Understanding Lamotrigine Extended-Release Tablets: Your Complete Patient Guide to Seizure Control

If you or someone you care about has been diagnosed with seizures or epilepsy, you might have heard about a medicine called lamotrigine. Specifically, we are going to talk about extended-release tablets, which are designed to release the medicine slowly into your body over a long period. This helps keep a steady level of medicine in your system to calm down overactive nerves.

Navigating a new seizure medicine can feel overwhelming at first. However, understanding how your medicine works, what side effects to watch for, and how to take it correctly can give you confidence in your treatment plan. This guide is here to walk you through everything you need to know in plain, simple English.

Always talk to your healthcare team if you have questions about your specific condition or treatment plan. Let us break down the most important details you need to keep in mind while taking lamotrigine extended-release tablets.

What is this medicine used for?

Simply put, lamotrigine is a medicine given to people with epilepsy to stop and control seizures. Inside your brain, nerve cells sometimes fire off too many signals all at once. When that happens, you experience a seizure. This medicine works by calming down that heavy nerve activity.

Sometimes, doctors may also prescribe this medicine for other health conditions. If you have questions about why you are taking it, your best option is to ask your doctor or pharmacist. A very common brand name for this medicine is Lamictal XR.

What should you tell your medical team before taking this medicine?

Before you start taking lamotrigine, you need to tell your doctor if you have any health conditions. This is very important because it helps your doctor decide if the medicine is safe for you or how you should take it.

• Tell your doctor if you have heart disease.
• Tell them if you have a history of irregular heartbeats.
• Tell them if you have problems with your immune system.
• Tell them if you have kidney disease.
• Tell them if you have liver disease.
• Tell them if your body has a low folic acid level.
• Tell them if you have lupus.
• Tell them if you have a mental illness.
• Tell them if you have a history of thoughts or attempts of suicide, or if anyone in your family has experienced this.
• Tell them if you have had an unusual allergic reaction to lamotrigine, other seizure medicines, foods, dyes, or preservatives.
• Tell them if you are pregnant or trying to get pregnant.
• Tell them if you are breastfeeding a baby.

Being honest about your health history is vital for your own personal safety.

How should you use this medicine correctly?

You should take this medicine by mouth with a full glass of water. Always follow the directions written on your prescription label carefully.

The most important rule is that you must swallow these tablets whole. Never chew, crush, or break these tablets under any circumstances.

Because this is an extended-release tablet, breaking it open can ruin how the medicine works in your body. If you swallow them whole, the medicine releases slowly and safely.

Sometimes, this medicine might upset your stomach a little bit. If that happens, take your dose with food or a glass of milk. Try to take your medicine at the exact same times every single day. Do not take more medicine than your doctor tells you to take.

When you pick up your prescription from the pharmacy, you will usually receive a special patient guide called a MedGuide. Make sure you read it every time you get a refill. It contains a lot of helpful information for you.

If you are wondering about giving this medicine to children, talk to your medical team. Doctors sometimes prescribe this to children as young as 13 years old, but there are special rules and careful steps to follow.

Medicine Overdose: If you think you have taken too much of this medicine, call a poison control center or go to the nearest hospital emergency room right away.

Important Note: This medicine was prescribed only for you. Never share your medicine with anyone else, even if they have the exact same symptoms you do.

What should you do if you miss a dose?

If you forget to take your medicine, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose completely. Just take your next dose at the regular time. Never take two doses at the same time to make up for a missed one, as this can cause dangerous levels of medicine in your body.

What other things can interact with this medicine?

Certain medicines can cause problems if you take them at the same time as lamotrigine. If you use any of the following products, let your doctor know right away:

• Atazanavir .
• Birth control pills .
• Certain medicines for irregular heartbeats .
• Other seizure medicines, such as carbamazepine, phenobarbital, phenytoin, primidone, or valproic acid .
• Lopinavir .
• Rifampin .
• Ritonavir .

This list does not mention every single possible drug interaction. Therefore, give your doctor a complete list of everything you take, including prescription drugs, over-the-counter items, herbal remedies, vitamins, and dietary supplements. Also tell your doctor if you smoke, drink alcohol, or use street drugs, because these substances can also interact with your medicine.

What should you watch out for while taking this medicine?

While you take this medicine, you need to visit your doctor for regular checkups to see how you are doing. If possible, carry an identification card or wear a medical alert bracelet that lists your condition, your medicines, and your doctor's phone number. This can save your life in an emergency.

It is crucial that you take your exact dose at the exact times your doctor recommended. When you first start, your doctor will increase your dose very slowly. It can take weeks or even months to find the exact dose that works best for your body. If your seizures get worse or you experience a new type of seizure, contact your medical team right away.

Never stop taking this medicine suddenly without talking to your doctor first. Stopping abruptly can make your seizures come back much stronger or happen much more often.

Watch out for serious skin reactions!

This medicine can cause serious skin allergic reactions. These can happen a few weeks or even a few months after you start taking the pills. If you get a skin rash along with a fever or flu-like symptoms, see your doctor right away. The rash might look red or purple before turning into blisters or peeling skin. Also tell your doctor if you notice red rashes accompanied by swelling in your face, lips, or swollen lymph nodes in your neck and armpits.

Other important notes

• This medicine can make you feel sleepy, dizzy, or give you blurry vision. Do not drive a car, operate heavy machinery, or do anything that requires mental alertness until you know how this medicine affects you. To avoid dizziness or fainting spells, do not stand up or sit down too quickly, especially if you are an older adult. Drinking alcohol can make your sleepiness and dizziness much worse, so you should avoid alcohol while taking this medicine.

• Taking this medicine may slightly increase your chances of having thoughts or actions of self-harm or suicide. Pay close attention to your mood and feelings. If you notice your mental state getting worse or you feel hopeless, tell your medical team right away.

• Your mouth might feel dry while taking this medicine. You can help this by chewing sugar-free gum, sucking on sugar-free hard candies, and drinking plenty of water throughout the day. If your dry mouth is severe and does not go away, talk to your doctor.

• Women who become pregnant while taking this medicine can call 1-888-233-2334 to join the North American Antiepileptic Drug Pregnancy Registry. This registry collects helpful safety information about taking seizure medicines during pregnancy.

• This medicine can lower the folic acid levels in your body. Make sure you talk to your medical team about your diet and whether you need to eat specific foods or take a vitamin supplement.

What side effects might this medicine cause?

Like all medicines, lamotrigine can cause side effects. Some side effects are mild. This others can be serious.

Side effects that need medical attention right away:

If you experience any of the following warning signs, contact your medical team as soon as possible:

• Allergic reactions — skin rash, hives, itching, or swelling of your face, lips, tongue, or throat.
• Vision changes — blurring or seeing things differently.
• Signs of meningitis — fever, stiff neck, sensitivity to light, headache, nausea, vomiting, or confusion.
• Heart rhythm changes — fast or irregular heartbeat, dizziness, fainting, chest pain, or trouble breathing.
• Signs of infection — fever, chills, cough, or a sore throat.
• Liver injury — pain in the upper right side of your belly, loss of appetite, nausea, pale stools, dark yellow or brown urine, yellow skin or eyes, or unusual tiredness.
• Low red blood cell count — unusual tiredness, weakness, dizziness, headache, or trouble breathing.
• Serious skin reactions — rashes with fever and swollen glands; red, blistering, or peeling skin (including inside your mouth).
• Mood changes — thoughts of suicide or self-harm, worsening depression, or unusual sadness.
• Unusual bleeding or bruising — getting black and blue marks easily.

Side effects that are usually mild and may not need medical care:

These symptoms usually fade away after your body gets used to the medicine. However, if they continue or become bothersome, let your doctor know:

• Loose stools or diarrhea .
• Dizziness .
• Drowsiness .
• Headache .
• Nausea .
• Stomach pain .
• Shaking or tremors in your hands .

This list does not cover every possible side effect. If you notice other strange symptoms, ask your doctor or pharmacist about them.

Where should you store your medicine?

Keep this medicine safely out of the reach of children and pets.

Store your pills at room temperature, around 25 degrees Celsius (77 degrees Fahrenheit). Do not use your medicine after the expiration date printed on the bottle has passed. Safely throw away any expired or leftover pills.

How should you throw away unused or expired medicine?

Throwing medicine straight into the trash or flushing it down the toilet is usually not safe. Instead, follow these simple steps:

• Whenever possible, take your unused medicine to a local drug take-back program. You can ask your local pharmacy or police station if they have a collection site near you.
• If a take-back program is not available, check the packaging or patient leaflet for specific disposal instructions. If you are unsure, ask your medical team.
• If the instructions say it is safe to throw the medicine in the household trash, take the pills out of their container. Mix them with something unappealing like used coffee grounds, dirt, or cat litter. Put the mixture inside a sealed bag or container, seal it tightly, and then throw it in your trash bin.

Sources and References

• Cleveland Clinic. Lamotrigine Extended-Release Tablets: Uses, Side Effects, and Warnings. Available online.
• Mayo Clinic. Lamotrigine (Oral Route) Proper Use and Precautions. Patient Education Resources.
• National Health Service (NHS UK). Lamotrigine: Epilepsy medicine information and safety.
• Centers for Disease Control and Prevention (CDC). Epilepsy Management and Treatment Overview.
• U.S. Food and Drug Administration (FDA). Lamictal XR Patient Information Guide and Medicine Guide.