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Lamogin – 25 mg Tablet/pcs
৳ 10.00
Generic Name: Lamotrigine
Therapeutic class: Anti-epileptic ( Sodium Channel Blocker)
Manufacturer: Incepta Pharmaceuticals Ltd.
Note: চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন
Indications
Lamotrigine is indicated for:
Epilepsy-combination therapy in patients aged 2 years and older:
- partial-onset seizures
- primary generalized tonic-clonic seizures
- generalized seizures of Lennox-Gastaut syndrome
Epilepsy-monotherapy in patients aged 16 years and older.
Adults with Bipolar Disorder.
Dosage & Administration
Epilepsy–
Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
- In patients taking Valproate: 25 mg every other day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
Weeks 3 & 4:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
- In patients taking Valproate: 25 mg every day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
Week 5 onward to maintenance:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
- In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
Usual maintenance dose:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
- In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
- In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
Weeks 3 & 4:
In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
- In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
Week 5 onward to maintenance:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
- In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
Usual maintenance dose:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
- In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy
Weeks 1 & 2:
- If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
- If the patients weight is 14.1 kg to 27 kg: 2 mg every day
- If the patients weight is 27.1 kg to 34 kg: 4 mg every day
- If the patients weight is 34.1 kg to 40 kg: 5 mg every day
Weeks 3 & 4:
- If the patients weight is 6.7 kg to 14 kg: 2 mg every day
- If the patients weight is 14.1 kg to 27 kg: 4 mg every day
- If the patients weight is 27.1 kg to 34 kg: 8 mg every day
- If the patients weight is 34.1 kg to 40 kg: 10 mg every day
Bipolar disorder–
Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
- In patients taking Valproate: 25 mg every other day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
Weeks 3 & 4:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
- In patients taking Valproate: 25 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
Week 5:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
- In patients taking Valproate: 50 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
Week 6:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
- In patients taking Valproate: 100 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
Week 7:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
- In patients taking Valproate: 100 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
Side Effects
Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
Pregnancy & Lactation
Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Precautions & Warnings
Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
Use in Special Populations
Pediatric Use:
- Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient’s aged 1 to 24 months.
- Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient’s aged 10 to 17 years.
Overdose Effects
Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
Storage Conditions
Store below 30°C. Protect from light and moisture. Keep out of the reach of children.
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