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These events usually resolve when the dose of carbamazepine is reduced. Breastfeeding will also benefit both you and your baby.If you notice your baby is not feeding as well as usual, seems unusually sleepy, or you have any other concerns about them, talk to your pharmacist, health visitor or doctor as soon as possible.Some medicines and lamotrigine interfere with each other and increase the chances of side effects.

This information is intended for use by health professionalsPeach coloured, mottled, shield shaped uncoated tablets debossed with 'D' and '94'on one side and scoreline on the other side. In addition, pharmacokinetics of lamotrigine was studied in 12 healthy elderly subjects following a 150 mg single dose. In patients receiving concomitant therapy with rifampicin, the appropriate treatment regimen should be used (see section 4.2).In a study in healthy volunteers, lopinavir/ritonavir approximately halved the plasma concentrations of lamotrigine, probably by induction of glucuronidation. The reason is unclear.In children taking lamotrigine for the treament of typical absence seizures, efficacy may not be maintained in all patients.Arrhythmogenic ST-T abnormality and typical Brugada ECG pattern has been reported in patients treated with lamotrigine.The use of lamotrigine should be carefully considered in patients with Brugada syndrome.HLH has been reported in patients taking lamotrigine (see section 4.8). The result of the primary efficacy analysis (time to occurrence of a bipolar event – TOBE) did not reach statistical significance (p=0.0717), thus efficacy was not shown. Your doctor may need to change your dose of lamotrigine.Check with your pharmacist or doctor if you're taking:There might be a problem taking some herbal remedies and supplements alongside lamotrigine, especially ones that can cause rashes, sleepiness or shaking and tremors.Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.It usually takes around 6 weeks for lamotrigine to work properly. However, if you stop antiepileptic treatment because you get pregnant, the seizures that you may have as a result can potentially be more harmful than continuing treatment. Re-exposure resulted in a rapid return of symptoms that were frequently more severe. These have included potentially Life-threatening cutaneous rashes Stevens-Johnson syndrome (SJS),toxic epidermal necrolysis (TEN) Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS); also known as hypersensitivity syndrome (HSS) (See section 4.8)Patients should be advised of the signs and symptoms and monitored closely for skin reactions. 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 (see sections 4.4 and 5.2).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. No adjustments to the recommended dose escalation guidelines for lamotrigine should be necessary solely based on the use of hormonal contraceptives, but the maintenance dose of lamotrigine will need to be increased or decreased in most cases when starting or stopping hormonal contraceptives (see section 4.2).In a study of 16 female volunteers, a steady state dose of 300 mg lamotrigine had no effect on the pharmacokinetics of the ethinyloestradiol component of a combined oral contraceptive pill. Initially 50 mg once daily for 14 days, then 50 mg twice daily for further 14 days, then increased in steps of up to 100 mg every 7–14 days; maintenance 200–400 mg daily in 2 divided doses, increased if necessary up to 700 mg daily, dose titration should be repeated if restarting after interval of more than 5 days. Increases in lamotrigine concentrations may be associated with dose-related adverse events.
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