Medication Description: Lamotrigine
3,5-Diamino-6- (2,3-dichlorophenyl) -1,2,4-triazine.
Synonyms: Lamictal, Lamictal.
The anticonvulsant (antiepileptic) drug, original in structure and action.
Anticonvulsant action is associated with the stabilization of the presynaptic neuronal membrane, the blockade of potential-dependent sodium channels and the prevention of the release of excitatory neurotransmitter amino acids (mainly glutamate, as well as aspartate).
When administered, the drug is well absorbed, C max is 2-2.5 hours; T 1/2 - 30 h; metabolized in the liver to form glucoronides; mainly urine is excreted in small amounts by feces.
Applied to monotherapy and additional therapy of partial and generalized sepsia epilepsy. Effective in cases of resistance to other antiepileptic drugs.
Prescribed to adults and children over 12 years old with monotherapy, starting with a dose of 0.025 g (25 mg) 1 time per day for 2 weeks, then increase the dose to 0.05 g 1 time per day for the next 2 weeks, then gradually increase the dose by 0.05-0.1 g every 1-2 weeks to obtain a therapeutic effect. The average maintenance dose of 0.2 g per day in 2 doses (in some cases up to 0.5 g per day).
Children from 2 to 12 years old are prescribed starting from 0.2 mg / kg 1 time per day for 2 weeks, then at 0.5 mg / kg 1 time per day for 2 weeks, then an effective therapeutic dose is selected. The average maintenance dose of 1-5 mg / kg per day in 1-2 doses.
Lamotrigine is also used in combination with other antiepileptic drugs. However, it is necessary to take into account that phenobarbital, carbamazepine, hexamidine (due to the induction of liver metabolizing enzymes) can weaken its action, and sodium valproate slows down the metabolism of lamotrigine and enhances its action. Therefore, when taken simultaneously with sodium valproroan, the dose of lamotrigine is reduced: the initial daily dose (in the first 2 weeks) is reduced to 0.05 g, and the maintenance dose is reduced to 0.2-0.4 g.
The drug is usually well tolerated; however, dizziness, headache, drowsiness or irritability, diplopia, allergic reactions (skin rash, Quincke edema) may occur.
Contraindicated in liver failure.
Caution is required when prescribing lamotrigine to older people and pregnant women; in the absence of emergency in the first 3 months of pregnancy, the drug should not be taken. It is not recommended to prescribe lamotrigine to children under 2 years of age.
Form release: pills to 0.025; 0.05 and 0.1 g (25, 50 and 100 mg), chewable tablets - 0.005; 0.025 and 0.1 g (N.30).
Storage: List B.