{"id":4130,"date":"2025-03-31T18:11:58","date_gmt":"2025-03-31T18:11:58","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/lamotrigine-txt\/"},"modified":"2025-03-31T18:11:58","modified_gmt":"2025-03-31T18:11:58","slug":"lamotrigine-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/lamotrigine-txt\/","title":{"rendered":"Lamotrigine.txt"},"content":{"rendered":"

Lamotrigine <\/h1>\n

CLINICAL USE <\/H3>
\nMonotherapy and adjunctive treatment of partial seizures, and primary and secondary generalised tonic-clonic seizuresTrigeminal neuralgia (unlicensed)

DOSE IN NORMAL RENAL FUNCTION <\/H3>25\u2013200 mg daily in 1\u20132 divided doses, according to clinical indication. Maximum 500 mg daily; 700 mg with enzyme-inducing drugs

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :256.1<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :55<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp :
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :0.92\u20131.22<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :24\u201335\/Unchanged

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Caution. Start with low doses and monitor closely
  • 10 to 20 &nbsp &nbsp : Caution. Start with low doses and monitor closely
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Caution. Start with low doses and monitor closely

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely dialysability. Dose as in GFR <10 mL\/min. <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR 10 to 20 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Antibacterials: concentration reduced by rifampicin\n
  • Antidepressants: antagonism of anticonvulsant effect\n
  • Antimalarials: mefloquine antagonises anticonvulsant effect; chloroquine and hydroxychloroquine occasionally reduce seizure thresholdOestrogens and progestogens: concentration of lamotrigine reduced and the dose may need to be increased by as much as 2-fold

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Oral

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>\u2013

    OTHER INFORMATION <\/H4>There is no experience of treatment with lamotrigine in patients with renal failure. Pharmacokinetic studies using single doses in subjects with renal failure indicate that lamotrigine pharmacokinetics are little affected, but plasma concentrations of the major glucuronide metabolite increase almost 8-fold due to reduced renal clearanceThe 2-N-glucuronide is inactive and accounts for 75\u201390% of the metabolised drug present in the urine. Although the metabolite is inactive the consequences of accumulation are unknown; hence the company advise caution with the use of lamotrigine in renal impairmentThe half-life of lamotrigine is affected by other drugs; reduced to 14 hours when given with enzyme-inducing drugs, e.g. carbamazepine and phenytoin, and is increased to approximately 70 hours when co-administered with sodium valproate alone.
    \n","protected":false},"excerpt":{"rendered":"

    Lamotrigine CLINICAL USE Monotherapy and adjunctive treatment of partial seizures,<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4130","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4130","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4130"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4130\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4130"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4130"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}