Drug Name

Lamictal (Lamotrigine)

Drug Uses

Lamictal is used in combination with other anti-seizure drugs in the treatment of some types of seizures. It also is used alone for treating partial seizures in patients of 16 years old and older when converting from the anti-epileptic drug valproate.

How Taken

The initial dose of lamictal in patients, not taking valproic acid (Depakote), is 50 mg once daily for two weeks, followed by 100 mg daily, given in two divided doses for two weeks. Thereafter, the usual maintenance dose is 300 to 500 mg daily, given in two divided doses. In patients taking valproic acid, the initial dose of lamictal is 25 mg every other day for two weeks, then 25 mg once daily for two weeks, slowly increasing the dose (by 25 to 50 mg per day) every one to two weeks) until a dose of 100 to 150 mg daily is reached. Standard doses of lamictal are given twice daily.

Drug Class and Mechanism

Lamictal is an oral drug that is used for treating seizures. It is chemically unrelated to other anti-seizure drugs. The precise mechanism by which lamictal exerts its anti-seizure action is not known.

Missed Dose

Try to take each dose at the scheduled time. If you miss a dose, take it as soon as remembered; do not take it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Storage

Store this medication at room temperature at 77 degrees F (25 degrees C) away from heat, light, and moisture. Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Do not store in the bathroom. Keep this and all medications out of the reach of children.

Warnings/Precautions

Rarely, serious (sometimes fatal) skin rashes have occurred while using this medication. These rashes (e.g., Stevens-Johnson syndrome) are more common in children (less than 16 years old) than in adults. Therefore, lamictal should only be used in children who have partial seizures or seizures, associated with Lennox-Gastaut syndrome. Immediately notify your doctor if you develop any type of rash. If this medication is the cause of the rash, the drug must be stopped.

Even after stopping this medication, it is still possible for the rash to cause permanent or life-threatening scarring along with other problems. The possibility of a rash may be increased by using too much of this medication when treatment begins, increasing the dose beyond what your doctor prescribes during treatment, or taking valproic acid with lamictal. Most life-threatening rashes have occurred within 2 to 8 weeks of starting this medication.

However, such serious rashes have also occurred after 6 months of use. Tell your doctor if you have: other illnesses, heart problems, liver problems, kidney problems, allergies (especially drug allergies). Sunscreen and/or protective clothing is recommended to protect against a possible severe rash, triggered by sunlight. Use caution operating machinery or engaging in activities, requiring alertness. Limit alcohol intake while taking this drug. This medication should be used only if clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This drug is excreted into breast milk. Due to possible risks to nursing infants, breast-feeding while using this drug is not recommended. Consult your doctor.

Possible Side Effects

Headache, fatigue, drowsiness, dizziness, blurred vision, weakness, clumsiness may occur the first several days as your body adjusts to the medication. If any of these effects continue or become bothersome, inform your doctor. If you develop a rash, stop using this drug and seek immediate medical attention. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, hives, fever, swollen glands, swelling of the lips or tongue, painful sores in the mouth or around the eyes, severe dizziness, trouble breathing. If you notice other effects, not listed above, contact your doctor or pharmacist.

More Information

Laboratory tests may be done periodically while taking this medication to monitor the effects. See your doctor regularly.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Other Useful Information:

Radiation: 1. Rays of energy. Gamma rays and X-rays are two of the types of energy waves often used in medicine. 2. The use of energy waves to diagnose or treat disease.

Replantation: 1. Literally, the act of planting again. 2. In surgery, the restoration of any part of the body to its original site. Also known as reimplantation.

The Chinese surgeon Zhong Wei Chen (1929-2004) was the "father of replantation." Dr. Chen was the first to reattach a severed hand with success which he did in 1963. Dr. Chen also developed many microsurgical procedures including techniques for preserving severed extremities, reattaching amputated fingers and thumbs, reconstructing muscles and repairing nerves and blood vessels.

Rheumatism: Rheumatism is an older term, used to describe any of a number of painful conditions of muscles, tendons, joints, and bones.

Rheumatism conditions have been classified as either localized, regional, or generalized. Localized rheumatism conditions include bursitis and tendinitis. Regional rheumatism conditions include chest wall pain, temporomandibular joint pain, and myofascial pain syndromes. Generalized rheumatism conditions include fibromyalgia.

Another category of rheumatism is psychogenic rheumatism. With this term it is understood that the patient is reporting inconsistent pains of muscles and joints that do not correspond to true anatomy and physiology. The patient is felt to have underlying psychological causes for the symptoms.

Rheumatology: A subspecialty of internal medicine that involves the non-surgical evaluation and treatment of the rheumatic diseases and conditions. Rheumatic diseases and conditions are characterized by symptoms involving the musculoskeletal system. Many of the rheumatic diseases and conditions feature immune system abnormalities. Therefore, rheumatology also involves the study of the immune system. Classical rheumatology training includes 4 years of medical school, 1 year of internship in internal medicine, 2 years of internal medicine residency, and 2 years of rheumatology fellowship. There is a subspecialty board for rheumatology certification. The American College of Rheumatology is the official organization acting on behalf of the field of rheumatology in the United States.

T cell: A type of white blood cell that is of key importance to the immune system and is at the core of adaptive immunity, the system that tailors the body's immune response to specific pathogens. The T cells are like soldiers who search out and destroy the targeted invaders.

Immature T cells (termed T-stem cells) migrate to the thymus gland in the neck, where they mature and differentiate into various types of mature T cells and become active in the immune system in response to a hormone called thymosin and other factors. T-cells that are potentially activated against the body's own tissues are normally killed or changed ("down-regulated") during this maturational process.

There are several different types of mature T cells. Not all of their functions are known. T cells can produce substances called cytokines such as the interleukins which further stimulate the immune response. T-cell activation is measured as a way to assess the health of patients with HIV/AIDS and less frequently in other disorders.

T cell are also known as T lymphocytes. The "T" stands for "thymus" -- the organ in which these cells mature. As opposed to B cells which mature in the bone marrow.

Teleology: The study of the ultimate purpose of the design of something in nature.

For example, "what is the true purpose of the nose?" is a teleological question and, to say that all evolutionary changes occur for a definite purpose is a teleological explanation of evolution.

"Teleology" comes from ancient Greek roots but it (and teleological) did not enter English until the 18th century. It is a compound of the Greek "tele-, telos," meaning "end or purpose" + the ending "logos" meaning "the science or study of" = the study of the ends or purposes.

Testosterone: A "male hormone" -- a sex hormone produced by the testes that encourages the development of male sexual characteristics, stimulates the activity of the male secondary sex characteristics, and prevents changes in them following castration. Chemically, testosterone is 17-beta-hydroxy-4-androstene-3-one.

Testosterone is the most potent of the naturally occurring androgens. The androgens cause the development of male sex characteristics, such as a deep voice and a beard; they also strengthen muscle tone and bone mass.

High levels of testosterone appear to promote good health in men, for example, lowering the risks of high blood pressure and heart attack. High testosterone levels also correlate with risky behavior, however, including increased aggressiveness and smoking, which may cancel out these health benefits.

Testosterone may be given to treat medical conditions, including female (but not male) breast cancer, hypogonadism (low gonadal function) in the male, cryptorchism (nondescent of the testis into the scrotum), and menorrhagia (irregular periods).