Adjunctive or monotherapy in the treatment of epilepsy, for partial & generalised seizures, including tonic-clonic seizures & seizures associated w/ Lennox-Gastaut syndrome Adult >18 yr & adolescent 12-18 yr Monotherapy 25 mg once daily for 2 wk, then 50 mg once daily for 2 wk. May be increased by max 50-100 mg every 1-2 wk. Maintenance: 100-200 mg (once daily or as 2 divided doses).
Add-on therapy w/ valproate 25 mg every alternate day for 2 wk. May be increased by max 25-50 mg every 1-2 wk. Maintenance: 100-200 mg/day given once daily or in 2 divided doses.
Add-on therapy w/ phenytoin, carbamazepine, phenobarb, primidone or other lamotrigine glucuronidation inducer 50 mg once daily for 2 wk, then 100 mg/day in 2 divided doses for 2 wk. May be increased by 100 mg every 1-2 wk. Maintenance: 200-400 mg/day in 2 divided doses.
Add-on therapy w/ drugs that do not significantly inhibit or induce lamotrigine glucuronidation 25 mg once daily for 2 wk then 50 mg daily for 2 wk. May be increased by 50-100 mg every 1-2 wk. Maintenance: 100-200 mg once daily or in 2 divided doses.
Childn 2-12 yr Add-on therapy w/ valproate 0.15 mg/kg given once daily for 2 wk, then 0.3 mg/kg/day once daily for 2 wk. May be increased by 0.3 mg/kg every 1-2 wk. Maintenance: 1-5 mg/kg/day given once daily or in 2 divided doses to max 200 mg/day.
Add-on therapy w/ phenytoin, carbamazepine, phenobarb, primidone or other lamotrigine glucuronidation inducer 0.6 mg/kg/day, then 1.2 mg/kg/day. Administer in 2 divided doses for 2 wk. May be increased by max 1.2 mg/kg every 1-2 wk. Maintenance: 5-15 mg/kg/day given in 2 divided doses. Max: 400 mg/day.
Add-on therapy w/ drugs that do not significantly inhibit or induce lamotrigine glucuronidation 0.3 mg/kg/day, then 0.6 mg/kg/day. To be given once daily or 2 divided doses for 2 wk. May be increased by 0.6 mg/kg every 1-2 wk. Maintenance: 1-10 mg/kg/day given once daily or in 2 divided doses to max 200 mg/day.
Prevention of mood episodes in bipolar disorder, predominantly by preventing depressive episodes Adult ≥18 yr Adjunct therapy w/ valproate 25 mg every alternate day for 2 wk, then 25 mg once daily for 2 wk. May be increased to 50 mg once daily (or 2 divided doses) in wk 5. Target stabilization: 100 mg once daily or in 2 divided doses, may be increased to 200 mg/day.
Adjunct therapy w/ phenytoin, carbamazepine, phenobarb, primidone or other lamotrigine glucuronidation inducer 50 mg once daily for 2 wk, then 100 mg in 2 divided doses for 2 wk, increased to 200 mg/day in 2 divided doses in wk 5, may be increased in wk 6 to 300 mg/day. Target stabilization: 400 mg/day in 2 divided doses which may be given from wk 7.
Monotherapy or adjunct therapy w/ drugs that do not significantly inhibit or induce lamotrigine glucuronidation 25 mg once daily for 2 wk, then 50 mg once daily or 2 divided doses for 2 wk. Increase to 100 mg/day on wk 5. Target stabilization: 200 mg once daily or 2 divided doses.
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