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Sedatives

Lamostad 50


Pack size:

Box of 3 blisters x 10 tablets.


Composition:

Each tablet contains lamotrigine 50 mg.


Shelf-life:

36 months from the date of manufacturing.

Store in a well-closed container, in a dry place.

Protect from moisture. Do not store above 30oC.

 


 

  • Indications and Dosage & Administration
  • Contraindications
  • Adverse reactions
  • Precautions

Indications:
​Epilepsy

  • Adults and children over 12 years of age:
    Adjunctive or monotherapy treatment of partial seizures and generalised seizures, including tonic-clonic seizures.
    Seizures associated with Lennox-Gastaut syndrome. Lamotrigine is given adjunctive therapy but may be the initial antiepileptic drug (AED) to start with in Lennox-Gastaut syndrome.
  • Children aged 2 to 12 years:
    Adjunctive treatment of partial seizures and generalised seizures, including tonic-clonic seizures and the seizures associated with Lennox-Gastaut syndrome.
    Monotherapy of typical absence seizures.
Bipolar disorder
  • Adults aged 18 years and above: Prevention of depressive episodes in patients with bipolar I disorder who experience predominantly depressive episodes. 
Administration and dosage
Administration 
  • Lamostad 50 should be swallowed whole and not be crushed or chewed.
Dosage 
  • If the calculated dose (for example for treatment for children) does not correspond to whole tablets, the dose to be administered is that equal to the lower number of whole tablets (i.e. if the calculated dose is 78 mg daily, patients should use one Lamostad 50 tablet plus one Lamotad 25 tablet, if the calculated dose less than 5 mg, do not use Lamostad).
Restarting therapy

Prescribers should assess the need for escalation to maintenance dose when restarting lamotrigin in patients who have discontinued lamotrigin for any reason, since the risk of serious rash is associated with high initial doses and exceeding the recommended dose escalation for lamotrigine. The greater the interval of time since the previous dose, the more consideration should be given to escalation to the maintenance dose. When the interval since discontinuing lamotrigine exceeds five half-life, lamotrigin should generally be escalated to the maintenance dose according to the appropriate schedule.
It is recommended that Lamostad not be restarted in patients who have discontinued due to rash associated with prior treatment with lamotrigine unless the potential benefit clearly outweighs the risk.

  • Epilepsy 
    Dosage in monotherapy;
    Adults and children over 12 years: 
    Weeks 1 + 2: 25 mg once a day.
    Weeks 3 + 4: 50 mg once a day. Thereafter, the dose should be increased by a maximum of 50 – 100 mg every 1 – 2 weeks until the optimal response is achieved.
    Usual maintenance dose: 100 – 200 mg once a day or two divided doses. Some patients have required 500 mg/day of lamotrigine to achieve the desired response.
    Children aged 2 to 12 years:
    Monotherapy of typical absence seizures:
    Weeks 1 + 2: 0.3 mg/kg/day (once a day or two divided doses).
    Weeks 3 + 4: 0.6 mg/kg/day (once a day or two divided doses).
    Usual maintenance dose: 1 – 15 mg/kg/day (once a day or two divided doses). To achieve maintenance, doses may be increased by maximum of 0.6 mg/kg/day every one to two weeks until optimal response is achieved, with a maximum maintenance dose of 200 mg/day.
    Dosage in add-on therapy
    Adults and children over 12 years:
    In patients taking valproate with/ without any other antiepileptic drug (AED):
    Weeks 1 + 2: 25 mg on alternate days.
    Weeks 3 + 4: 25 mg once a day. Thereafter, the dose should be increased by a maximum of 25 – 50 mg every 1 – 2 weeks until the optimal response is achieved.
    Usual maintenance dose: 100 – 200 mg once a day or two divided doses.
    In those patients taking concomitant AEDs or other medications that induce lamotrigine glucuronidation (such as phenytoin, carbamazepine, phenobarbitone, primidone, rifampicin, lopinavir/ ritonavir) with/ without other AEDs (except valproate):
    Weeks 1 + 2: 50 mg once a day.
    Weeks 3 + 4: 100 mg two divided doses. Thereafter, the dose should be increased by a maximum of 100 mg every 1 – 2 weeks until the optimal response is achieved.
    Usual maintenance dose: 200 – 400 mg two divided doses. Some patients have required 700 mg/day of lamotrigine to achieve the desired response.
    In those patients taking oxcarbazepine without any other inducers or inhibitors of lamotrigine glucuronidation:
    Weeks 1 + 2: 25 mg once a day.
    Weeks 3 + 4: 50 mg once a day. Thereafter, the dose should be increased by a maximum of 50 – 100 mg every 1 – 2 weeks until the optimal response is achieved.
    Usual maintenance dose: 100 – 200 mg once a day or two divided doses.
    Children aged 2 to 12 years:
    In patients taking valproate with/ without any other antiepileptic drug (AED):
    Weeks 1 + 2: 0.15 mg/kg once a day.
    Weeks 3 + 4: 0.3 mg/kg once a day. Thereafter, the dose should be increased by a maximum of 0.3 mg/kg/day every 1 – 2 weeks until the optimal response is achieved.
    Usual maintenance dose: 1 – 5 mg/kg/day (once a day or two divided doses). To achieve maintenance, doses may be increased by maximum of 0.3 mg/kg/day every one to two weeks until optimal response is achieved, with a maximum maintenance dose of 200 mg/day.
    In those patients taking concomitant AEDs or other medications that induce lamotrigine glucuronidation (such as phenytoin, carbamazepine, phenobarbitone, primidone, rifampicin, lopinavir/ ritonavir) with/ without other AEDs (except valproate):
    Weeks 1 + 2: 0.6 mg/kg/day two divided doses.
    Weeks 3 + 4: 1.2 mg/kg/day two divided doses. Thereafter, the dose should be increased by a maximum of 1.2 mg/kg/day every 1 – 2 weeks until the optimal response is achieved.
    Usual maintenance dose: 5 – 15 mg/kg/day (once a day or two divided doses). To achieve maintenance, doses may be increased by maximum of 1.2 mg/kg every one to two weeks until optimal response is achieved, with a maximum maintenance dose of 400 mg/day.
    In those patients taking oxcarbazepine without any other inducers or inhibitors of lamotrigine glucuronidation:
    Weeks 1 + 2: 0.3 mg/kg/day once a day or two divided doses.
    Weeks 3 + 4: 0.6 mg/kg/day once a day or two divided doses. Thereafter, the dose should be increased by a maximum of 0.6 mg/kg/day every 1 – 2 weeks until the optimal response is achieved.
    Usual maintenance dose: 1 – 10 mg/kg/day once a day or two divided doses, with a maximum of 200 mg/day.
     
  • Bipolar disorder
    Recommended dose escalation to the maintenance total daily stabilisation dose in treatment of bipolar disorder:
    Monotherapy with lamotrigine or adjunctive therapy without valproate and without inducers of lamotrigine glucuronidation:
    Weeks 1 + 2: 25 mg/day once a day.
    Weeks 3 + 4: 50 mg/day once a day or two divided doses. 
    Week 5: 100 mg/day once a day or two divided doses.
    Target stabilisation dose (week 6)*: 200 mg/day once a day or two divided doses. 
    Adjunctive therapy with valproate (inhibitor of lamotrigine glucuronidation):
    Weeks 1 + 2: 25 mg on alternate days.
    Weeks 3 + 4: 25 mg/day once a day. 
    Weeks 5: 50 mg/day once a day or two divided doses.
    Target stabilisation dose (week 6)*: 100 mg/day once a day or two divided doses. Maximum dose of 200 mg/day can be used depending on clinical response.
    Adjunctive therapy without valproate and with inducers of lamotrigine glucuronidation (phenytoin, carbamazepine, phenobarbitone, primidone, rifampicin, lopinavir/ ritonavir):
    Weeks 1 + 2: 50 mg once a day.
    Weeks 3 + 4: 100 mg/day two divided doses. 
    Week 5: 200 mg/day two divided doses.
    Target stabilisation dose (week 6)*: 300 mg/day two divided doses in week 6, if necessary increasing to usual target dose of 400 mg/day two divided doses in week 7, to achieve optimal response.
    (*The target stabilisation dose will alter depending on clinical response).
    Maintenance stabilisation total daily dose following withdrawal of concomitant medicinal products in treatment of bipolar disorder:
    Withdrawal of valproate (inhibitor of lamotrigine glucuronidation), depending on original dose of lamotrigine. When valproate is withdrawn, double the stabilisation dose, not exceeding an increase of more than 100 mg/week.
    If current lamotrigine stabilisation dose (prior to withdrawal) is 100 mg/day: Week 1 (beginning with withdrawal): 200 mg/day; Week 2 and week 3 onwards*: Maintain this dose (200 mg/day) (two divided doses).
    If current lamotrigine stabilisation dose (prior to withdrawal) is 200 mg/day: Week 1 (beginning with withdrawal): 300 mg/day; Week 2: 400 mg/day; Week 3 onwards: Maintain this dose (400 mg/day).
    Withdrawal of inducers of lamotrigine glucuronidation (phenytoin, carbamazepine, phenobarbitone, primidone, rifampicin, lopinavir/ ritonavir), depending on original dose of lamotrigine:
    If current lamotrigine stabilisation dose (prior to withdrawal) is 400 mg/day: Week 1 (beginning with withdrawal): 400 mg/day; Week 2: 300 mg/day; Week 3 onwards*: 200 mg/day.
    If current lamotrigine stabilisation dose (prior to withdrawal) is 300 mg/day: Week 1 (beginning with withdrawal): 300 mg/day; Week 2: 225 mg/day; Week 3 onwards*: 150 mg/day.
    (*Dose may be increased to 400 mg/day as needed).
    Withdrawal of medicinal products that do not significantly inhibit or induce lamotrigine glucuronidation: This dosage regimen should be used when other medicinal products that do not significantly inhibit or induce lamotrigine glucuronidation are withdrawn:
    Maintain target dose achieved in dose escalation (200 mg/day; two divided doses) (dose range 100 - 400 mg/day).
    Adjustment of lamotrigine daily dosing following the addition of other medicinal products in treatment of bipolar disorder:
    Addition of valproate (inhibitor of lamotrigine glucuronidation), depending on original dose of lamotrigine: This dosage regimen should be used when valproate is added regardless of any concomitant medicinal products:
    If current lamotrigine stabilisation dose (prior to addition) is 200 mg/day: Week 1 (beginning with addition): 100 mg/day; Week 2 and week 3 onwards: Maintain this dose (100 mg/day).
    If current lamotrigine stabilisation dose (prior to addition) is 300 mg/day: Week 1 (beginning with addition): 150 mg/day; Week 2 and week 3 onwards: Maintain this dose (150 mg/day).
    If current lamotrigine stabilisation dose (prior to addition) is 400 mg/day: Week 1 (beginning with addition): 200 mg/day; Week 2 and week 3 onwards: Maintain this dose (200 mg/day).
    Addition of inducers of lamotrigine glucuronidation in patients not taking valproate, depending on original dose of lamotrigine: This dosage regimen should be used when the following are added without valproate (phenytoin, carbamazepine, phenobarbitone, primidone, rifampicin, lopinavir/ ritonavir): 
    If current lamotrigine stabilisation dose (prior to addition) is 200 mg/day: Week 1 (beginning with addition): 200 mg/day; Week 2: 300 mg/day; Week 3 onwards: 400 mg/day.
    If current lamotrigine stabilisation dose (prior to addition) is 150 mg/day: Week 1 (beginning with addition): 150 mg/day; Week 2:  225 mg/day; Week 3 onwards: 300 mg/day.
    If current lamotrigine stabilisation dose (prior to addition) is 100 mg/day: Week 1 (beginning with addition): 100 mg/day; Week 2:  150 mg/day; Week 3 onwards: 200 mg/day.
    Addition of medicinal products that do not significantly inhibit or induce lamotrigine glucuronidation:
    This dosage regimen should be used when other medicinal products that do not significantly inhibit or induce lamotrigine glucuronidation are added: Maintain target dose achieved in dose escalation (200 mg/day; dose range 100 - 400 mg/day).
General dosing recommendations for lamotrigine in special patient populations:
  • Women taking hormonal contraceptives:
    The use of an ethinyloestradiol/ levonorgestrel (30 μg/150 μg) combination increases the clearance of lamotrigine by approximately two-fold, resulting in decreased lamotrigine levels. Following titration, higher maintenance doses of lamotrigine (by as much as two-fold) may be needed to attain a maximal therapeutic response. During the pill-free week, a two-fold increase in lamotrigine levels has been observed. Dose-related adverse events cannot be excluded. Therefore, consideration should be given to using contraception without a pill-free week, as first-line therapy (for example, continuous hormonal contraceptives or non-hormonal methods).
    Starting hormonal contraceptives in patients already taking maintenance doses of lamotrigine and not taking inducers of lamotrigine glucuronidation:
    The maintenance dose of lamotrigine will in most cases need to be increased by as much as two-fold. It is recommended that from the time that the hormonal contraceptive is started, the lamotrigine dose is increased by 50 to 100 mg/day every week, according to the individual clinical response. Dose increases should not exceed this rate, unless the clinical response supports larger increases. Measurement of serum lamotrigine concentrations before and after starting hormonal contraceptives may be considered, as confirmation that the baseline concentration of lamotrigine is being maintained. If necessary, the dose should be adapted. In women taking a hormonal contraceptive that includes one week of inactive treatment, serum lamotrigine level monitoring should be conducted during week 3 of active treatment, i.e. on days 15 to 21 of the pill cycle. 
    Stopping hormonal contraceptives in patients already taking maintenance doses of lamotrigine and not taking inducers of lamotrigine glucuronidation:
    The maintenance dose of lamotrigine will in most cases need to be decreased by as much as 50%. It is recommended to gradually decrease the daily dose of lamotrigine by 50 - 100 mg each week (at a rate not exceeding 25% of the total daily dose per week) over a period of 3 weeks, unless the clinical response indicates otherwise. Measurement of serum lamotrigine concentrations before and after stopping hormonal contraceptives may be considered, as confirmation that the baseline concentration of lamotrigine is being maintained. In women who wish to stop taking a hormonal contraceptive that includes one week of inactive treatment, serum lamotrigine level monitoring should be conducted during week 3 of active treatment, i.e. on days 15 to 21 of the pill cycle. Samples for assessment of lamotrigine levels after permanently stopping the contraceptive pill should not be collected during the first week after stopping the pill.
    Starting lamotrigine in patients already taking hormonal contraceptives: 
    Dose escalation should follow the normal dose recommendation.
    Starting and stopping hormonal contraceptives in patients already taking maintenance doses of lamotrigine and taking inducers of lamotrigine glucuronidation:
    Adjustment to the recommended maintenance dose of lamotrigine may not be required.
  • Use with atazanavir/ritonavir:
    No adjustments to the recommended dose escalation of lamotrigine should be necessary when lamotrigine is added to the existing atazanavir/ritonavir therapy. In patients already taking maintenance doses of lamotrigine and not taking glucuronidation inducers, the lamotrigine dose may need to be increased if atazanavir/ritonavir is added, or decreased if atazanavir/ritonavir is discontinued. Plasma lamotrigine monitoring should be conducted before and during 2 weeks after starting or stopping atazanavir/ritonavir, in order to see if lamotrigine dose adjustment is needed.
  • Hepatic impairment:
    Initial, escalation and maintenance doses should generally be reduced by approximately 50% in patients with moderate (Child-Pugh grade B) and 75% in severe (Child-Pugh grade C) hepatic impairment. Escalation and maintenance doses should be adjusted according to clinical response. 
  • Renal impairment:
    Caution should be exercised when administering lamotrigine to patients with renal failure. For patients with end-stage renal failure, initial doses of lamotrigine should be based on patients' concomitant medicinal products; reduced maintenance doses may be effective for patients with significant renal functional impairment.


Or as prescribed by physicians.

 

  • Hypersensitive to lamotrigine or to any ingredient of the drug.

     

​Very common  

  • Headache.
  • Skin rash.

Common

  • Aggression, irritability.
  • Somnolence, dizziness, tremor, insomnia, agitation.
  • Nausea, vomiting, diarrhea, dry mouth.
  • Arthralgia.
  • Tiredness, pain, back pain.

Uncommon

  • Ataxia.
  • Diplopia, blurred vision. 

Rare 

  • Nystagmus, aseptic meningitis.
  • Conjunctivitis.
  • Stevens-Johnson syndrome.
     

  • Sudden unexplained death in epilepsy (SUDEP): During the premarketing development of lamotrigine, 20 sudden and unexplained deaths were reported among a cohort of 4700 patients with epilepsy receiving adjunctive therapy with the drug (5747 patient-years of exposure). Although the rate of these deaths exceeds that expected to occur in a healthy (nonepileptic) population matched for age and gender, this rate was similar to that occurring in a similar population of epileptic patients receiving a chemically unrelated anticonvulsant agent. This evidence suggests, but does not prove, that the incidence of sudden, unexplained death observed with lamotrigine adjunctive therapy may be reflective of the population itself rather than the effects of lamotrigine.
  • Status epilepticus: Valid estimates of the incidence of treatment-emergent status epilepticus among patients treated with lamotrigine are difficult to obtain because reporters participating in clinical trials did not all employ identical rules for identifying cases. At a minimum, 7 of 2,343 adult patients had episodes that could unequivocally be described as status epilepticus. In addition, a number of reports of variably defined episodes of seizure exacerbation (e.g., seizure clusters, seizure flurries, etc.) were made.
  • Clinical worsening and suicide risk: Suicidal ideation and behaviour have been reported in patients treated with AEDs in several indications. A meta-analysis of randomised placebo-controlled trials of AEDs has also shown a small increased risk of suicidal ideation and behaviour. The mechanism of this risk is not known and the available data do not exclude the possibility of an increased risk for lamotrigine. Therefore patients should be monitored for signs of suicidal ideation and behaviours and appropriate treatment should be considered. Patients (and caregivers of patients) should be advised to seek medical advice should signs of suicidal ideation or behaviour emerge. In patients with bipolar disorder, worsening of depressive symptoms and/or the emergence of suicidality may occur whether or not they are taking medications for bipolar disorder, including lamotrigine. Therefore patients receiving lamotrigine for bipolar disorder should be closely monitored for clinical worsening (including development of new symptoms) and suicidality, especially at the beginning of a course of treatment, or at the time of dose changes. Certain patients, such as those with a history of suicidal behaviour or thoughts, young adults, and those patients exhibiting a significant degree of suicidal ideation prior to commencement of treatment, may be at a greater risk of suicidal thoughts or suicide attempts, and should receive careful monitoring during treatment. Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients who experience clinical worsening (including development of new symptoms) and/or the emergence of suicidal ideation/behaviour, especially if these symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms.
  • Skin rash: There have been reports of adverse skin reactions, which have generally occurred within the first eight weeks after initiation of lamotrigine treatment. The majority of rashes are mild and self-limiting; however serious rashes requiring hospitalisation and discontinuation of lamotrigine have also been reported. These have included potentially life-threatening rashes such as Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS); also known as hypersensitivity syndrome (HSS).
    In children, the initial presentation of a rash can be mistaken for an infection, physicians should consider the possibility of a reaction to lamotrigine treatment in children that develop symptoms of rash and fever during the first eight weeks of therapy.
    Additionally the overall risk of rash appears to be strongly associated with:
    High initial doses of lamotrigine and exceeding the recommended dose escalation of lamotrigine therapy.
    Concomitant use of valproate.
    Caution is also required when treating patients with a history of allergy or rash to other AEDs as the frequency of non-serious rash after treatment with lamotrigine was approximately three times higher in these patients than in those without such history.
    All patients (adults and children) who develop a rash should be promptly evaluated and lamotrigine withdrawn immediately unless the rash is clearly not related to lamotrigine treatment. It is recommended that lamotrigine not be restarted in patients who have discontinued due to rash associated with prior treatment with lamotrigine unless the potential benefit clearly outweighs the risk. If the patient has developed SJS, TEN or DRESS with the use of lamotrigine, treatment with lamotrigine must not be restarted in this patient at any time.
    Rash has also been reported as part of a hypersensitivity syndrome associated with a variable pattern of systemic symptoms including fever, lymphadenopathy, facial oedema, abnormalities of the blood and liver and aseptic meningitis. The syndrome shows a wide spectrum of clinical severity and may, rarely, lead to disseminated intravascular coagulation and multiorgan failure. It is important to note that early manifestations of hypersensitivity (for example fever, lymphadenopathy) may be present even though rash is not evident. If such signs and symptoms are present the patient should be evaluated immediately and lamotrigine discontinued if an alternative aetiology cannot be established.
    Aseptic meningitis was reversible on withdrawal of the drug in most cases, but recurred in a number of cases on re-exposure to lamotrigine. Re-exposure resulted in a rapid return of symptoms that were frequently more severe. Lamotrigine should not be restarted in patients who have discontinued due to aseptic meningitis associated with prior treatment of lamotrigine.
  • Hormonal contraceptives:
    Effects of hormonal contraceptives on lamotrigine efficacy: The use of an ethinyloestradiol/levonorgestrel (30 μg/150 μg) combination increases the clearance of lamotrigine by approximately two-fold resulting in decreased lamotrigine levels. A decrease in lamotrigine levels has been associated with loss of seizure control. Following titration, higher maintenance doses of lamotrigine (by as much as two-fold) will be needed in most cases to attain a maximal therapeutic response. When stopping hormonal contraceptives, the clearance of lamotrigine may be halved. Increases in lamotrigine concentrations may be associated with dose-related adverse events. Patients should be monitored with respect to this.
    In women not already taking an inducer of lamotrigine glucuronidation and taking a hormonal contraceptive that includes one week of inactive treatment (for example "pill-free week"), gradual transient increases in lamotrigine levels will occur during the week of inactive treatment. Variations in lamotrigine levels of this order may be associated with adverse effects. Therefore, consideration should be given to using contraception without a pill-free week, as first-line therapy (for example, continuous hormonal contraceptives or non-hormonal methods).
    Effects of lamotrigine on hormonal contraceptive efficacy: When lamotrigine and a hormonal contraceptive (ethinyloestradiol/levonorgestrel combination) are administered in combination, there is a modest increase in levonorgestrel clearance and changes in serum FSH and LH. The impact of these changes on ovarian ovulatory activity is unknown. However, the possibility of these changes resulting in decreased contraceptive efficacy in some patients taking hormonal preparations with lamotrigine cannot be excluded. Therefore patients should be instructed to promptly report changes in their menstrual pattern, i.e. breakthrough bleeding.
    Specialist contraceptive advice should be given to women who are of child-bearing age. Women of child-bearing age should be encouraged to use effective alternative non-hormonal methods of contraception.
  • Precautions relating to epilepsy:
    As with other AEDs, abrupt withdrawal of lamotrigin may provoke rebound seizures. Unless safety concerns (for example rash) require an abrupt withdrawal, the dose of lamotrigin should be gradually decreased over a period of two weeks.
    There are reports in the literature that severe convulsive seizures including status epilepticus may lead to rhabdomyolysis, multiorgan dysfunction and disseminated intravascular coagulation, sometimes with fatal outcome. Similar cases have occurred in association with the use of lamotrigine.
    A clinically significant worsening of seizure frequency instead of an improvement may be observed. In patients with more than one seizure type, the observed benefit of control for one seizure type should be weighed against any observed worsening in another seizure type.
    Myoclonic seizures may be worsened by lamotrigine.
    There is a suggestion in the data that responses in combination with enzyme inducers are less than in combination with non-enzyme inducing antiepileptic agents. The reason is unclear.
    In children taking lamotrigine for the treatment of typical absence seizures, efficacy may not be maintained in all patients.
  • Pregnancy: 
    If therapy with lamotrigine is considered necessary during pregnancy, the lowest possible therapeutic dose is recommended. Lamotrigine has a slight inhibitory effect on dihydrofolic acid reductase and could therefore theoretically lead to an increased risk of embryofoetal damage by reducing folic acid levels. Intake of folic acid when planning pregnancy and during early pregnancy may be considered.
    Physiological changes during pregnancy may affect lamotrigine levels and/or therapeutic effect. There have been reports of decreased lamotrigine plasma levels during pregnancy. Appropriate clinical management of pregnant women during lamotrigine therapy should be ensured.
  • Lactation:
    There is limited information on the use of lamotrigine in lactation. Preliminary data indicate that it passes into breast milk in concentrations usually of the order of 40 – 60% of the serum concentration. In a small number of infants known to have been breast-fed, the serum concentrations of lamotrigine reached levels at which pharmacological effects may occur. The potential benefits of breast feeding should be weighed against the potential risk of adverse effects occurring in the infant.
  • Effects on ability to drive and use machines:
    No studies on the effects on the ability to drive and use machines have been performed. Lamotrigine adverse reactions of a neurological character such as dizziness and diplopia have been reported. Therefore, patients should see how lamotrigine therapy affects them before driving or operating machinery.

 

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