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Overview: Lamotrigine is a medicine that is used to manage certain types of seizures or bipolar disorder. The most common side effects of lamotrigine are dizziness, drowsiness, tremor, double/blurred vision, headache, trouble with balance and coordination, nausea, or vomiting. Tell your health care provider right away if you get a rash, fever, swollen lymph nodes, or feel depressed or short of breath. Do not stop this medicine without talking to your health care provider.

Uses

What is lamotrigine used for?

Lamotrigine is commonly used to treat certain types of seizures or bipolar disorder.

Lamotrigine may also be used for other conditions as determined by your health care provider.

How does lamotrigine work (mechanism of action)?

Lamotrigine seems to affect certain pathways and chemicals in the brain to calm brain activity, lowering your seizure risk and helping with mood changes in bipolar disorder.

How is lamotrigine supplied (dosage forms)?

Lamotrigine (Lamictal, Lamictal CD, Lamictal ODT, Lamictal XR) is available in the following dosage forms that are taken by mouth.

  • 25 mg, 50 mg, 100 mg, 200 mg, 250 mg, 300 mg extended-release oral tablets
  • 25 mg, 100 mg, 150 mg, 200 mg oral tablets
  • 2 mg, 5 mg, 25 mg tablets for oral suspension
  • 25 mg, 50 mg, 100 mg, 200 mg orally disintegrating tablets

How should I store lamotrigine?

Lamotrigine should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place and protect from light.

If you receive lamotrigine in a blister pack, do not remove tablets from blister packs until ready to take.

Side Effects

What are the most common side effects of lamotrigine?

The most common side effects of lamotrigine are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Dizziness and drowsiness
  • Tremor 
  • Double or blurry vision
  • Headache
  • Trouble with balance or coordination
  • Nausea, vomiting, diarrhea, or stomach pain
  • Runny nose, stuffy nose, or sore throat
  • Rash
  • Infection
  • Fever

There may be other side effects of lamotrigine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of lamotrigine?

While less common, the most serious side effects of lamotrigine are described below, along with what to do if they happen.

Severe Allergic Reactions. Lamotrigine can cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severe Skin Reactions. Lamotrigine can cause severe skin reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), that can lead to death if not treated. If you get a rash, call your health care provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Flu-like symptoms, including fever, chills, and muscle aches

Immune System Problem. Lamotrigine may cause a condition called hemophagocytic lymphohistiocytosis (HLH), which can cause inflammation throughout your body. Call your health care provider if you have any of the following symptoms.

  • Fever
  • Rash
  • Swollen lymph nodes
  • Coughing and trouble breathing
  • Stomach pain
  • Nausea and vomiting
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
  • Trouble walking
  • Changes in your vision
  • Headache

Blood Disorders. Lamotrigine can cause blood disorders, such as low levels of a type of white blood cell (called neutrophils) which is known as neutropenia, low white blood cell levels (leukopenia), low red blood cell levels (anemia), low platelet levels (thrombocytopenia), aplastic anemia, pancytopenia, and a condition where your bone marrow does not make enough normal red blood cells called pure red cell aplasia. Get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Suicidal Thoughts and Actions. Lamotrigine may cause suicidal thoughts or actions in a small number of people. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your health care provider right away if you have any of the following symptoms.

  • New or increased thoughts of suicide or death
  • Suicide attempt
  • New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior
  • Panic attacks
  • Difficulty sleeping
  • New or worsening irritability, aggression, anger, or violence
  • Impulsiveness
  • Talking more or faster than usual
  • Excessive happiness or an extreme increase in activity and talking (mania)

Meningitis. Lamotrigine may cause you to develop a condition called meningitis. People with meningitis have swelling around the protective lining around their brain and spine. Sometimes, medicines like lamotrigine can cause meningitis. You may be at a higher risk of this happening if you have a connective tissue condition, such as lupus. Call your health care provider right away if you have any of the following symptoms. 

  • Headache
  • Fever or chills
  • Nausea and vomiting
  • Stiff neck
  • Rash
  • Light sensitivity
  • Muscle pain
  • Confusion
  • Sleepiness

Status Epilepticus. Lamotrigine may cause a condition called status epilepticus, where your seizure lasts longer than expected or lasts for 5 minutes or longer. Get emergency help if you or a loved one experience a seizure that does not go away or lasts longer than usual. 

Death. Lamotrigine could, in very rare cases, contribute to your risk of sudden, unexpected death in epilepsy (SUDEP). This is a rare condition in which people with epilepsy die suddenly during a seizure. It is believed to be caused by heart or breathing problems. Talk to your health care provider about your risk and if you have concerns.

Warnings & Precautions

Who should not use lamotrigine?

Allergies to Ingredients. People who are allergic to any of the following should not take lamotrigine.

  • Lamictal
  • Lamictal CD
  • Lamictal ODT
  • Lamictal XR
  • Lamotrigine
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific lamotrigine products they stock.

What should I know about lamotrigine before using it?

Do not take lamotrigine unless it has been prescribed to you by a health care provider. Take it as prescribed. Do not stop taking lamotrigine without talking to your health care provider. Stopping lamotrigine suddenly can cause you to have seizures more often. Talk to your health care provider about how to stop lamotrigine slowly. 

Do not share lamotrigine with other people, even if they have the same condition as you. It may harm them.

Keep lamotrigine out of the reach of children.

It may take a few weeks to see the full effects of lamotrigine. Tell your health care provider if your seizures worsen or if you have any new types of seizures. 

Lamotrigine can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how lamotrigine affects you.

Do not chew, cut, or crush lamotrigine tablets, extended-release tablets, or orally disintegrating tablets (ODT). Talk to your health care provider if you are having trouble swallowing lamotrigine tablets. There is a tablet for oral suspension that you can crush, chew, or mix with liquid. If you chew the tablet for oral suspension, take it either with water or fruit juice mixed with water. You can also mix this type of tablet with liquid. To do this, take a glass or spoon with the tablet on it and add enough liquid to where it covers the tablet. Wait at least 1 minute or until the tablet is completely broken up, mix the tablet and liquid mixture, and take it right away.

If you have been prescribed lamotrigine orally disintegrating tablets (ODT), place the tablet on your tongue and move it around your mouth. Once the tablet has disintegrated, swallow it with or without water.

Tell your health care provider if you have any changes in your period (menstrual cycle) or have breakthrough bleeding between your periods, especially if you start or stop birth control. See the Interactions section for more details.

Lamotrigine can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how lamotrigine affects you.

What should I tell my health care provider before using lamotrigine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if lamotrigine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Depression, mood problems, or suicidal thoughts or behavior
  • Personal or family history of heart problems, including heart disease or heart rhythm problems
  • Blood disorders
  • Liver or kidney problems
  • An autoimmune disease, such as systemic lupus erythematosus

Allergies. Tell your health care provider if you have had a rash or allergic reaction to another medicine for seizures.

Meningitis. Tell your health care provider if you have taken lamotrigine in the past and had meningitis.

Other Medicines and Supplements. Lamotrigine may interact with other medicines and supplements. Before taking lamotrigine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how lamotrigine could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will advise you if you should take lamotrigine while you are pregnant or trying to get pregnant. If you become pregnant while taking lamotrigine, you can sign up for the North American Antiepileptic Drug Pregnancy Registry by calling 888-233-2334 or at www.aedpregnancyregistry.org. This registry collects safety information about the use of antiseizure medicines during pregnancy.

Breastfeeding. Lamotrigine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should take lamotrigine while breastfeeding. If you breastfeed while taking lamotrigine, monitor your baby for side effects. These may include breathing problems, excessive sleepiness, and trouble feeding. Tell your health care provider if you notice any of these things.

Interactions

Does lamotrigine interact with foods or drinks?

There are no known interactions between lamotrigine and foods or drinks.

It is unknown if drinking alcohol will affect lamotrigine. The risk of dizziness and drowsiness may increase if you drink alcohol while taking lamotrigine.

Does lamotrigine interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking lamotrigine.

  • A birth control pill, patch, vaginal ring, implant, injection, or intrauterine device (IUD) that contains hormones
  • Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • A barbiturate, such as phenobarbital or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Divalproex sodium, valproate sodium (Depakote and others), and valproic acid, which are medicines used for seizures and other conditions
  • Dofetilide (Tikosyn), which is a medicine used to help keep a normal heart rhythm in people who have had atrial fibrillation or atrial flutter

Some other medicines may alter the blood levels of lamotrigine, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with lamotrigine. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much lamotrigine?

If you or someone else has used too much lamotrigine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of lamotrigine?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.