Lamotrigine, Oral

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KEY POINTS

• This medicine is taken by mouth to treat seizures or to help prevent extreme mood swings in people with bipolar disorder. Take it exactly as directed.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause serious (and sometimes fatal) skin conditions, aseptic meningitis, or other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• This medicine may increase suicidal thoughts or actions in some people.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Carry some form of ID stating that you are taking an antiseizure medicine.

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What are other names for this medicine?

Type of medicine: antiseizure; antiepileptic

Generic and brand names: lamotrigine, oral; Lamictal; Lamictal XR; Lamictal ODT

What is this medicine used for?

This medicine is taken by mouth to treat seizures. It may be used alone or along with other medicines. This medicine is also used to help prevent extreme mood swings in people with bipolar disorder.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A blood disorder or bone marrow problem
• Depression or thoughts of suicide
• Folate deficiency
• Heart disease
• Kidney or liver disease

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine.

How do I take it?

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

Some people have been given the wrong medicine because other medicines have similar names. When you get your prescription filled, always check that you have the correct medicine.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it more often than prescribed. You must take the proper dose each day to help reduce or eliminate your seizures. You may not feel the full effect of this medicine for several weeks. Do not stop taking this medicine without your healthcare provider's approval. You may have to gradually reduce your dosage. Otherwise, the seizures may increase. Be sure you understand how and when to take all your medicines.

Check with your healthcare provider before using this medicine in children. Some brands should not be used in children under a certain age.

If you have extended-release tablets, do not break, crush, or chew them. Swallow them whole. You may take the extended-release tablets with or without food. Ask your pharmacist if you have the extended-release tablets.

If you have the regular tablets, do not break, crush, or chew them. Swallow them whole.

If you have the chewable dispersible tablets, you may swallow them whole, chew them, or mix in water or diluted fruit juice. If you chew the tablets, drink a full glass of water or diluted fruit juice after taking the tablets. To dissolve chewable dispersible tablets, add the tablets to 1 teaspoon of water or juice (just enough to cover the medicine) in a glass. When the tablets are dissolved (about 1 minute), mix the solution and drink immediately.

If you have the orally disintegrating tablets (ODT), place the tablet on your tongue and let it dissolve. You can take these tablets with or without food or water.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: trouble walking, drowsiness, vision problems, nausea, vomiting, coma, slowed breathing, lack of coordination, increased seizures.

What should I watch out for?

Contact your healthcare provider right away if you develop a rash. A rash may be a sign of a serious or life-threatening problem. A rash can happen at any time, but is more likely to happen in the first 8 weeks of treatment. Also contact your provider if your seizures are not controlled or if they get worse.

This medicine may cause aseptic meningitis. Contact your healthcare provider right away if you have symptoms such as headache, sensitivity to light, fever, nausea, vomiting, stiff neck, rash, muscle pain, confusion, or drowsiness.

You may need to have blood tests to see how this medicine affects you. Keep all appointments.

Antiseizure medicines may increase suicidal thoughts or actions in some people. Call your healthcare provider right away if you have new or increased thoughts of suicide or unusual changes in your behavior.

This medicine may cause dizziness, drowsiness, double vision, or blurred vision. Do not drive or operate machinery unless you are fully alert and can see clearly.

Do not start or stop using hormonal birth control unless you talk with your healthcare provider. Stopping or starting these products may cause side effects (such as dizziness, lack of coordination, or double vision). Hormonal birth control may make this medicine less effective. If you notice side effects or changes such as break-through bleeding while taking this medicine, contact your provider right away.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine. This medicine may cause a false-positive on some drug tests.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Headache; fever; stiff neck; severe nausea or vomiting; any skin rash, blisters or peeling skin; sensitivity to light; confusion; unusual drowsiness; increase of seizures; swelling in hands or feet; chest pain; irregular heartbeat; sores in the mouth or around the eyes; swollen lymph glands; unusual bruising or bleeding; yellowing of the skin or eyes; dark urine; light-colored bowel movements; severe stomach pain; loss of appetite; severe muscle pain; severe weakness or tiredness; thoughts of suicide; new or worsening depression; unusual changes in your mood or behavior; changes in your menstrual cycle (for women); cough; sore throat; trouble breathing; increased urination; painful urinating.

Other: Drowsiness, vision problems, diarrhea, constipation, trouble sleeping, dry mouth, mild stomach pain, stuffy or runny nose, dizziness, tiredness, unsteadiness, tremors, back pain, mild nausea.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Acetaminophen and medicines that contain acetaminophen
• Antidepressants such as amitriptyline, desipramine (Norpramin), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), sertraline (Zoloft), trazodone, and venlafaxine (Effexor)
• Antihistamines such as azelastine (Astelin, Astepro), chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), hydroxyzine (Vistaril), and meclizine (Dramamine)
• Antipsychotic medicines such as chlorpromazine, haloperidol (Haldol), iloperidone (Fanapt), olanzapine (Zyprexa), prochlorperazine (Compro), risperidone (Risperdal), thioridazine, trifluoperazine, and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), fosphenytoin (Cerebyx), methsuximide (Celontin), oxcarbazepine (Trileptal), phenytoin (Dilantin, Phenytek), primidone (Mysoline), and valproic acid (Depacon, Depakene, Depakote)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Bupropion (Aplenzin, Forfivo, Wellbutrin, Buproban, Zyban)
• Desmopressin
• Dofetilide (Tikosyn)
• Doxepin (Silenor)
• HIV medicines such as atazanavir (Reyataz), atazanavir/cobicistat (Evotaz), lopinavir/ritonavir (Kaletra), and ritonavir (Norvir)
• Hormonal birth control implants, IUDs, patches, pills, shots, and vaginal rings
• Narcotic pain medicines such as codeine, fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone/acetaminophen (Norco, Vicodin), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Roxicodone), and oxycodone/acetaminophen (Percocet, Roxicet)
• Natural remedies such as evening primrose oil, gotu kola, kava, St. John's wort, and valerian
• Oxaliplatin (Eloxatin)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Rifampin (Rifadin)
• Sleeping pills such as flurazepam, temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo)

Do not drink alcohol while you are taking this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.