Lamitrin ER Tablet (Extended Release) 50 mg

Lamitrin ER Tablet (Extended Release) 50 mg Uses, Dosage, Side Effects, Food Interaction and all others data.

Lamitrin ER Tablet (Extended Release) 50 mg controls epileptic seizures by inhibiting voltage-sensitive sodium channels, thereby stabilizes neuronal membranes and consequently inhibits presynaptic excitatory neurotransmitter (e.g., glutamate and aspartate) release.

Lamitrin ER Tablet (Extended Release) 50 mg likely prevents seizures and prevents mood symptoms via stabilizing presynaptic neuronal membranes and preventing the release of excitatory neurotransmitters such as glutamate, which contribute to seizure activity.

A note on cardiovascular effects

The metabolite of lamotrigine, 2-N-methyl metabolite (formed by glucuronidation), is reported to cause dose-dependent prolongations of the PR interval, widening of the QRS complex, and at higher doses, complete AV block. Although this harmful metabolite is only found in trace amounts in humans, plasma concentrations may increase in conditions that cause decreased drug glucuronidation, such as liver disease.

Trade Name Lamitrin ER Tablet (Extended Release) 50 mg
Availability Prescription only
Generic Lamotrigine
Lamotrigine Other Names Lamotrigina, Lamotrigine, Lamotriginum
Related Drugs Vraylar, gabapentin, fluoxetine, clonazepam, quetiapine, diazepam, Abilify, Prozac, pregabalin, Seroquel
Weight 50 mg
Type Tablet (Extended Release)
Formula C9H7Cl2N5
Weight Average: 256.091
Monoisotopic: 255.007850663
Protein binding

The plasma protein binding of lamotrigine is estimated at 55%. This drug is not expected to undergo clinically significant interactions with other drugs via competition for protein binding sites due its lower protein binding.

Groups Approved, Investigational
Therapeutic Class Primary anti-epileptic drugs
Manufacturer ACI Limited
Available Country Bangladesh
Last Updated: October 19, 2023 at 6:27 am
Lamitrin ER Tablet (Extended Release) 50 mg
Lamitrin ER Tablet (Extended Release) 50 mg

Uses

Lamitrin ER Tablet (Extended Release) 50 mg is an antiepileptic drug (AED) used for:

Epilepsy (adjunctive 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).Bipolar disorder in patients aged 18 years and older.

Lamitrin ER Tablet (Extended Release) 50 mg is also used to associated treatment for these conditions: Bipolar 1 Disorder, Grand mal Generalized tonic-clonic seizure, Partial-Onset Seizures, Generalized seizure, Conversion to monotherapy

How Lamitrin ER Tablet (Extended Release) 50 mg works

The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.

Lamitrin ER Tablet (Extended Release) 50 mg likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.

Lamitrin ER Tablet (Extended Release) 50 mg displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamitrin ER Tablet (Extended Release) 50 mg also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.

Dosage

Lamitrin ER Tablet (Extended Release) 50 mg dosage

Monotherapy of seizures (adult and child over 16 years): Initially 25 mg once daily for 14 days, then 50 mg once daily for further 14 days, then increased by maximum 50 mg/day every 7-14 days; usual maintenance dose 225-375 mg/day in 1-2 divided doses.

Adjunctive therapy of seizures with Valproate:

  • Adult and child over 12 years: Initially 25 mg on alternate days for 14 days, then 25 mg once daily for further 14 days, thereafter increased by maximum 25-50 mg/day every 7-14 days; usual maintenance, 100-200 mg/day in 1-2 divided doses.
  • Child 2-12 years: Initially 150 mcg/kg/day in 1-2 divided doses for 14 days (those weighing under 13 kg may receive 2 mg on alternate days for first 14 days), then 300 mcg/kg/day in 1-2 divided doses for further 14 days, thereafter increased by maximum 300 mcg/kg/day every 7-14 days; usual maintenance 1-3 mg/kg/day in 1-2 divided doses.

Adjunctive therapy of seizures (with enzyme inducing drugs e.g., Carbamazepine, Phenytoin, Phenobarbital, or Primidone) without Valproate:

  • Adult and child over 12 years: Initially 50 mg once daily for 14 days, then 50 mg twice daily for further 14 days, thereafter increased by maximum 100 mg/day in every 7-14 days; usual maintenance 300-500 mg daily in 2 divided doses.
  • Child 2-12 years: Initially 600 mcg/kg/day in 2 divided doses for 14 days, then 1.2 mg/kg/day in 2 divided doses for further 14 days, thereafter increased by maximum 1.2 mg/kg/day in every 7-14 days; usual maintenance 5-15 mg/kg/day in 2 divided doses (maximum 400 mg/day in 2 divided doses).

Monotherapy therapy of bipolar disorder (without enzyme inducing Drugs) without Valproate:

  • Adult over 18 years: Initially 25 mg once daily for 14 days, then 50 mg once daily for further 14 days, then 100 mg once daily for further 7 days; usual maintenance dose 200 mg once daily; maximum 200 mg daily.

Adjunctive therapy of bipolar disorder with valproate:

  • Adult over 18 years: Initially 25 mg on alternate days for 14 days, then 25 mg once daily for further 14 days, then 50 mg once daily for further 7 days; usual maintenance dose 100 mg daily; maximum 100 mg daily.

Adjunctive therapy of bipolar disorder (with enzyme inducing drugs with enzyme inducing drugs e.g., Carbamazepine, Phenytoin, Phenobarbital, or Primidone) without Valproate:

  • Adult over 18 years: Initially 50 mg once daily for 14 days, then 50 mg twice daily for further 14 days, then 100 mg twice daily for further 7 days, then 150 mg twice daily for further 7 days; usual maintenance 200 mg twice daily

Side Effects

Adult: Dizziness, headache, diplopia, ataxia, nausea, blurred vision, somnolence, rhinitis, pharyngitis, and rash.

Children: Vomiting, diarrhea, infection, fever, abdominal pain, and tremor.

Toxicity

The oral LD50 in mouse and rat is 205 mg/kg and 245 mg/kg, respectively.

Fatal cases of overdose of up to 15g of lamotrigine have been reported. Overdose with lamotrigine has been manifested by ataxia, nystagmus, increased seizures, decreased level of consciousness, coma, and intraventricular conduction delay. Though no known antidote exists for lamotrigine, hospitalization and general supportive measures should be employed in the case of a suspected lamotrigine overdose. Gastric lavage and emesis may be warranted with simultaneous protection of the airway. It is uncertain at this time whether hemodialysis is an effective means of removing lamotrigine from the sytemic circulation.

Precaution

  • Discontinue at the first sign of rash.
  • Blood dyscrasias (e.g., neutropenia, thrombocytopenia, pancytopenia): May occur, either with or without an associated hypersensitivity syndrome. Monitor for signs of anemia, unexpected infection, or bleeding.
  • Suicidal behavior and ideation: Monitor for suicidal thoughts or behaviors.
  • Aseptic meningitis: Monitor for signs of meningitis.

Interaction

  • Valproate increases lamotrigine concentrations more than 2-fold.
  • Carbamazepine, phenytoin, phenobarbital, primidone, and rifampin decrease lamotrigine concentrations by approximately 40%.
  • Estrogen-containing oral contraceptives decrease lamotrigine concentrations by approximately 50%.
  • Protease inhibitors lopinavir/ritonavir and atazanavir/lopinavir decrease lamotrigine exposure by approximately 50% and 32%, respectively.

Food Interaction

  • Take with or without food. The absorption is unaffected by food.

[Moderate] GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents.

Use in combination may result in additive central nervous system depression and
MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol.

Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Lamitrin ER Tablet (Extended Release) 50 mg Disease Interaction

Major: depression, rashModerate: suicidal tendency, blood dyscrasias, heart disease, meningitis, renal/liver disease, PKU

Volume of Distribution

The mean apparent volume of distribution (Vd/F) of lamotrigine following oral administration ranges from 0.9 to 1.3 L/kg and is independent of dose administered. Lamitrin ER Tablet (Extended Release) 50 mg accumulated in the kidney of the male rat, and likely behaves in a similar fashion in humans. Lamitrin ER Tablet (Extended Release) 50 mg also binds to tissues containing melanin, such as the eyes and pigmented skin.

Elimination Route

Lamitrin ER Tablet (Extended Release) 50 mg is rapidly and entirely absorbed with minimal first-pass metabolism effects, with a bioavailability estimated at 98%. Cmax is reached in the range of 1.4 to 4.8 hours post-dose, but this depends on the dose administered, concomitant medications, and epileptic status. The rate and extent of lamictal absorption is considered equivalent between the compressed tablet form taken with water to that of the chewable dispersible tablets, taken with or without water.

Half Life

The average elimination half-life of lamotrigine ranges from approximately 14-59 hours. The value is dependent on the dose administered, concomitant drug therapy, as well as disease status. One pharmacokinetic study revealed a half-life of 22.8 to 37.4 hours in healthy volunteers. It also reported that enzyme-inducing antiepileptic drugs such as pheobarbital, phenytoin, or carbamazepine decrease the half-life of lamotrigine. On the other hand, valproic acid increases the half-life of lamotrigine (in the range of 48-59 hours).

Clearance

The mean apparent plasma clearance (Cl/F) ranges from 0.18 to 1.21 mL/min/kg. The values vary depending on dosing regimen, concomitant antiepileptic medications, and disease state of the individual. In one study, healthy volunteers on lamictal monotherapy showed a clearance of about 0.44 mL/min/kg after a single dose.

Elimination Route

Lamitrin ER Tablet (Extended Release) 50 mg is excreted in both the urine and feces. Following oral administration of 240 mg radiolabelled lamotrigine, about 94% of total drug and its metabolites administered is recovered in the urine and 2% is recovered in the feces. One pharmacokinetic study recovered 43 to 87% of a lamotrigine dose in the urine mainly as glucuronidated metabolites. 2-N-glucuronide is mainly excreted in the urine.

Pregnancy & Breastfeeding use

Pregnancy category C. Either studies in animals have revealed adverse effects on the fetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the fetus.

Nursing Mothers: Lamitrin ER Tablet (Extended Release) 50 mg is present in milk from lactating women taking Lamitrin ER Tablet (Extended Release) 50 mg.

Contraindication

Hypersensitivity (e.g., rash, angioedema, acute urticaria, extensive pruritus, mucosal ulceration) to the drug or its ingredients.

Special Warning

Hepatic impairment: Dosage adjustments required in patients with moderate and severe liver impairment.

Renal impairment: Reduced maintenance doses may be effective for patients with significant renal impairment.

Acute Overdose

Symptoms: Nystagmus and muscle hypertonicity, QRS interval prolongation, low-grade fever, erythema, and periorbital oedema, generalised tonic-clonic seizures, tremor, muscle weakness, ataxia, hypertonia.

Management: Gastric lavage and activated charcoal.

Storage Condition

Store below 30°C. Protect from light and moisture. Keep out of the reach of children

FAQ

What is Lamitrin ER Tablet (Extended Release) 50 mg used for?

Lamitrin ER Tablet (Extended Release) 50 mg is a medication used to treat epilepsy and in regards to mental health, help the recurrence of depressive manic episodes in bipolar disorder. For epilepsy, this includes focal seizures, tonic-clonic seizures, and seizures in Lennox-Gastaut syndrome.

How safe is Lamitrin ER Tablet (Extended Release) 50 mg?

To date, there are no known problems associated with long term use of Lamitrin ER Tablet (Extended Release) 50 mg. It is a safe and effective medication when used as directed.

How safe is Lamitrin ER Tablet (Extended Release) 50 mg?

Lamitrin ER Tablet (Extended Release) 50 mg work by decreasing the intensity of irregular electrical activity in the brain.

What are the common side effects of Lamitrin ER Tablet (Extended Release) 50 mg?

Common side effects of Lamitrin ER Tablet (Extended Release) 50 mg are include:

  • loss of balance or coordination
  • double vision
  • blurred vision
  • uncontrollable movements of the eyes
  • difficulty thinking or concentrating
  • difficulty speaking
  • headache
  • drowsiness
  • dizziness
  • diarrhea
  • constipation
  • loss of appetite
  • weight loss
  • heartburn
  • nausea
  • vomiting
  • dry mouth
  • stomach, back, or joint pain
  • missed or painful menstrual periods
  • swelling, itching, or irritation of the vagina
  • uncontrollable shaking of a part of the body

Is Lamitrin ER Tablet (Extended Release) 50 mg safe during pregnancy?

Pregnancy registries have consistently demonstrated Lamitrin ER Tablet (Extended Release) 50 mg to be among the safest medications for a developing fetus, both in terms of fetal malformations and postpartum cognitive development.

Is Lamitrin ER Tablet (Extended Release) 50 mg safe during breastfeeding?

The results indicated that Lamitrin ER Tablet (Extended Release) 50 mg is a safe anti-epileptic drug for breastfeeding women with rare and usually mild adverse effects among neonates exposed to high milk concentration of this Lamitrin ER Tablet (Extended Release) 50 mg and its metabolites.

Can I drink alcohol with Lamitrin ER Tablet (Extended Release) 50 mg?

Yes, you can drink alcohol with Lamitrin ER Tablet (Extended Release) 50 mg. But it may make you feel sleepy or tired, and alcohol and hangovers can bring on seizures in some people with epilepsy. During the first few days of taking Lamitrin ER Tablet (Extended Release) 50 mg, it's best to stop drinking alcohol until you see how the medicine affects you.

Can I drive after taking Lamitrin ER Tablet (Extended Release) 50 mg ?

feeling drowsy, sleepy or dizzy as your body gets used to Lamitrin ER Tablet (Extended Release) 50 mg, these side effects should wear off. Do not drive, ride a bike or operate machinery until you feel more alert.

When is best taken of Lamitrin ER Tablet (Extended Release) 50 mg?

You can take it with or without food. If you take it twice a day, try to space your doses evenly through the day. For example, first thing in the morning and in the evening.

How often can I take Lamitrin ER Tablet (Extended Release) 50 mg?

It's usual to take Lamitrin ER Tablet (Extended Release) 50 mg once or twice a day.

Can I take Lamitrin ER Tablet (Extended Release) 50 mg on an empty stomach?

Lamitrin ER Tablet (Extended Release) 50 mg may be taken with or without food or on a full or empty stomach.

How long does Lamitrin ER Tablet (Extended Release) 50 mg take to work?

It usually takes around 6 weeks for lamotrigine to work properly.

How long does Lamitrin ER Tablet (Extended Release) 50 mg stay in my system?

Lamitrin ER Tablet (Extended Release) 50 mg will be out of your system after your last dose in about 338.8 hours (approximately 14 days). After multiple dosing of lamotrigine the elimination half-life is noted to be between 11.6 to 61.6 hours.

Can I take Lamitrin ER Tablet (Extended Release) 50 mg for a long time ?

Many people can take Lamitrin ER Tablet (Extended Release) 50 mg safely for several months or years. But there are some side effects that might happen over a long time. Long-term treatment with Lamitrin ER Tablet (Extended Release) 50 mg can cause osteoporosis and osteopenia, increasing your risk of breaking a bone.

What does Lamitrin ER Tablet (Extended Release) 50 mg do to the brain?

Lamitrin ER Tablet (Extended Release) 50 mg also binds and weakly inhibits several other signaling receptors in the brain, including those to which dopamine and serotonin normally bind.

Is Lamitrin ER Tablet (Extended Release) 50 mg bad for my liver?

Lamitrin ER Tablet (Extended Release) 50 mg is a widely used antiseizure medication that is a rare but well known cause of idiosyncratic liver injury, that can be severe and even fatal.

Does Lamitrin ER Tablet (Extended Release) 50 mg shorten my life?

Lamitrin ER Tablet (Extended Release) 50 mg decreased mortality and increased lifespan in parallel with a reduction in locomotor activity and a trend towards metabolic rate depression.

Can Lamitrin ER Tablet (Extended Release) 50 mg damage my kidneys?

Talk to your doctor if you have any concerns. Lamitrin ER Tablet (Extended Release) 50 mg may cause serious allergic reactions affecting multiple body organs (eg, liver or kidney).

Who should not take Lamitrin ER Tablet (Extended Release) 50 mg?

You should not take Lamitrin ER Tablet (Extended Release) 50 mg if you are allergic to it. Lamitrin ER Tablet (Extended Release) 50 mg may cause a severe or life-threatening skin rash, especially in children and in people who take a very high starting dose.

Can I stop taking Lamitrin ER Tablet (Extended Release) 50 mg?

Do not start or stop taking seizure Lamitrin ER Tablet (Extended Release) 50 mg during pregnancy without your doctor's advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention. Overdose symptoms may include blurred vision, problems with coordination, increased seizures, feeling light-headed, or fainting.

Will Lamitrin ER Tablet (Extended Release) 50 mg affect my fertility?

Lamitrin ER Tablet (Extended Release) 50 mg does not seem to affect sperm counts, motility, or sex hormones in men.

Can Lamitrin ER Tablet (Extended Release) 50 mg affects my heart?

Lamitrin ER Tablet (Extended Release) 50 mg can increase the risk of serious arrhythmias, which can be life-threatening, in patients with clinically important structural or functional heart disorders.

http://classyfire.wishartlab.com/tax_nodes/C0000000
http://classyfire.wishartlab.com/tax_nodes/C0002448
http://classyfire.wishartlab.com/tax_nodes/C0002279
http://classyfire.wishartlab.com/tax_nodes/C0000035
http://classyfire.wishartlab.com/tax_nodes/C0002564
http://classyfire.wishartlab.com/tax_nodes/C0001693
http://classyfire.wishartlab.com/tax_nodes/C0003886
http://classyfire.wishartlab.com/tax_nodes/C0001030
http://classyfire.wishartlab.com/tax_nodes/C0004107
http://classyfire.wishartlab.com/tax_nodes/C0004144
http://classyfire.wishartlab.com/tax_nodes/C0004139
http://classyfire.wishartlab.com/tax_nodes/C0002450
http://classyfire.wishartlab.com/tax_nodes/C0004557
http://classyfire.wishartlab.com/tax_nodes/C0001516
http://classyfire.wishartlab.com/tax_nodes/C0004150
https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:6367
http://www.hmdb.ca/metabolites/HMDB0014695
http://www.genome.jp/dbget-bin/www_bget?drug:D00354
https://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3878
https://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?sid=46505408
https://www.chemspider.com/Chemical-Structure.3741.html
http://www.bindingdb.org/bind/chemsearch/marvin/MolStructure.jsp?monomerid=50031299
https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=28439
https://www.ebi.ac.uk/chebi/searchId.do?chebiId=6367
https://www.ebi.ac.uk/chembldb/index.php/compound/inspect/CHEMBL741
https://zinc.docking.org/substances/ZINC000000013156
http://bidd.nus.edu.sg/group/cjttd/ZFTTDDRUG.asp?ID=DAP000039
http://www.pharmgkb.org/drug/PA450164
http://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=2622
http://www.rxlist.com/cgi/generic/lamotrigine.htm
https://www.drugs.com/cdi/lamotrigine.html
https://en.wikipedia.org/wiki/Lamotrigine
*** Taking medicines without doctor's advice can cause long-term problems.
Share