Lamotrigine belongs to a group of medicines called anti-epilepsy medicines, which are used to treat a number of different types of seizures (convulsions or fits) including generalised tonic-clonic seizures.
Lamotrigine can be used on its own to treat adults and children aged 12 years or older. It can also be used in combination with other anti-epilepsy medicines in both adults and children aged two years or older. It is available as tablets and dispersible tablets in various strengths.
How is lamotrigine given?
- Lamotrigine is usually given twice a day: once in the morning and once in the late afternoon or early evening.
- The tablets should be taken with water and swallowed whole, not chewed. The dispersible tablets can either be chewed or dispersed in two tablespoons of water or juice.
- Lamotrigine will be prescribed in increasing doses according to your child’s weight, so it will be very specific to them. It is important that you do not give them more than the prescribed amount either as a single dose or in a 24-hour period.
- The correct dose is when your child’s seizures are well controlled with few or no side effects.
- Do not stop taking the medicine without consulting your doctor.
Are there any side effects to lamotrigine?
Each person reacts differently to medicines and so your child will not necessarily suffer from every side effect mentioned. If you are concerned, please ask your doctor, nurse or pharmacist. In general, lamotrigine appears to be very effective in controlling epileptic seizures in many patients, and apart from possible skin rash, it is considered to be safe and free from serious side effects.
The most common side effect is a skin rash that occurs in one in 10 people taking lamotrigine during the first eight weeks of treatment.
Sometimes a serious rash can develop. This occurs in one in every 300 children under 12 taking lamotrigine and in one in every 1,000 children over 12 and adults. The rash is more likely to develop if your child is also taking sodium valproate, another anti-epileptic medicine. This is less likely to happen if the medicines are introduced and increased slowly. The rash usually develops within eight weeks of starting treatment, and can affect the body, face, or mouth where blisters may occur. A high temperature and a feeling of being generally unwell may also develop alongside the rash. In a small number of cases, the rash and general illness may rarely be severe, but generally improves when lamotrigine is stopped. If your child develops a rash, please tell your doctor immediately, but do not stop taking the medicine unless advised to do so.
A rare side effect is drowsiness. If a child becomes drowsy it is usually when the medicine is first started. If your child is excessively tired or drowsy, please tell your doctor.
Another uncommon side effect is dizziness or tremor (shakiness). If this happens, it is also usually when the medicine is first started. However, it can develop later if the dosage is too high for your child, and blurred vision may develop alongside the dizziness. If your child develops dizziness, please tell your doctor.
Other rare side effects include blurring or double vision or an upset stomach.
Lamotrigine and other medicines
- Paracetamol (Calpol®, Disprol® or Medinol® among others) and most other over-the-counter (OTC) medicines can be safely taken with lamotrgine. OTC medicines are those that can be bought without a prescription.
- Antibiotics can be taken with lamotrigine.
- Lamotrigine can be taken safely with other anti-epilepsy medicines.
- There is a very important interaction between sodium valproate and lamotrigine. Sodium valproate causes the levels of lamotrigine to be much higher and so the dose of lamotrigine used with sodium valproate is much lower. Your doctor will take this into consideration and your child will be monitored closely when both medicines are used in combination.
Important information about lamotrigine
- Always give the medicine as prescribed by your doctor.
- In certain circumstances, medicines may be prescribed for a child outside the age range recommended by the manufacturer. Unlicensed medicines are often used in children for a number of reasons for example limited data available for use in children.This is not necessarily hazardous but should be explained and agreed before use. Your doctor will explain this further to you.
- Always check with your doctor or pharmacist before giving your child any other medicines, including herbal or complementary medicines.
- If you miss a dose of the medicine and you remember up to four hours afterwards, give the forgotten dose immediately. If you remember at or near the time that the next dose is due, just give your child the usual dose.
- If your child vomits within a short time of taking a dose and you are able to see the tablet in the vomit, then give the dose again. If you cannot see the tablet, do not give it again.
- If your child has been taking the medicine regularly, do not stop it suddenly without advice. Your doctor may need to reduce the dose gradually.
- If your child stops using a medicine or it passed its expiry date, please return it to your pharmacist. Do not flush it down the toilet or throw it away.
- Some anti-epilepsy medicines can affect how well the contraceptive pill works. Please discuss this with your doctor.
- Some anti-epilepsy medicines can affect an unborn baby if taken during pregnancy. Please discuss this with your doctor.
- Keep medicines in a safe place where children cannot see or reach them.
- Keep medicines at room temperature, away from bright light or direct sunlight, and away from heat.
- Always check that you have enough medicine and remember to order a new prescription in plenty of time.
Last reviewed by Great Ormond Street Hospital: July 2009
Ref: 09F0740 © GOSH Trust July 2009
Compiled by The National Centre for Young People with Epilepsy, GOSH Epilepsy Service and GOSH Pharmacy department in collaboration with the Child and Family Information Group, GOSH.
Please read this information in conjunction with any patient information leaflet provided by the manufacturer. However, please note that this information explains about the use of medicines in children and young people so may differ from the manufacturer’s information.
Each person reacts differently to medicines so your child will not necessarily suffer every side effect mentioned. This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.