Introduction
Lamogin 2 belongs to a group of medicines called anti-epileptics. It is used to treat two conditions, epilepsy and bipolar disorder. It works by blocking the signals in the brain that trigger epileptic seizures (fits) and in another way to prevent extreme mood swings.
Lamogin 2 can be used alone or in combination with other medicines. It may be taken with or without food. Your doctor will decide the correct dose for you. This may increase gradually until your condition is stable. This medicine may take several weeks to work but it is important to take it regularly to get the maximum benefit. Do not stop taking it, even if you feel fine unless your doctor advises you to. You may have more seizures, or your bipolar disorder may get worse.
The most common side effects of this medicine include skin rashes, headache, nausea and vomiting, difficulty sleeping, dizziness, and feeling sleepy or drowsy. Most side effects wear off, but if they bother you or do not go away, tell your doctor. Inform your doctor immediately if you notice a rash or peeling of skin. There may be ways of preventing or reducing these effects. Long-term treatment can cause weakness in your bones (osteoporosis), increasing your risk of breaking a bone.
Before taking this medicine, tell your doctor if you have kidney or liver problems, depression or suicidal thoughts. Also let your healthcare professional know about all other medications you are using as some may affect, or be affected by, this medicine, including contraceptive pills. Consult your doctor if you are pregnant or breastfeeding as the dose may need to be adjusted. You should avoid driving or anything that requires concentration if this medicine makes you drowsy or dizzy. You may need frequent blood tests to check how you are responding to this medicine.
Uses of Lamogin 2
- Epilepsy/Seizures
- Bipolar disoder
Side effects of Lamogin 2
Common
- Skin rash
- Headache
- Nausea
- Vomiting
- Dryness in mouth
- Insomnia (difficulty in sleeping)
- Sleepiness
- Dizziness
- Back pain
- Abdominal pain
- Blurred vision
- Double vision
- Impaired coordination
- Nasal congestion (stuffy nose)
- Infection
How to use Lamogin 2
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Lamogin 2 may be taken with or without food, but it is better to take it at a fixed time.
How Lamogin 2 works
Lamogin 2 is an antiepileptic medication. It controls seizures or fits by decreasing the abnormal and excessive activity of the nerve cells in the brain.
What if you forget to take Lamogin 2?
If you miss a dose of Lamogin 2, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Epilepsy,—adjunctive therapy in patients aged 2 years and older:
• partial-onset seizures.
• primary generalized tonic-clonic seizures.
• generalized seizures of Lennox-Gastaut syndrome
Epilepsy,—monotherapy in patients aged 16 years and older
Bipolar disorder
Administration
May be taken with or without food.
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
Contraindication
Hypersensitivity.
Mode 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.
Precaution
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. Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
Lactation: Distributed into human breast milk; caution advised
Side Effect
>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.
Interaction
Metabolism enhanced by enzyme-inducing drugs e.g. phenytoin, carbamazepine, phenobarbitone, primidone, rifampicin, ethinyloestradiol/levonorgestrel combination. Metabolism reduced by sodium valproate.