Lamictal ODT

This section provides information on the proper use of a number of products that contain lamotrigine. It may not be specific to LaMICtal ODT. Please read with care.

Take lamotrigine only as directed by your doctor to help your condition as much as possible and to decrease the chance of unwanted effects. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Lamotrigine may be taken with or without food or on a full or empty stomach. However, if your doctor tells you to take the medicine a certain way, take it exactly as directed.

If you are taking the chewable dispersible tablets, they may be swallowed whole, chewed, and swallowed, or dispersed in a small amount of liquid and swallowed. If the tablets are chewed, they should be followed with a small amount of water or diluted fruit juice to aid in swallowing. To break up these tablets, add the tablets in enough water or diluted fruit juice to cover the tablets (about a teaspoonful), wait until the tablets are completely dispersed (about 1 minute), then swirl the solution and swallow it immediately.

If you are taking the disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil, then taking the tablet out. Do not push the tablet through the foil. Place the tablet into your tongue and moved around in your mouth. It should melt quickly. After the tablet has melted, swallow or take a sip of water.

Swallow the extended-release tablets whole. Do not break, crush, or chew it.

Use only the brand of this medicine that your doctor prescribed. Different brands and dosage forms may not work the same way.

This medicine can be used with other seizure medicines. Keep using all of your seizure medicines unless your doctor tells you to stop.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage forms (chewable dispersible tablets, disintegrating tablets, or tablets):
  • For treatment of bipolar disorder:
    • Adults not taking valproic acid (Depakote®) and not taking carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)—At first, 25 milligrams (mg) of lamotrigine once a day for two weeks, then a total of 50 mg divided into two smaller doses each day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 200 mg a day.
    • Adults taking valproic acid (Depakote®)—At first, 25 mg of lamotrigine once every other day for two weeks, then 25 mg once a day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 100 mg a day.
    • Adults not taking valproic acid (Depakote®) but taking carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)—At first, 50 mg of lamotrigine once a day for two weeks, then a total of 100 mg divided into two smaller doses each day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 400 mg a day.
    • Adults who are discontinuing valproic acid (Depakote®) or discontinuing carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)—Dose will be determined by your doctor.
    • Children—Use and dose must be determined by your doctor.
  • For treatment of epilepsy:
    • Adults and teenagers not taking valproic acid (Depakote®) but taking carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)—At first, 50 milligrams (mg) of lamotrigine once a day for two weeks, then a total of 100 mg divided into two smaller doses each day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 500 mg a day.
    • Adults and teenagers not taking valproic acid (Depakote®), carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)—At first, 25 mg of lamotrigine once a day for two weeks, then 50 mg once a day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 375 mg a day.
    • Adults and teenagers taking valproic acid (Depakote®) and also taking carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)—At first, 25 mg of lamotrigine once every other day for two weeks, then 25 mg once a day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 400 mg a day.
    • Adults who are discontinuing valproic acid (Depakote®) or discontinuing carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)—Dose will be determined by your doctor.
    • Children 2 to 12 years of age:
      • Children not taking valproic acid (Depakote®) but taking carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)— At first, 0.6 milligrams (mg) per kilogram (kg) (0.27 mg per pound) of body weight of lamotrigine once a day for two weeks, then 1.2 mg/kg (0.54 mg per pound) of body weight divided into two smaller doses each day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 400 mg a day.
      • Children not taking valproic acid (Depakote®), carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)— At first, 0.3 milligrams (mg) per kilogram (kg) (0.14 mg per pound) of body weight of lamotrigine once a day for two weeks, then 0.6 mg/kg (0.27 mg per pound) of body weight divided into two smaller doses each day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 300 mg a day.
      • Children taking valproic acid (Depakote®) and also taking carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)— At first, 0.15 mg per kg (0.07 mg per pound) of body weight of lamotrigine given in one dose or two smaller doses each day for two weeks, then 0.3 mg/kg (0.136 mg per pound) of body weight given in one dose or two smaller doses each day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 200 mg a day.
    • Children younger than 2 years of age—Use and dose must be determined by your doctor.

• For oral dosage form (extended-release tablet):
  • For seizures:
    • Adults and teenagers older than 13 years of age not taking valproic acid (Depakote®) but taking carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)—At first, 50 milligrams (mg) of lamotrigine once a day for two weeks, then 100 mg once a day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 600 mg a day.
    • Adults and teenagers older than 13 years of age not taking valproic acid (Depakote®), carbamazepine (Tegretol®), phenobarbital (Luminal®), phenytoin (Dilantin®), and/or primidone (Mysoline®)—At first, 25 mg of lamotrigine once a day for two weeks, then 50 mg once a day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 400 mg a day.
    • Adults and teenagers older than 13 years of age taking valproic acid (Depakote®)—At first, 25 mg of lamotrigine once every other day for two weeks, then 25 mg once a day for two weeks. After this, your doctor may gradually increase your dose if needed. However, the dose is usually not more than 250 mg a day.
    • Children younger than 13 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Get emergency medical help if you have signs of an allergic reaction: hives; fever; swollen glands; painful sores in or around your eyes or mouth; difficulty breathing; swelling of your face, lips, tongue, or throat.

Seek emergency medical attention if you have signs of a life-threatening skin rash: fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

If you have to stop taking lamotrigine because of a serious skin rash, you may not be able to take it again in the future.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• the first sign of any skin rash, no matter how mild;

• changes in your menstrual periods;

• low blood cell counts--flu-like symptoms, swollen gums, mouth sores, skin sores, rapid heart rate, pale skin, easy bruising, unusual bleeding, feeling light-headed;

• possible signs of brain inflammation--fever, chills, headache, neck stiffness, increased sensitivity to light, purple spots on the skin, confusion, drowsiness; or

• signs of inflammation in your body--swollen glands, severe tingling or numbness, muscle weakness, upper stomach pain, jaundice (yellowing of the skin or eyes), chest pain, new or worsening cough with fever, trouble breathing.

Common side effects may include:

• headache, dizziness;

• blurred vision, double vision;

• tremor, loss of coordination;

• dry mouth, nausea, vomiting, stomach pain, diarrhea;

• fever, sore throat, runny nose;

• drowsiness, tired feeling;

• back pain; or

• sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Epilepsy:

Specific dosing recommendations are provided depending upon concomitant AEDs or other concomitant medications (see manufacturer product information):

DOSAGE REGIMEN FOR ORAL TABLETS, CHEWABLE DISPERSIBLE TABLETS, AND ORALLY DISINTEGRATING TABLETS:
-IN PATIENTS TAKING VALPROATE:
Weeks 1 and 2: 25 mg orally every other day
Weeks 3 and 4: 25 mg orally per day
Week 5 to maintenance: Increase by 25 to 50 mg per day every 1 to 2 weeks
Usual maintenance dose:
1) 100 to 200 mg orally per day (1 or 2 divided doses) with valproate only
2) 100 to 400 mg orally per day (1 or 2 divided doses) with valproate and other drugs that induce glucuronidation
-IN PATIENTS NOT TAKING CARBAMAZEPINE, PHENYTOIN, PHENOBARBITAL, PRIMIDONE, OR VALPROATE:
Weeks 1 and 2: 25 mg orally per day
Weeks 3 and 4: 50 mg orally per day
Week 5 to maintenance: Increase by 50 mg per day every 1 to 2 weeks
Usual maintenance dose: 225 to 375 mg orally per day (in 2 divided doses)
-IN PATIENTS TAKING CARBAMAZEPINE, PHENYTOIN, PHENOBARBITAL, OR PRIMIDONE AND NOT TAKING VALPROATE:
Weeks 1 and 2: 50 mg orally per day
Weeks 3 and 4: 100 mg orally per day (in 2 divided doses)
Week 5 to maintenance: Increase by 100 mg orally per day every 1 to 2 weeks
Usual maintenance dose: 300 to 500 mg orally per day (in 2 divided doses)

Comments:
-As other drugs are subsequently introduced or withdrawn, the dose of lamotrigine may need to be adjusted.
-Safety and effectiveness have not been established:
1) As initial monotherapy
2) For conversion to monotherapy from AEDs other than carbamazepine, phenytoin, phenobarbital, primidone, or valproate
3) For simultaneous conversion to monotherapy from 2 or more concomitant AEDs

Uses: As adjunctive therapy for the following seizure types:
-Partial-onset seizures.
-Primary generalized tonic-clonic (PGTC) seizures.
-Generalized seizures of Lennox-Gastaut syndrome.

CONVERSION FOR ORAL TABLETS, CHEWABLE DISPERSIBLE TABLETS, AND ORALLY DISINTEGRATING TABLETS AS ADJUNCTIVE THERAPY WITH VALPROATE TO MONOTHERAPY IN PATIENTS AGED 16 YEARS AND OLDER WITH EPILEPSY:
The regimen for the withdrawal of the concomitant AED is based on experience from clinical trials:
-CONVERSION FROM ADJUNCTIVE THERAPY WITH CARBAMAZEPINE, PHENYTOIN, PHENOBARBITAL, OR PRIMIDONE TO MONOTHERAPY WITH LAMOTRIGINE: After achieving a dose of 500 mg per day according to the guidelines, the concomitant enzyme-inducing AED should be withdrawn by 20% decrements each week over a 4-week period.
-CONVERSION FROM ADJUNCTIVE THERAPY WITH VALPROATE TO MONOTHERAPY WITH LAMOTRIGINE:
1) Achieve a dose of 200 mg per day of lamotrigine; maintain stable dose of valproate.
2) Maintain lamotrigine dose at 200 mg per day; decrease valproate dose by decrements no greater than 500 mg per day and maintain for 1 week.
3) Increase lamotrigine dose to 300 mg per day and maintain for 1 week; decrease valproate dose to 250 mg per day and maintain for 1 week.
4) Increase lamotrigine dose by 100 mg per day every week to achieve a maintenance dose of 500 mg per day; discontinue valproate.
-CONVERSION FROM ADJUNCTIVE THERAPY WITH ANTIEPILEPTIC DRUGS (OTHER THAN CARBAMAZEPINE, PHENYTOIN, PHENOBARBITAL, PRIMIDONE, OR VALPROATE) TO MONOTHERAPY WITH LAMOTRIGINE:
-No specific dosing guidelines can be provided for conversion to monotherapy with lamotrigine with AEDs other than carbamazepine, phenytoin, phenobarbital, primidone, or valproate.

Comments:
-The goal of the transition regimen is to attempt to maintain seizure control while mitigating the risk of serious rash associated with the rapid titration.
-The recommended maintenance dose as monotherapy is 500 mg per day given in 2 divided doses.
-To avoid an increased risk of rash, the recommended initial dose and subsequent dose escalations should not be exceeded.
-The regimen for the withdrawal of the concomitant AED is based on experience from clinical trials.
-Safety and effectiveness have not been established:
1) As initial monotherapy
2) For conversion to monotherapy from AEDs other than carbamazepine, phenytoin, phenobarbital, primidone, or valproate
3) For simultaneous conversion to monotherapy from 2 or more concomitant AEDs

USES: For conversion to monotherapy in adults (aged 16 years and older) with partial-onset seizures who are receiving treatment with carbamazepine, phenytoin, phenobarbital, primidone, or valproate as the single antiepileptic drug (AED)


DOSAGE REGIMEN FOR ORAL EXTENDED RELEASE CAPSULES:
Initial: 200 mg orally 2 times a day
Increase at weekly intervals by adding up to 200 mg per day until the optimal response is obtained.
Maintenance dose: Adjust dosage to the minimum effective level, usually 800 to 1200 mg per day
Maximum dose: 1600 mg per day

Comments:
-The extended-release formulation is for twice a day administration. When converting patients from immediate release to extended-release capsules, the same total daily mg dose of carbamazepine should be administered.
-The extended-release formulation may be used alone or with other anticonvulsants. When added to existing anticonvulsant therapy, the drug should be added gradually while the other anticonvulsants are maintained or gradually decreased, except phenytoin, which may have to be increased.
-Safety and effectiveness of have not been established:
1) As initial monotherapy
2) For conversion to monotherapy from AEDs other than carbamazepine, phenytoin, phenobarbital, primidone, or valproate
3) For simultaneous conversion to monotherapy from 2 or more concomitant AEDs.

Uses:
-Partial seizures with complex symptomatology (psychomotor, temporal lobe). Patients with these seizures appear to show greater improvements than those with other types
-Generalized tonic-clonic seizures (grand mal)
-Mixed seizure patterns which include the above, or other partial or generalized seizures (absence seizures [petit mal] do not appear to be controlled by carbamazepine)

Usual Adult Dose for Bipolar Disorder:

ESCALATION REGIMEN FOR LAMOTRIGINE IN PATIENTS WITH BIPOLAR DISORDER:
-WEEKS 1 AND 2:
For patients taking valproate: 25 mg every other day
For patients not taking carbamazepine (or other enzyme-inducing drugs) or valproate: 25 mg daily
For patients taking carbamazepine (or other enzyme-inducing drugs) and not taking valproate: 50 mg daily
-WEEKS 3 AND 4:
For patients taking valproate: 25 mg daily
For patients not taking carbamazepine (or other enzyme-inducing drugs) or valproate: 50 mg daily
For patients taking carbamazepine (or other enzyme-inducing drugs) and not taking valproate: 100 mg daily in divided doses
-WEEK 5:
For patients taking valproate: 50 mg daily
For patients not taking carbamazepine (or other enzyme-inducing drugs) or valproate: 100 mg daily
For patients taking carbamazepine (or other enzyme-inducing drugs) and not taking valproate: 200 mg daily in divided doses
-WEEK 6:
For patients taking valproate: 100 mg daily
For patients not taking carbamazepine (or other enzyme-inducing drugs) or valproate: 200 mg daily
For patients taking carbamazepine (or other enzyme-inducing drugs) and not taking valproate: 300 mg daily in divided doses
-WEEK 7:
For patients taking valproate: 100 mg daily
For patients not taking carbamazepine (or other enzyme-inducing drugs) or valproate: 200 mg daily
For patients taking carbamazepine (or other enzyme-inducing drugs) and not taking valproate: up to 400 mg daily in divided doses

Comments:
-As other drugs are subsequently introduced or withdrawn, the dose of lamotrigine may need to be adjusted.

Use: For the maintenance treatment of bipolar I disorder to delay the time to occurrence of mood episodes (depression, mania, hypomania, mixed episodes) in adults treated for acute mood episodes with standard therapy. (The effectiveness in the acute treatment of mood episodes has not been established.)

DOSAGE ADJUSTMENTS TO LAMOTRIGINE IN PATIENTS WITH BIPOLAR DISORDER FOLLOWING DISCONTINUATION OF PSYCHOTROPIC MEDICATIONS:
-DISCONTINUATION OF PSYCHOTROPIC DRUGS (EXCLUDING VALPROATE, CARBAMAZEPINE, PHENYTOIN, PHENOBARBITAL, OR PRIMIDONE:
WEEK 1:
Maintain current dose of lamotrigine
WEEK 2:
Maintain current dose of lamotrigine
WEEK 3 ONWARD:
Maintain current dose of lamotrigine
-AFTER DISCONTINUATION OF VALPROATE AND CURRENT DOSE OF LAMOTRIGINE IS 100 MG PER DAY:
WEEK 1:
150 mg per day
WEEK 2:
200 mg per day
WEEK 3 ONWARD:
200 mg per day
-AFTER DISCONTINUATION OF CARBAMAZEPINE, PHENYTOIN, PHENOBARBITAL, OR PRIMIDONE AND CURRENT DOSE OF LAMOTRIGINE DOSE IS 400 MG PER DAY:
WEEK 1:
400 mg per day
WEEK 2:
300 mg per day
WEEK 3:
200 mg per day

Usual Pediatric Dose for Epilepsy:

Dosage depends on patient's concomitant medications (i.e., valproic acid, enzyme-inducing AEDs specifically phenytoin, phenobarbital, carbamazepine, and primidone), or AEDs other than carbamazepine, phenytoin, phenobarbital, primidone, or valproic aced. Patients receiving concomitant rifampin or other drugs that induce lamotrigine glucuronidation and increase clearance should follow the same dosing regimen as that used with anticonvulsants that have this effect (e.g., phenytoin, phenobarbital, carbamazepine, and primidone).

ESCALATION REGIMEN FOR LAMOTRIGINE IN PATIENTS AGED 2 TO 12 YEARS WITH EPILEPSY:

-IN PATIENTS TAKING VALPROATE:
WEEKS 1 and 2:
0.15 mg/kg/day in 1 or 2 divided doses, rounded down to the nearest whole tablet
WEEKS 3 and 4:
0.3 mg/kg/day, in 1 or 2 divided doses, rounded down to the nearest whole tablet
WEEK 5 ONWARD TO MAINTENANCE:
The dose should be increased every 1 to 2 weeks as follows: calculate 0.3 mg/kg/day, round this amount down to the nearest whole tablet, and add this amount to the previously administered daily dose
USUAL MAINTENANCE DOSE:
1 to 5 mg/kg/day (maximum 200 mg per day in 1 or 2 divided doses)
1 to 3 mg/kg/day with valproate alone
MAINTENANCE DOSE IN PATIENTS LESS THAN 30 KG:
May need to be increased by as much as 50%, based on clinical response

IN PATIENTS NOT TAKING CARBAMAZEPINE, PHENYTOIN, PHENOBARBITAL, PRIMIDONE, OR VALPROATE:
WEEKS 1 and 2:
0.3 mg/kg/day in 1 to 2 divided doses, rounded down to nearest whole tablet
WEEKS 3 and 4:
0.6 mg/kg/day in 2 divided doses, rounded down to nearest whole tablet
WEEK 5 ONWARD TO MAINTENANCE:
The dose should be increased every 1 to 2 weeks as follows: calculate 0.6 mg/kg/day, round this amount down to the nearest whole tablet, and add this amount to the previously administered daily dose
USUAL MAINTENANCE DOSE:
4.5 to 7.5 mg/kg/day (maximum 300 mg per day in 2 divided doses)
MAINTENANCE DOSE IN PATIENTS LESS THAN 30 KG:
May need to be increased by as much as 50%, based on clinical response

IN PATIENTS TAKING CARBAMAZEPINE, PHENYTOIN, PHENOBARBITAL, OR PRIMIDONE AND NOT TAKING VALPROATE:
WEEKS 1 and 2:
0.6 mg/kg/day in 1 to 2 divided doses, rounded down to nearest whole tablet
WEEKS 3 and 4:
1.2 mg/kg/day in 2 divided doses, rounded down to nearest whole tablet
WEEK 5 ONWARD TO MAINTENANCE:
The dose should be increased every 1 to 2 weeks as follows: calculate 1.2 mg/kg/day, round this amount down to the nearest whole tablet, and add this amount to the previously administered daily dose
USUAL MAINTENANCE DOSE:
5 to 15 mg/kg/day (maximum 400 mg per day in 2 divided doses)
MAINTENANCE DOSE IN PATIENTS LESS THAN 30 KG:
May need to be increased by as much as 50%, based on clinical response

WEIGHT BASED DOSING FOR PATIENTS 2 TO 12 YEARS TAKING VALPROATE:
PATIENT WEIGHT: GREATER THAN 6.7 KG AND LESS THAN 14 KG:
WEEKS 1 and 2: 2 mg every other day
WEEKS 3 and 4: 2 mg every day
PATIENT WEIGHT: GREATER THAN 14.1 KG AND LESS THAN 27 KG:
WEEKS 1 and 2: 2 mg every day
WEEKS 3 and 4: 4 mg every day
PATIENT WEIGHT: GREATER THAN 27.1 KG AND LESS THAN 34 KG:
WEEKS 1 and 2: 4 mg every other day
WEEKS 3 and 4: 8 mg every day
PATIENT WEIGHT: GREATER THAN 34.1 KG AND LESS THAN 40 KG:
WEEKS 1 and 2: 5 mg every day
WEEKS 3 and 4: 10 mg every day

CONVERSION FROM ADJUNCTIVE THERAPY WITH VALPROATE TO MONOTHERAPY WITH LAMOTRIGINE IN PATIENTS AGED 16 YEARS AND OLDER WITH EPILEPSY:
STEP 1:
Lamotrigine: Achieve a dose of 200 mg/day according to guidelines
Valproate: Maintain established stable dose
STEP 2:
Lamotrigine: Maintain dose at 200 mg per day
Valproate: Decrease dose by decrements no greater than 500 mg/day/week to 500 mg per day and then maintain for 1 week
STEP 3:
Lamotrigine: Increase dose to 300 mg per day and maintain for 1 week
Valproate: Decrease dose to 250 mg per day and maintain for 1 week
STEP 4:
Lamotrigine: Increase dose by 100 mg per day every week to achieve maintenance dose of 500 mg per day
Valproate: Discontinue

CONVERSION FROM ADJUNCTIVE THERAPY WITH ANTIEPILEPTIC DRUGS OTHER THAN CARBAMAZEPINE, PHENYTOIN, PHENOBARBITAL, PRIMIDONE, OR VALPROATE TO MONOTHERAPY WITH LAMOTRIGINE:
No specific dosing guidelines can be provided for conversion to monotherapy with lamotrigine other than carbamazepine, phenytoin, phenobarbital, primidone, or valproate.


Use: As adjunctive therapy for the following seizure types in patients aged 2 years and older:
-Partial-onset seizures
-Primary generalized tonic-clonic (PGTC) seizures
-Generalized seizures of Lennox-Gastaut syndrome