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Lamictal (Lamotrigine) Buyer and Patient Handbook - South Africa

What is Lamictal?

Lamictal is the brand name for lamotrigine, an anticonvulsant that also works as a mood-stabilising agent. It is mainly used to treat bipolar disorder (preventing mood swings) and to manage certain types of partial seizures. The product is authorised by the SA Health Products Regulatory Authority (SAHPRA) and is supplied as a tablet (pill).

Who Should Use Lamictal?

• Adults diagnosed with bipolar I or II disorder who need mood-stabilisation.
• Individuals aged ≥ 12 years with partial-onset Seizures, when other options are unsuitable.
• Patients who have responded to lamotrigine in the past and require a consistent formulation.

How Does It Work?

Lamotrigine blocks voltage-gated sodium channels in nerve cells, reducing the release of excitatory neurotransmitters such as glutamate. This stabilises neuronal firing, which helps to prevent the rapid mood shifts seen in Bipolar Disorder and to stop seizure activity. The medication does not produce a “high” and has a low potential for abuse.

Why Choose Lamictal?

• Proven efficacy for both mood-stabilisation and seizure control.
• Once-daily dosing simplifies routine adherence.
• A well-studied safety profile compared with older mood stabilisers.
• Generic lamotrigine tablets are available, offering a cost-effective alternative while delivering the same therapeutic effect.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

*Titration is essential to minimise skin-rash risk; follow the schedule advised by your pharmacist.

How to Take

• Swallow the tablet whole with a full glass of water.
• Can be taken with or without food, but maintain the same routine each day.
• Do not crush, chew, or split extended-release tablets (if prescribed).

Missed Dose

• If you miss a dose by less than 12 hours, take it as soon as you remember.
• If more than 12 hours have passed, skip the missed dose and resume your regular schedule. Do not double-dose.

Overdose

• Call emergency services (112 in South Africa) immediately.
• Symptoms may include severe dizziness, uncontrolled seizures, or loss of consciousness.
• Bring the medication packaging to aid medical staff.

Special Populations

• Elderly: Start at the lowest dose (25 mg) and increase slowly.
• Children ≥ 12 years: Dosing is weight-based; the same titration schedule applies.
• Renal or hepatic impairment: Reduce starting dose and extend titration intervals; monitor blood levels if possible.

Lifestyle & Diet

• Avoid abrupt discontinuation; taper under professional guidance to prevent seizure recurrence or mood destabilisation.
• Grapefruit juice does not significantly affect lamotrigine, but maintain consistent dietary habits.
• Alcohol does not interfere with efficacy, but excessive drinking may worsen mood symptoms.

Precautions and Warnings

• Skin rash: May progress to Stevens-Johnson syndrome; seek medical help if a rash appears.
• Pregnancy: Lamotrigine is generally considered safer than many alternatives, but discuss risks with a specialist.
• Suicidal thoughts: Monitor mood closely, especially during the first few weeks of therapy.
• Kidney or liver disease: Dose adjustments required.

Drug Interactions

Potential Side Effects

Common Side Effects

• Headache
• Dizziness
• Nausea
• Mild Fatigue

Less Common Side Effects

• Blurred vision
• Tremor
• Insomnia

Serious Side Effects

• Severe skin rash or blistering (Stevens-Johnson syndrome) - stop medication and seek urgent medical care.
• Mood worsening or emergence of suicidal thoughts - contact a health professional immediately.

Who Should Avoid This Medication?

• Individuals with a known hypersensitivity to lamotrigine or any tablet component.
• Patients who have previously experienced a serious rash from lamotrigine.
• Those currently taking other medications that significantly interact without dose adjustment.

Storage Instructions

• Keep tablets in the original blister pack until use.
• Store at 15 °C-30 °C; protect from moisture and direct sunlight.
• Keep out of reach of children and pets.

Lamictal Alternatives

Frequently Asked Questions

How long does it take for Lamictal to start working?

Most patients notice mood-stabilising effects after 2-4 weeks, while seizure control may become evident within 1-2 weeks of reaching a therapeutic dose.

Can I take Lamictal with my coffee?

Yes. Caffeine does not affect lamotrigine levels, so you may continue your usual coffee consumption.

Will alcohol affect Lamictal?

Moderate alcohol use does not change lamotrigine’s effectiveness, but excessive drinking can aggravate mood symptoms and should be avoided.

What should I do if I develop a rash?

Stop the medication immediately and seek urgent medical attention, even if the rash seems mild.

Is Lamictal safe during breastfeeding?

Lamotrigine passes into breast milk in small amounts; discuss risks and benefits with your healthcare provider.

Can I switch from brand Lamictal to a generic?

Yes, provided the generic is approved by SAHPRA; the therapeutic effect should be equivalent.

Do I need regular blood tests while on Lamictal?

Routine therapeutic drug monitoring is not mandatory, but periodic liver and kidney function tests are advisable.

What happens if I miss several doses?

Contact a pharmacist or doctor for a personalized taper-restart plan; do not self-adjust the dose.

Is there any special monitoring for the elderly?

Start at the lowest dose and increase slowly; watch for dizziness and falls.

Can Lamictal be taken with other mood stabilisers?

Combining with other mood stabilisers is possible but requires careful dose coordination to avoid side-effects.

Glossary

• Anticonvulsant: A drug that prevents or reduces the severity of seizures.
• Mood stabiliser: Medication that helps keep mood swings within a normal range.
• Stevens-Johnson syndrome: A rare, potentially life-threatening skin reaction.
• Titration: Gradual adjustment of a medication dose to reach the optimal therapeutic level.
• Therapeutic drug monitoring: Measuring drug concentrations in the blood to ensure effectiveness and safety.

Disclaimer

The information provided here is for general educational purposes only and does not constitute medical advice. Off-label uses are not discussed; any such consideration should be made in consultation with a qualified health professional. Our online pharmacy service offers convenient ordering and delivery of SAHPRA-approved medicines, but you remain responsible for confirming suitability, dosage, and monitoring with your own clinician. Always seek professional guidance before starting, stopping, or altering any medication.