Your guide to medication Lamotrigine

You and your doctor should talk about how long you need to take lamotrigine before you begin treatment with this medication.

If you take lamotrigine for bipolar disorder you will probably take it for at least six months (any shorter and your old symptoms can come back). If it works for you, you may take it for much longer than that.

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

You may have to take lamotrigine once or twice a day.

It doesn’t matter what time you take it each day – choose a time that you can always remember. This could be at mealtimes, or when you brush your teeth. You can take it before or after food.

If you are taking the tablets that you swallow whole, wash them down with a glass of water. Do not try and chew them – they will taste unpleasant.

If you are taking the orodispersible tablets (melts), get a glass of cold water and mix the tablet(s) in at least enough water to cover them. You can stir the drink to help them break up. 'Dispersible' doesn’t mean you will get a totally clear solution - it will look a little cloudy. Drink it all, and then add more water to the glass and drink that in order to make sure you get all the medicine in the tablet.

You can also chew the dispersible tablets, but it may help to rinse them down with some cold water.

You can still swallow the dispersible tablets whole with water if you prefer.

If you remember later during the day, take it as soon as possible. If you forget to take it by the time of the next dose, just start again with the next dose.

Do not take a double dose.

If you forget to take your tablets for a few days, you may start getting your old symptoms of low mood back.

Although you may not be taking your lamotrigine for seizures (fits), if you stop the medication suddenly, there is a chance you may have a seizure. This is because after taking lamotrigine for some time, your body will have got used to having an anticonvulsant (anti-seizure) medicine on board. Suddenly stopping the use of lamotrigine may therefore cause a seizure. But don't worry - this doesn't mean you are suddenly epileptic.

If you have stopped taking lamotrigine, you need to speak to your doctor so that you can safely start it again and build back up to your dose. It is best to be honest; they will help you get back on track.

If you are thinking of stopping treatment with lamotrigine, talk to your doctor before doing this.

If you have taken more lamotrigine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

While taking lamotrigine, some people may think about hurting themselves or taking their own lives. You must go straight to hospital with your medicine if you have any of these thoughts.

Lamotrigine can cause other serious side effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), skin rashes and other serious symptoms. Go to a hospital with your medicine if you get any of these symptoms.

Lamotrigine does not mix well with some other medicines and drugs. The contraceptive Pill can affect the level of lamotrigine in your blood. Talk to your doctor about this if you are on the Pill.

You might feel dizzy or have double vision in the first few days after taking lamotrigine. Do not drive a car, ride a bike or operate machines until you see how this affects you.

Use good contraception while you are taking lamotrigine. If you take it while you are pregnant, it is unlikely to affect the developing baby. However, it can cause symptoms in babies if you breastfeed while taking lamotrigine. Talk to your doctor or midwife about this and get their help.

If you have taken more lamotrigine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different. Go to A&E, and take your medicine with you to show the doctors. Tell them how much you have taken. Get a friend to go with you, if you can, just in case you feel ill on the way.

You might get any of the following symptoms:

• quick, uncontrollable body movements
• clumsiness and lack of co-ordination, causing problems with your balance
• heart rhythm changes
• loss of consciousness, convulsions/seizures (fits) or coma

While taking lamotrigine some people may think about hurting themselves or have thoughts of taking their own lives. This can happen to anyone, including people who are under 25. These thoughts may happen or get worse in the first few weeks of taking the medicine. You must go straight to hospital with your medicine if you have any of these thoughts and tell the doctor that you are taking lamotrigine. There are other medications you can take instead.

You should also go to a doctor or hospital straight away if you get any of the following symptoms:

• skin rashes or redness with blisters and peeling skin around the mouth, nose, eyes and groin/sex organs (genitals)
• peeling of large areas of skin (up to 30% - almost a third – of your body surface)
• ulcers in the mouth, throat, nose or around your groin/sex organs (genitals)
• red or swollen eyes
• a high temperature (fever), flu-like symptoms or drowsiness
• swelling around your face
• swollen glands in your neck, armpit or groin
• unexpected bleeding or bruising
• your fingers turning blue
• a sore throat
• more infections (such as colds) than usual

If these reactions occur, they tend to be during the first eight weeks of taking lamotrigine.

Some side effects that appear should get better after a few days. If they do not, you should go back to your doctor.

Do not stop taking the tablets until you talk to your doctor, or you may get withdrawal symptoms as well.

Very common side effects of taking lamotrigine (affecting more than one in ten people) include:

• headaches
• skin rashes

Common side effects of taking lamotrigine (affecting up to one in ten people) include:

• feeling aggressive, agitated or irritable
• feeling sleepy, tired or drowsy
• insomnia (having difficulty sleeping)
• feeling dizzy
• shaking or tremors
• diarrhoea (loose poo)
• dry mouth
• nausea (feeling sick) or vomiting (being sick)
• having pain in your back or joints, or elsewhere

There are other side effects that you can get when taking this medicine; we have only included the most common ones here.

Please look at the leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know whether you are getting a side effect from your medicine.

If you do get a side effect, please think about reporting it via the Yellow Card Scheme.