Where is lamictal absorbed

Central to its anti-seizure activity is its action on neuronal ion channels, particularly sodium channels and chloride channels.

Administration of lamotrigine is purported to have anti-glutamatergic effects as well as putative anti-kindling effects. Kindling is described as the clinical development of bipolar disorder from reactive and triggered symptoms to a more frequent, severe and spontaneously occurring form. Lamotrigine enhances the release of gamma-aminobutyric acid GABA , an inhibitory neurotransmitter that attenuates neuronal electrical activity associated with paroxysms.

From PI. Concomitant therapy with inducers of lamotrigine glucuronidation e. Starting hormonal contraceptives in patients already taking maintenance doses of lamotrigine and NOT taking enzyme inducers of lamotrigine glucuronidation:. Stopping hormonal contraceptives in patients already taking maintenance doses of lamotrigine and NOT taking enzyme inducers of lamotrigine glucuronidation :. The patient presented with wide spread rash 4 weeks after initiation of Lamotrigine.

Lamotrigine was discontinued and the rash subsided completely. No associated symptoms were present. The safety of lamotrigine in pregnancy is covered in a previous article. There were specific concerns about the risk of cleft palate. In summary, there is no increased risk of orofacial cleft or clubfoot if the mother was being administered lamotrigine during the first trimester. Lamotrigine is an evidence-based mood stabiliser in the treatment of bipolar disorder. It has particular efficacy for acute bipolar depression and the prophylaxis of depressive episodes.

It is well tolerated and is not associated with weight gain compared to the other medications in bipolar disorder. Lamictal is sometimes prescribed "off-label" for certain types of pain. The only people who definitely should not take Lamictal lamotrigine are those who are allergic to it. People with liver disease and those who must take certain other types of medicines may need to be more cautious than others about taking Lamictal.

Most of them can take it successfully, however, if they work with the doctor to determine the correct amount to take. That is why it is so important to make sure the doctor knows about any liver disease and about every kind of medicine in use. Sometimes one kind of medicine changes the way another kind of medicine works in the body.

This is true not only for prescription medicines, but also for medicines you just pick up off the shelf at the store. Any time a doctor suggests a new prescription, be sure to talk about what other medicines you are already using. If two kinds of medicine affect each other, the doctor may want to prescribe something else or change the amount to be taken.

How does Lamictal affect other medicines? Lamictal has no effect on other seizure medicines. And unlike some other seizure medicines, it does not reduce the effectiveness of birth control pills.

How does birth control affect Lamictal? Although Lamictal does not reduce the effectiveness of birth control pills, there is a possiblity that birth control pills can lower the amount of lamotrigine levels in your blood, thus increasing the likelihood of unexpected seizures. If you start or stop taking an oral contraceptive, and are currently taking Lamictal lamotrigine --please notify your doctor.

How do other seizure medicines affect Lamictal? Some other seizure medicines do affect the level of Lamictal in the body, either raising it or lowering it.

Many of these interactions vary from person to person, however. Some may even vary from time to time for the same person. Make sure that your doctor is aware of all the seizure medicines you're using. One common seizure medicine, Depakote and others closely related to it , will make the level of Lamictal in the body much higher. People who take both Depakote and Lamictal need to take smaller amounts of Lamictal.

On the other hand, some other seizure medicines reduce the amount of Lamictal in the body, so more must be taken. This is not true if Depakote is also being used. The seizure medicines with this effect are:. The FDA has approved Lamictal for some seizures in children as young as 2 years of age. Research suggests that it is effective for many seizure types, including Lennox-Gastaut syndrome. Many children take Depakote or other valproate medicines Depakene, valproic acid.

These medicines make Lamictal stay in the body much longer. To keep from having too much Lamictal in their body which would probably cause unwanted side effects , these children must take very small doses of it. Other children may take up to 5 times as much!

Doctors figure out how much medicine to give to young children based mostly on their weight. Children ages 2 to 12 who are also taking Depakote will probably end up taking 1 to 5 milligrams mg per day of Lamictal for every kilogram kg, about 2. For example, a pound child taking 3 mg per kg would be given 75 mg per day.

Of course, they will start by taking much less. Children who don't take Depakote generally take between 5 and 15 mg per kg per day.

The pills are usually given twice a day. The amount of Lamictal taken by children over 12 is more like the adult dose, which also depends on whether the person is taking Depakote. Recently, the North American AED Pregnancy Registry, located at Massachusetts General Hospital in Boston, Massachusetts, found that infants who are exposed to lamotrigine as monotherapy during pregnancy lamotrigine was used as the only AED by the mother have a much higher risk of having an oral cleft problem, than infants born to women in a comparison group and who were not exposed to lamotrigine during pregnancy.

Oral cleft problems are birth defects that may involve the lip cleft lip , the palate cleft palate , or both. During pregnancy, the normal openings between the upper lip and the nose seen with cleft lip or between the roof or back of the mouth and the nose seen in cleft palate may not close properly. These problems can often be seen with ultrasound testing and can usually be corrected after birth with surgery.

In this study, of women who received lamotrigine alone, 5 instances of isolated cleft lip or palate not seen as part of any specific syndrome were seen in the babies. This data gives a prevalence rate of 8. This number is 24 times higher than the risk of oral cleft problems seen in babies from the comparison group used in the study. This information should be interpreted with caution and further analysis is underway. Women taking lamotrigine should talk to their doctors if they become pregnant or are considering pregnancy, and discuss the risks and benefits of taking lamotrigine during pregnancy.

The manufacturer of Lamictal, the brand name version of lamotrigine, has stated that "Lamictal should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus". Women who are interested in participating in pregnancy registries , may enroll themselves in the North American AED Pregnancy Registry by calling Taking medications during pregnancy is often a concern for women who are pregnant.

Most medications carry some risk, but the extent of risk is often unknown. The risks of antiepileptic drugs to babies born to women taking AEDs during pregnancy is a source of ongoing research around the world. Lamictal is listed in Pregnancy Category C. This indicates that caution is advised, but the benefits of the medicine may outweigh the potential risks.

Studies in animals have shown some harm to the baby, but there haven't been any good studies of results in women. There is no indication yet that Lamictal causes serious birth defects. The risk of birth defects is higher for women who take more than one seizure medicine and for women with a family history of birth defects. All women who are capable of becoming pregnant should take at least 0.

The most well-known of these is spina bifida, in which the spinal cord is not completely enclosed. Women at high risk, such as those with a history of this kind of defect in a previous pregnancy, should take mcg 4 mg daily, beginning before they become pregnant. This appears to be particularly true for Lamictal. It is helpful for the doctor to check the levels of medicine in the blood regularly during pregnancy so that the dosage can be adjusted if necessary.

Talk to the doctor if about your options if you're interested in breast-feeding the baby. The baby will get some Lamictal through the milk, and its possible effects are unknown. For this reason, breast-feeding while taking Lamictal is not recommended. Lamictal is commonly prescribed for epilepsy in people over It's important for the doctor to prescribe a very low dose at the beginning and increase it more slowly than for a younger person.

Seniors tend to be more sensitive than younger adults to medicines and their side effects, and may have more trouble as a result. For instance, even before they start taking Lamictal, some seniors have problems with unsteadiness or dizziness. These are common side effects of this medicine. If the Lamictal makes them worse, the person could be in real danger from falls or other accidents.

Starting at a very low dose of Lamictal and being very cautious about any increases should help to control side effects. The best amount is the amount that completely controls seizures without causing troublesome side effects. It depends on many factors, which are different for every individual. No one should stop taking Lamictal or change the amount they take without talking to the doctor first.

Results First Posted : January 20, Last Update Posted : January 20, Study Description. People over 65 years of ag break down metabolize drugs differently than younger adults. It is not known why this happens or how elderly people absorb or break down these drug differently. These difference may show that elderly individuals need lower doses of medications to avoid possible toxicity. We are interested in studying how yor body absorbs and breaks down your lamotrigine medication.

This research may indicate that doses of lamotrigine should be lowered as people get older. Detailed Description:. Drug Information available for: Lamotrigine. FDA Resources.

Arms and Interventions. Outcome Measures. Eligibility Criteria. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Inclusion Criteria: Clinical Diagnosis of Epilepsy or Bipolar Depression able to have a venus catheter implanted for blood withdrawal and for intravenous infusion equal to or over the age of 65 Exclusion Criteria: not on any medication that will interact with lamotrigine e.

John's wort, rifampin, tamoxifen. Contacts and Locations. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials. More Information. National Library of Medicine U.