mg daily
  • With Valproate: 100 mg daily
  • With Carbamazepine, Phenytoin, Phenobarbital, or Primidone (without Valproate): Up to 400 mg daily (in divided doses)

✔️ Use in Special Populations

• Pediatric Use:
  • Epilepsy: The safety and effectiveness of Lamitrin as adjunctive treatment for partial-onset seizures have not been established in children aged 1 to 24 months.
  • Bipolar Disorder: The safety and effectiveness for maintenance treatment of bipolar disorder have not been established in children aged 10 to 17 years.

✔️ Overdose EffectsInt

Overdose can result in symptoms such as lack of coordination (ataxia), involuntary eye movement (nystagmus), seizures (including tonic-clonic seizures), decreased consciousness, coma, and delays in intraventricular conduction.

✔️ Interaction

• Increased Concentrations: Valproate
• Decreased Concentrations: Carbamazepine, Phenytoin, Phenobarbital, Primidone, Rifampin, Estrogen-containing oral contraceptives, Protease inhibitors (lopinavir/ritonavir, atazanavir/ritonavir)

✔️ Contraindications

Hypersensitivity.

✔️ Pregnancy & Lactation

• Pregnancy: Classified as Category C. Lamotrigine is secreted in breast milk, so there is potential for adverse reactions in nursing infants. A decision should be made whether to discontinue breastfeeding or discontinue the medication, considering the drug's importance to the mother.

✔️ Precautions & Warnings

• Discontinue immediately if a rash appears.
• Monitor for conditions like neutropenia, thrombocytopenia, and pancytopenia. Watch for signs of anemia, unexpected infections, or bleeding.
• Monitor for signs of suicidal thoughts or behaviors.
• Be vigilant for symptoms of meningitis.

✔️ Storage Conditions

Store in a dry place, below 25°C, and protect from light. Keep out of reach of children.