Description of the medicine: Lamotrigine (Lamotrigine)
3,5-diamino-6- (2,3-dichlorophenyl) -1,2,4-triazine.
Synonyms: Lamictal, Lamictal.
The anticonvulsant (antiepileptic) drug, original in structure and action.
The anticonvulsant effect is associated with stabilization of presynaptic neuronal membranes, blockade of voltage-gated sodium channels and 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 hours; metabolized in the liver with the formation of glucuronides; excreted mainly in urine, in small amounts by feces.
Used for monotherapy and additional therapy of partial and generalized seizures of eplepsia. Effective in cases of resistance to other antiepileptic drugs.
Assign to adults and children over 12 years of age 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 until a therapeutic effect is obtained. The average maintenance dose of 0.2 g per day in 2 divided doses (in some cases up to 0.5 g per day).
Children from 2 to 12 years of age are prescribed starting from 0.2 mg / kg once a day for 2 weeks, then 0.5 mg / kg once a 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 metabolizing liver enzymes) can weaken its effect, and sodium valproate slows the metabolism of lamotrigine and enhances its effect. Therefore, while taking sodium with valproan, the dose of lamotrigine is reduced: the initial daily (in the first 2 weeks) is up to 0.05 g, and the maintenance dose is up to 0.2-0.4 g.
The drug is usually well tolerated; however, dizziness, headache, drowsiness or increased irritability, diplopia, allergic reactions (skin rash, Quincke's edema) can be observed.
Contraindicated in liver failure.
Caution is required when prescribing lamotrigine to the elderly and pregnant; in the absence of emergency, the drug should not be taken in the first 3 months of pregnancy. It is not recommended to prescribe lamotrigine to children under 2 years of age.
Release form: tablets on 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.