Lametec Tablet
Lamotrigine
25 mg
Cipla Ltd.
| Pack size | 1 |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 7.61 NPR |
Available as:
Indications
Lametec Tablet is used for:
Epilepsy, Bipolar disorder
Adult Dose
Oral
Epilepsy
Adult: Initially, 25 mg once daily for 2 wk followed by 50 mg once daily for 2 wk; thereafter, increase the dose by a max of 50-100 mg every 1-2 wk to usual maintenance doses of 100-200 mg daily, as a single dose or in 2 divided doses. Some patients may require up to 500 mg daily.
Adjunct in epilepsy
Adult: With valproate: Initially, 25 mg on alternate days for 2 wk followed by 25 mg once daily for 2 wk; thereafter, increase by a max of 25-50 mg every 1-2 wk; usual maintenance doses: 100-200 mg daily in 1-2 divided doses.
With enzyme-inducing antiepileptics but not with valproate: 50 mg once daily for 2 wk followed by 50 mg bid for 2 wk; thereafter, increase by a max of 100 mg every 1-2 wk; usual maintenance doses: 200-400 mg/day in 2 divided doses; up to 700 mg/day in some patients.
With oxcarbazepine but no enzyme-inducing or -inhibiting antiepileptics: 25 mg once daily for 2 wk followed by 50 mg once daily for 2 wk; thereafter increase dose by a max of 50-100 mg every 1-2 wk; usual maintenance doses: 100-200 mg daily in 1-2 divided doses; up to 500 mg daily in some patients.
Bipolar disorder
Adult: Monotherapy: Initially, 25 mg once daily for 2 wk followed by 50 mg once daily for 2 wk; thereafter, double the daily dose at wkly intervals to usual maintenance dose of 200 mg daily. Max dose: 200 mg/day.
With valproate: Initially, 25 mg every other day for 2 wk followed by 25 mg once daily for 2 wk; thereafter, double the daily dose at wkly intervals to usual maintenance dose of 100 mg daily.
With enzyme-inducing antiepileptics but not with valproate: Initially, 50 mg once daily for 2 wk followed by 100 mg daily in 2 divided doses for 2 wk; thereafter, increase in 100-mg increments wkly to usual maintenance dose of 400 mg daily in 2 divided doses.
Hepatic impairment: Moderate impairment (Child-Pugh category B): Reduce dose by about 50%. Severe impairment (Child-Pugh category C): Reduce dose by about 75%.
Child Dose
Oral
Epilepsy
Child: >12 yr: Initially, 25 mg once daily for 2 wk followed by 50 mg once daily for 2 wk; thereafter, increase the dose by a max of 50-100 mg every 1-2 wk to usual maintenance doses of 100 -200 mg daily, as a single dose or in 2 divided doses. Some patients may require up to 500 mg daily.
<12 yr: Not recommended.
Adjunct in epilepsy
Child: With valproate: Initially, 0.15 mg/kg once daily for 2 wk followed by 0.3 mg/kg once daily for 2 wk; thereafter, increase by a max of 0.3 mg/kg every 1-2 wk to usual maintenance doses of 1-5 mg/kg once daily or in 2 divided doses.
Renal Dose
Renal impairment
Use caution; may consider reduce the dose in significant renal impairment
Administration
May be taken with or without food.
Contra Indications
Hypersensitivity.
Precautions
Hepatic or renal impairment. Closely monitor patient. Monitor children's body wt. Advise patient to report any hypersensitivity reaction. Avoid abrupt withdrawal unless severe skin reactions have developed. May impair ability to drive or operate machinery. Pregnancy and lactation.
Lactation: Distributed into human breast milk; caution advised
Pregnancy-Lactation
Interactions
Metabolism enhanced by enzyme-inducing drugs e.g. phenytoin, carbamazepine, phenobarbitone, primidone, rifampicin, ethinyloestradiol/levonorgestrel combination. Metabolism reduced by sodium valproate.
Adverse Effects
Side effects of Lamotrigine :
>10%
Dizziness (38%),Diplopia (26-30%),Headache (29%),Ataxia (22%),Blurred vision (16-20%),Rhinitis (11-15%),Somnolence (14%)
1-10%
Insomnia (6-10%),Fatigue (8%),Chest pain (5%),Peripheral edema (2-5%),Suicidal ideation (2-5%),Dermatitis (2-5%),Dry skin (2-5%),Increased libido (2-5%),Rectal hemorrhage (2-5%),Weakness (2-5%),Agitation (1-5%),Dysarthria (1-5%),Edema (1-5%),Fever (1-5%),Migraine (1-5%),Abnormal thoughts (1-5%),Urinary frequency (1-5%),Tremor (4%)
Frequency Not Defined
Palpitations,Anxiety,Chills,Depression,Decreased memory,Emotional lability,Incoordination,Malaise,Seizure exacerbation,Vertigo,Pruritus,Rash,Amenorrhea,Hot flashes,Abdominal pain,Constipation,Diarrhea,Dyspepsia,Nausea,Vomiting,Arthralgia,Neck pain,Cough,Flu syndrome,Infection,Vaginitis,Nystagmus
Potentially Fatal: Stevens-Johnson syndrome and toxic epidermal necrolysis.
Mechanism of Action
Lamotrigine inhibits voltage-sensitive sodium channels, thereby stabilising neuronal membranes and consequently inhibiting pathological release of excitatory amino acids (e.g. glutamate and aspartate). These amino acids play a role in the generation and spread of epileptic seizures.
Note
Lametec 25 mg Tablet manufactured by Cipla Ltd.. Its generic name is Lamotrigine. Lametec is availble in Nepal.
Farmaco Nepal drug index information on Lametec Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.