Lamotrigine - Brand name: Lamictal

What lamotrigine is for

Lamotrigine can be used to treat:

• seizures caused by epilepsy
• low mood (depression) in people with bipolar disorder

It works by blocking the signals in your brain that can cause seizures.

It’s not fully understood how it helps prevent depression in people with bipolar disorder.

How to take lamotrigine

Lamotrigine usually comes as tablets that you swallow. There's also a type of tablet that you dissolve in water and drink (dispersible tablets).

How much lamotrigine you need to take depends on your age, any other medicines you’re taking and whether you have kidney or liver problems.

Your doctor may prescribe a low dose to start with and increase it over a few weeks until you reach a dose that works for you.

When taking lamotrigine:

• take it once or twice a day as advised by your doctor – it can be taken with or without food
• swallow tablets whole with a glass of water – you can break them in half if you need to but do not chew or crush them
• if you're taking dispersible tablets, let the tablet dissolve in a glass of water before swallowing it
• always take the full dose your doctor has prescribed for you (never take only part of a tablet)

If you miss a dose of lamotrigine

If you forget to take lamotrigine, skip the missed dose and take your next dose at the usual time.

Do not take 2 doses to make up for a missed dose.

If you take too much lamotrigine

It's important to get medical advice if you take too much lamotrigine because it can sometimes be dangerous.

How to stop taking lamotrigine

Keep taking lamotrigine for as long as your doctor advises you to.

If your doctor advises you to stop taking it, your dose will usually need to be reduced gradually. Always follow your doctor's advice.

Side effects of lamotrigine

Like all medicines, lamotrigine can cause side effects, although not everyone gets them.

Common side effects

Common side effects of lamotrigine include:

• headaches
• a rash
• feeling sick (nausea) and being sick (vomiting)
• dizziness or drowsiness
• dry mouth
• diarrhoea
• tiredness and problems sleeping
• shaking or tremors
• feeling agitated, irritable or aggressive

If you feel dizzy or drowsy after taking lamotrigine, do not drive, ride a bike or use machinery until you no longer have these symptoms.

Serious side effects

Lamotrigine can sometimes cause more serious side effects, although most of them are rare.

Possible serious side effects of lamotrigine include:

• a skin reaction, such as a round, slightly raised rash (erythema multiforme), painful blisters (Stevens-Johnson syndrome), or peeling skin
• an allergic reaction (anaphylaxis) – causing symptoms such as a swollen throat or tongue, a raised, itchy rash or difficulty breathing
• problems with your liver – causing symptoms such as tiredness, itchy skin and yellowing of the whites of the eyes (jaundice)
• problems with your blood cells – causing symptoms such as shortness of breath, tiredness and headache (anaemia), or bruising and bleeding more easily than usual

Who can and cannot take lamotrigine

Most adults can take lamotrigine.

Children aged 2 to 17 can take it for epilepsy. It's not recommended for people with bipolar disorder under the age of 18.

Lamotrigine is not suitable for everyone. For example, it may not be suitable if:

• you have a liver or kidney condition
• you’ve had serious side effects after taking lamotrigine in the past, such as an allergic reaction
• you’ve had a rash or sunburn after taking lamotrigine in the past
• you have a heart condition called Brugada syndrome, or other heart problems

Before taking lamotrigine, tell your doctor if you have any medical conditions.

Breastfeeding and lamotrigine

Tell your doctor if you're breastfeeding.

Lamotrigine can be used while breastfeeding, but it's best to check because the medicine can pass into your breast milk.

Your doctor will discuss it with you and may advise you to continue taking lamotrigine if the benefits to you outweigh the risks to your baby.

Possible side effects your baby may get if you're taking lamotrigine and breastfeeding include:

• a rash
• drowsiness
• not gaining weight as expected

Speak to a healthcare professional or call NHS 111 if you notice these side effects or if you have any other concerns about your baby.

Pregnancy and lamotrigine

Tell your doctor if you're planning a pregnancy or you get pregnant while taking lamotrigine.

Lamotrigine can be used during pregnancy if needed. Your doctor will discuss the risks and benefits of taking it while you're pregnant.

If you need to take lamotrigine while you're pregnant, your doctor will prescribe the lowest possible effective dose. They may also advise you to take a higher dose of folic acid.

You may be advised to give birth in hospital so you and your baby can be closely monitored after you've given birth.

Find out more about taking lamotrigine during pregnancy on the Bumps (Best Use of Medicines in Pregnancy) website

Taking lamotrigine with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with lamotrigine.

This includes some types of:

• epilepsy medicines, such as sodium valproate and carbamazepine
• medicines used to treat mental health problems, such as risperidone
• antibiotics, such as rifampicin
• medicines used to treat human immunodeficiency virus (HIV)
• hormonal contraceptives, such as the combined pill – your doctor may recommend using a different type of hormonal contraceptive or another method of contraception, such as condoms

Before taking lamotrigine, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

Food, drink and alcohol with lamotrigine

You can eat as normal while taking lamotrigine.

You can drink alcohol, but it's best not to drink too much because it may make you feel sleepy and increase your chance of having a seizure.