Lamonil (100mg) 30 Tablets

Lamotrigine is a triazine derivative which inhibits the presynaptic release of glutamate (an excitatory amino acid) and aspartate. By inhibiting voltage-gated sodium channels, this drug stabilizes presynaptic neuronal membranes. Lamotrigine produces a weak inhibitory effect on the 5-HT3 receptor and inhibits dihydrofolate reductase. By stabilizing presynaptic neuronal membranes and preventing the release of excitatory neurotransmitters such as glutamate, this drug prevents seizures and mood symptoms.

Lamivudine

Tablet

Bipolar Disorders, Focal (partial) onset seizures and generalized onset seizures, Epilepsy

Dose must be taken according to doctor’s advice only; doses given below are suggested as supportive literature for better understanding in some areas of requirements. Adult dose: For Monotherapy of focal seizures, primary and secondary generalized, tonic-clonic seizures, seizures associated with Lennox-Gastaut syndrome: Initial dose is 25mg once daily for 14 days, then increased to 50mg once daily for further 14 days, then increased in steps of up to 100mg every 7–14 days; maintenance 100–200mg daily in 1–2 divided doses; increased if necessary up to 500mg daily, dose titration should be repeated if restarting after interval of more than 5 days. For Adjunctive therapy of focal seizures with valproate, Adjunctive therapy of primary and secondary generalized tonic-clonic seizures with valproate, Adjunctive therapy of seizures associated with Lennox-Gastaut syndrome with valproate: Initial dose is 25mg once daily on alternate days for 14 days, then 25mg once daily for further 14 days, then increased in steps of up to 50mg every 7–14 days; maintenance dose is 100–200mg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days. For Adjunctive therapy of focal seizures (with enzyme inducing drugs) without valproate, Adjunctive therapy of primary and secondary generalized tonic-clonic seizures (with enzyme inducing drugs) without valproate, Adjunctive therapy of seizures associated with Lennox-Gastaut syndromes (with enzyme inducing drugs) without valproate: Initial dose is 50mg once daily for 14 days, then 50mg twice daily for further 14 days, then increased in steps of up to 100mg every 7–14 days; maintenance dose is 200–400mg daily in 2 divided doses, increased if necessary up to 700mg daily, dose titration should be repeated if restarting after interval of more than 5 days. For Monotherapy or adjunctive therapy of bipolar disorder (without enzyme inducing drugs) without valproate: Initial dose is 25mg once daily for 14 days, then 50mg daily in 1–2 divided doses for further 14 days, then 100mg daily in 1–2 divided doses for further 7 days; maintenance dose is 200mg daily in 1–2 divided doses, patients stabilized on lamotrigine for bipolar disorder may require dose adjustments if other drugs are added to or withdrawn from their treatment regimens, consult product literature, dose titration should be repeated if restarting after interval of more than 5 days; maximum 400 mg per day For Adjunctive therapy of bipolar disorder with valproate: Initial dose is 25mg once daily on alternate days for 14 days, then 25mg once daily for further 14 days, then 50mg daily in 1–2 divided doses for further 7 days; maintenance dose is 100mg daily in 1–2 divided doses, patients stabilized on lamotrigine for bipolar disorder may require dose adjustments if other drugs are added to or withdrawn from their treatment regimens, consult product literature, dose titration should be repeated if restarting after interval of more than 5 days; maximum 200mg per day For Adjunctive therapy of bipolar disorder (with enzyme inducing drugs) without valproate: Initial dose is 50mg once daily for 14 days, then 50mg twice daily for further 14 days, then increased to 100mg twice daily for further 7 days, then increased to 150mg twice daily for further 7 days; maintenance 200mg twice daily, patients stabilized on lamotrigine for bipolar disorder may require dose adjustments if other drugs are added to or withdrawn from their treatment regimens—consult product literature, dose titration should be repeated if restarting after interval of more than 5 days Child dose: For Monotherapy of focal seizures, primary and secondary generalized, tonic-clonic seizures, seizures associated with Lennox-Gastaut syndrome: In children of age 12–17 years: Initial dose is 25mg once daily for 14 days, then increased to 50mg once daily for further 14 days, then increased in steps of up to 100mg every 7–14 days; maintenance dose is; 100–200mg daily in 1–2 divided doses; increased if necessary up to 500mg daily, dose titration should be repeated if restarting after an interval of more than 5 days. For Adjunctive therapy of focal seizures with valproate, Adjunctive therapy of primary and secondary generalized tonic-clonic seizures with valproate, Adjunctive therapy of seizures associated with Lennox-Gastaut syndrome with valproate: In children of age 2–11 years (body-weight up to 13kg): Initial dose is 2mg once daily on alternate days for first 14 days, then 300 mcg/kg once daily for further 14 days, then increased in steps of up to 300 mcg/kg every 7–14 days; maintenance 1–5 mg/kg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days; maximum dose is 200mg per day. In children of age 2–11 years (body-weight 13kg and above): Initial dose is 150mcg/kg once daily for 14 days, then 300 mcg/kg once daily for further 14 days, then increased in steps of up to 300 mcg/kg every 7–14 days; maintenance 1–5mg/kg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days; maximum dose is 200mg per day. In children of age 12–17 years: Initial dose is 25mg once daily on alternate days for 14 days, then 25mg once daily for further 14 days, then increased in steps of up to 50 mg every 7–14 days; maintenance dose is 100–200mg daily in 1–2 divided doses, dose titration should be repeated if restarting after an interval of more than 5 days. For Adjunctive therapy of focal seizures (with enzyme inducing drugs) without valproate, Adjunctive therapy of primary and secondary generalized tonic-clonic seizures (with enzyme inducing drugs) without valproate, Adjunctive therapy of seizures associated with Lennox-Gastaut syndromes (with enzyme inducing drugs) without valproate: In children of age; 2–11 years: Initial dose is; 300mcg/kg twice daily for 14 days, then 600mcg/kg twice daily for further 14 days, then increased in steps of up to 1.2mg/kg every 7–14 days; maintenance dose is; 5–15 mg/kg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days; maximum 400mg per day In children of age 12–17 years: Initial dose is 50mg once daily for 14 days, then 50mg twice daily for further 14 days, then increased in steps of up to 100mg every 7–14 days; maintenance dose is 200–400mg daily in 2 divided doses, increased if necessary up to 700mg daily, dose titration should be repeated if restarting after interval of more than 5 days.

Overdose of lamotrigine may cause; nausea, vomiting, ataxia, drowsiness, lethargy, ataxia, nystagmus, dizziness, and tachycardia. Supportive treatment for management of signs and symptoms of lamotrigine overdose must be initiated immediately.

In case you missed any dose, take the next dose as soon as you remember, but don't double your next dose to compensate for the missed one.

Take orally as advised. Avoid sudden withdrawal or stoppage of this medicine (decrease the dose gradually over 2 weeks or longer) unless in the case if a serious skin reaction occurs.

Cannot be used in patients with hypersensitivity to lamotrigine or any of its components.

Common Aggression Agitation Arthralgia Diarrhea Dizziness Drowsiness Dry mouth Fatigue . Headache Irritability Nausea Sleep disorders Tremor Vomiting Uncommon: Alopecia Movement disorders Vision disorders Rare: Aseptic meningitis Agranulocytosis Neutropenia Pancytopenia Pure red cell aplasia Aplastic anemia Skin rash Multiorgan hypersensitivity reactions like; Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) Hemophagocytic lymphohistiocytosis (HLH)

This medicine may cause central nervous system depression which can affect physical or mental abilities so patients should be cautioned about operating machinery or driving a vehicle. Use with caution in patients with heart disease. In case of unavoidable use, dose adjustments are required in pregnant ladies. Lamotrigine could be present in breast milk so caution is required with its use in pregnant ladies. Dose adjustment is required in liver or kidney impaired patients. Reduce maintenance dose in significant kidney impairment.

Kava Kava shrub that is used as a herbal remedy for mood stabilization, anxiety and insomnia treatment, may increase the effects of lamotrigine.

To monitor brain functioning along with the use of this medicine, go for CT- scan. To monitor live function, go for; LFT, Ultrasound. For monitoring Kidney function, go for; Renal Function Test, Ultrasound.