Lamictal XR, Lamictal Odt, Lamictal, Lamictal Chewable Dispersible, Lamictal Starter Not Taking Carbamazepine, Lamictal Starter Taking Valproate, Lamictal Starter Taking Carbamazepine Not Taking Valproate

Introduction

Written by Alex Brewer, PharmD, MBA
Medically reviewed by Patricia Weiser, PharmD
Updated on August 30, 2023

Lamotrigine (la MOE tri jeen) is a generic medication prescribed for certain types of seizures and bipolar I disorder. Lamotrigine belongs to a group of drugs called antiepileptic drugs.

The Food and Drug Administration (FDA) has approved lamotrigine to treat:

• focal onset (partial) seizures, generalized tonic-clonic seizures, and seizures related to Lennox-Gastaut syndrome (a severe form of epilepsy), when used together with other medications for epilepsy, in adults and certain children
• focal onset (partial) seizures, when used alone, in adults and certain adolescents
• bipolar I disorder, when used together with other treatments, in adults

These approved uses differ based on the form of lamotrigine your doctor prescribes.

This article doesn’t provide coupons for all forms of lamotrigine. To find coupons for lamotrigine extended-release (ER) oral tablet,* see this article. For coupons related to lamotrigine oral disintegrating tablet (ODT),† see this article.

* Lamotrigine ER oral tablet releases the drug slowly into your body over a long period of time.
† Lamotrigine ODT dissolves when placed in your mouth.

Boxed warning: Risk of serious skin rashes

Lamotrigine has a boxed warning about the risk of serious skin rashes. Boxed warnings are the most serious warnings from the FDA.

For details, see the “Interactions and warnings for lamotrigine” section.

Side effects of lamotrigine

Lamotrigine may cause mild or serious side effects. More common mild side effects of lamotrigine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about lamotrigine’s side effects, see this article or ask your doctor or pharmacist. You can also refer to the prescribing information for lamotrigine listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of lamotrigine are listed below. These side effects may differ based on the condition the drug is being used to treat.

This article doesn’t include all possible mild side effects of the drug. To learn more about lamotrigine’s side effects based on the form, refer to the prescribing information for lamotrigine listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Lamotrigine oral tablet’s mild side effects include:

• dizziness or problems with balance
• headache
• nausea
• blurry vision
• mild allergic reaction*

Lamotrigine extended-release oral tablet’s mild side effects include:

• dizziness
• vomiting
• muscle tremor
• problems with balance or coordination
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for lamotrigine” section.

Serious side effects

Serious side effects of lamotrigine are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about lamotrigine’s side effects, refer to the prescribing information for lamotrigine listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, lamotrigine’s serious side effects include:

• confusion
• anxiety
• irregular heart rhythm
• blood cell problems, including low white blood cell count
• lymphohistiocytosis (a condition in which your immune system becomes overactive and causes inflammation and damage throughout your body)
• increased risk of aseptic meningitis
• withdrawal seizures, if treatment with lamotrigine is suddenly stopped
• suicidal thoughts or behaviors
• boxed warning: risk of serious skin rashes*
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for lamotrigine” section.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Common questions about lamotrigine

Below you’ll find answers to a few commonly asked questions about lamotrigine.

Are there certain foods to avoid while taking lamotrigine?

No, there aren’t certain foods to avoid while taking lamotrigine. There aren’t known food interactions with this medication.

Grapefruit and grapefruit juice can interact with certain drugs used to treat epilepsy, but this doesn’t apply to lamotrigine. (Keep in mind that the drug is used to treat certain types of seizures due to epilepsy.)

According to the Epilepsy Foundation, avoiding certain foods may have a positive impact on managing seizures for some people. To learn more, talk with your doctor about foods that may be helpful to avoid when managing your seizures.

If you have questions about eating certain foods while taking lamotrigine, talk with your doctor or pharmacist.

Can lamotrigine be used for depression?

Lamotrigine is not approved for treating depression. But doctors may still prescribe it off-label for this or other uses. (With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.)

Talk with your doctor if you’d like to learn more about possible off-label uses for lamotrigine.

What is lamotrigine’s mechanism of action? How does the drug work?

How lamotrigine works to treat seizures isn’t fully understood. It’s thought the drug works by stabilizing electrical activity in your brain in a way that helps prevent seizures.

How lamotrigine works to treat bipolar I disorder currently isn’t known. But studies have shown that the drug is effective for treating this condition.

For treating seizures or bipolar I disorder, it can take several weeks for lamotrigine to take effect.

If you’d like to know more about how lamotrigine works, talk with your doctor or pharmacist.

Uses of lamotrigine

The Food and Drug Administration (FDA) approves prescription drugs such as lamotrigine for certain conditions. Approved uses for lamotrigine are described below. These uses differ based on the form of lamotrigine prescribed.

Use for bipolar disorder

Doctors may prescribe lamotrigine oral tablet, oral disintegrating tablet (ODT),* and chewable tablet† for treating bipolar I disorder. The drug is used for this purpose in adults. It’s usually prescribed as a long-term treatment.

Bipolar disorder is a mental health condition that causes extreme shifts in mood, ranging from episodes of mania (extremely elevated mood) to episodes of depression.

Symptoms of bipolar disorder include short-term episodes of:

• mania, which refers to feelings of high energy, excitement, and impulsivity
• hypomania, which involves similar but less severe symptoms than mania
• depression, which can cause symptoms such as deep sadness and low energy

Specifically, lamotrigine is FDA-approved to lower or help delay these mood episodes in people with bipolar I disorder. A person with bipolar I disorder has experienced at least one episode of mania (a manic episode) lasting a week or longer.

Lamotrigine is prescribed together with other medications for bipolar disorder, such as lithium (Lithobid).

Doctors may not prescribe lamotrigine in certain situations, such as for treating an acute (sudden) episode of mania or a mixed episode. (A mixed episode is also called bipolar disorder with mixed features. It involves having symptoms of both mania and depression at the same time.)

* Lamotrigine ODT dissolves when placed in your mouth.
† Lamotrigine chewable tablet may be swallowed whole, chewed, or dissolved in water or juice. Ask your doctor or pharmacist for more information about this.

Use for seizures

Doctors may prescribe lamotrigine oral tablets, extended-release (ER) oral tablet,* oral disintegrating tablet (ODT),† and chewable tablet‡ for treating certain types of seizures. The drug is usually prescribed as a long-term treatment.

Specifically, the FDA has approved lamotrigine to treat:

• focal onset (partial) seizures, generalized tonic-clonic seizures, and seizures related to Lennox-Gastaut syndrome (a severe form of epilepsy), when used together with other medications for epilepsy, in adults and children ages 2 years and older
• focal onset (partial) seizures, used alone, in adults and adolescents ages 16 years and older

Seizure symptoms can vary based on the type of seizure and the part of your brain that’s affected. For instance:

• Focal onset seizures may cause symptoms such as muscle contractions, unusual head or eye movements, or feelings of numbness, among others.
• Generalized tonic-clonic seizures may cause symptoms such as muscle stiffness and loss of consciousness, among others.
• A person with Lennox-Gastaut syndrome can experience multiple types of seizures, including focal onset, tonic-clonic, and other types. Symptoms can vary from person to person and depend on the type of seizure a person experiences.

Lamotrigine may be prescribed on its own or together with other medications for treating seizures, such as valproic acid.

* Lamotrigine ER oral tablet releases the drug slowly into your body over a long period of time.
† Lamotrigine ODT dissolves when placed in your mouth.
‡ Lamotrigine chewable tablet may be swallowed whole, chewed, or dissolved in water or juice. Ask your doctor or pharmacist for more information about this.

Interactions and warnings for lamotrigine

Below, you’ll find information about lamotrigine’s possible interactions and warnings.

Interactions of lamotrigine

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take lamotrigine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for lamotrigine” section below.

Warnings for lamotrigine

Some people should not take lamotrigine, and others should use it cautiously.

Boxed warning: Risk of serious skin rashes

Lamotrigine has a boxed warning about the risk of serious skin rashes. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

Serious skin rashes reported with lamotrigine use include Stevens-Johnson syndrome and toxic epidermal necrolysis. These side effects were rarely reported in studies of lamotrigine.

Symptoms may include:

• painful skin rash or hives that appears red or discolored
• blistering or peeling skin, affecting the eyes, mouth, nose, skin, or genitals
• skin that’s broken, raw, or shedding

Serious skin rashes with lamotrigine are rare, but children ages 2–16 years may be at a higher risk. While this side effect may occur at any time during treatment, most serious skin rashes have been reported within the first 2 months of taking lamotrigine.

If you experience any symptom of a skin rash while taking lamotrigine, immediately tell your doctor. They’ll likely recommend stopping treatment with lamotrigine. It can be difficult to distinguish between mild and severe rashes with lamotrigine, so it’s important to tell your doctor as soon as you notice symptoms.

If your symptoms are serious or feel life threatening, seek immediate medical attention, such as calling 911 or going to an emergency room.

To learn more, talk with your doctor or pharmacist.

Other warnings

Lamotrigine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether lamotrigine is a safe option for you.

Ask your doctor about specific warnings for lamotrigine, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Lamotrigine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to lamotrigine or any of its ingredients, your doctor will likely not prescribe lamotrigine. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to lamotrigine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of lamotrigine

You should not take more lamotrigine than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much lamotrigine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and lamotrigine

Information about lamotrigine and pregnancy and breastfeeding is described below.

Lamotrigine and pregnancy

It’s not known whether lamotrigine should be taken during pregnancy. But there are risks with having untreated epilepsy or bipolar disorder while pregnant. (Keep in mind that lamotrigine is used for treating epilepsy and seizures in certain people.)

If you’re planning a pregnancy or can become pregnant, talk with your doctor about epilepsy treatment options during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether or not you should take lamotrigine during pregnancy.

If you and your doctor decide you’ll take lamotrigine while pregnant, consider joining the drug’s pregnancy registry. Pregnancy registries help doctors and patients make decisions about safe treatment options during pregnancy. You can learn more or join the registry by calling 888-233-2334 or visiting this site.

Lamotrigine and breastfeeding

There are risks to taking lamotrigine while breastfeeding. For instance, lamotrigine may cause rash and low weight gain in a breastfed child. But there are also risks with having untreated epilepsy or bipolar disorder during this time.

If you’re planning to breastfeed, talk with your doctor about epilepsy or bipolar disorder treatment options. Together, you can discuss the risks and benefits of your treatment options and decide whether or not you should take lamotrigine during this time. Your doctor may also recommend other healthy ways to feed your child.

What to ask your doctor

Let your doctor know if you have questions about lamotrigine or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• How does lamotrigine compare with other treatments for my condition?
• If I’m prescribed lamotrigine for partial-onset seizures, how will we determine whether I should take it alone or with other antiepileptic drugs?
• Do any medications I take interact with lamotrigine and raise my risk of side effects?
• Can stopping lamotrigine cause certain side effects?
• What factors may affect whether lamotrigine works to treat my condition?

Resources

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Lamotrigine – lamotrigine tablet. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/2c1a246f-6830-498e-ab67-1f037420737a/spl-doc
• Lamotrigine – lamotrigine tablet, chewable. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/f54690b3-bcbb-4d94-95b9-b7591af00117/spl-doc
• Lamotrigine ER – lamotrigine er tablet, extended release. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/faccacb7-65f1-cb00-e053-6394a90a9fcb/spl-doc
• Lamotrigine – lamotrigine tablet, orally disintegrating. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/54ea1ec3-876b-4d3a-a92b-1a6d70951de0/spl-doc
• Nutrition and seizure control. (2022). https://www.epilepsy.com/lifestyle/diet-exercise/healthy-eating/nutrition-seizure-control

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.