Lamotrigine

It can take time to build up to the dose that is right for you, so it may take one to two months before you start to feel positive benefits. This can continue to improve over the next few months.

You will need to start with a low dose and gradually increase it every few days or weeks until you and your doctor find the dose that is right for you. It may take up to six weeks to do this, by which time you should be a on a stable, long-term dose and have seen some helpful results from the medication.

It is important not to hurry the dosing timetable as doing so can increase your chances of getting side effects, which may include a serious skin reaction.

A common side effect of lamotrigine is a dry mouth. Over a long time, this can increase your risk of developing tooth decay or gum disease. Make sure you brush your teeth well and have regular dental check-ups. Speak to your dentist, doctor or pharmacist about things you can do to help.

You may want to let your family and friends know you are taking lamotrigine so they can support you and help you look out for side effects.

Lamotrigine may make you feel very drowsy or sleepy when you start taking it. It may also make it difficult for you to get to sleep.

If these symptoms carry on for a long time, or if this is difficult for you, talk to your doctor or pharmacist about other medicines you could take.

Alcohol

It may be possible to drink some alcohol in moderation while taking lamotrigine but having the two together might make you very sleepy and unsteady on your feet.

During the first few weeks of treatment, it might be best to stop drinking alcohol until you see how the medicine affects you.

Drinking alcohol every day, or in large amounts, can make your symptoms worse and may mean you won’t get the maximum benefit from your medication.

Street drugs

We do not know how street drugs affect lamotrigine, but all these drugs affect the way the brain works so they may not mix well and it’s best to be cautious. There is no regulation of street drugs or ‘legal highs’, so even if there are no known issues with the medication you take, the supply you receive might be mixed with other substances that could be dangerous.

Lamotrigine can produce a false positive test for phencyclidine (PCP) on a urine drug screen. Talk to your doctor about this if it is a problem for you.

Get more advice on drugs and alcohol.

Lamotrigine does not mix well with some other medicines, including some vitamins and herbal remedies. They may affect the way in which they work and increase the risk of side effects.

Tell your doctor if you are taking any other medications including over-the-counter medicines for common illnesses and things you put on your skin.

Special information about contraceptive pills containing oestrogen:

• When lamotrigine is taken with any type of the pill (oral contraceptive) containing oestrogen, it lowers the level of lamotrigine that you have in your body.
• If you have a pill-free week, the levels of lamotrigine will then rise, which may give you side effects.
• If you take the pill without a break, it will make your lamotrigine levels stable. You will not be harmed by not having the break.
• Talk to your doctor or pharmacist before you start taking lamotrigine if you also take the pill.
• The morning-after pill does not affect the level of lamotrigine in your body as it does not contain oestrogen.

Look at the leaflet inside your medicine box for more information about other medicines that can interact with lamotrigine. With some medicines your doctor may need to adjust the dose of your medicines if you take them together. Ask a doctor or pharmacist for more information if you have any questions.

Lamotrigine tablets have lactose in them which may not suit people who have a problem drinking milk or eating certain sugars. Talk to your doctor or pharmacist about this if you think it could be a problem for you.

The liquid contains para hydroxybenzoates which may cause allergic reactions.

Always let your pharmacist know if you have any food allergies or intolerances, and always check with them if you’re concerned about any of the ingredients in your medication.

If you need to avoid animal products, please note that non-active ingredients used in the production of medicines may sometimes be of animal origin. Ask your pharmacist if you have any questions about the ingredients.

Further information about practical considerations for medicines if you need to avoid animal products can be found on the Vegan Society website.

Do not drive a car or ride a bike just after you start taking lamotrigine.

Taking lamotrigine may make you feel dizzy and may affect your eyesight (possibly causing blurred or double vision) when you start taking it or sometimes after an increase in dose.

This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus. It might be best to stop doing these things for the first few days, until you know how it affects you.

Most people drive as normal while taking lamotrigine. It you are worried about this or have any concerns you would like to discuss, speak to your doctor or pharmacist.

It is illegal to drive after taking medication if your ability to drive safely is impaired.

You must tell The DVLA (Driver and Vehicle Licensing Agency) if you have bipolar disorder, schizophrenia, schizoaffective disorder or other mental health conditions that could affect your driving.

You can be fined if you do not tell The DVLA about a medical condition that affects your driving and may be prosecuted if you are involved in an accident as a result.

Pregnancy

Studies of over 7,500 women taking lamotrigine showed no increase in problems during the early stages of pregnancy.

If you do become pregnant while you are on lamotrigine, you should carry on taking your medication and speak to your doctor about this as soon as possible. They can discuss the benefits and risks of continuing lamotrigine and help you make a decision that is best for you and your baby. They may refer you to a specialist perinatal mental health team to support you with this decision. You can find out more information about taking lamotrigine during pregnancy at Bumps (Best Use of Medicines in Pregnancy).

Untreated mental illness, like bipolar disorder, can also be harmful to you and your developing baby, so decisions about stopping or avoiding medication when you are pregnant need to be discussed carefully with your doctor. If you and your doctor agree that it is best for you to continue taking lamotrigine while pregnant, you should tell your midwife. If you are planning to get pregnant. It is recommended that you take folic acid while you are trying for a baby and during pregnancy,

From month four onwards in your pregnancy you might need a higher dose of lamotrigine to keep the level of the medication in your body constant. After giving birth, your lamotrigine dose will go back to what it was before.

If you are taking lamotrigine for epilepsy, any dose increases may be made based on the results of your blood level tests. Your doctor will help you make sure that you have the right levels you need.

Post-natal

Some new born babies whose mothers take lamotrigine during pregnancy can get withdrawal symptoms at birth and soon after, like breathing problems and restlessness.

Tell your midwife you are taking lamotrigine, so that they can help if the baby has any symptoms after birth.

Breastfeeding

Lamotrigine can be passed to the baby in breastmilk. The amount can vary dependent on how much the mother has taken.

If your baby was born early, then breastfeeding while you are taking lamotrigine may not be recommended. Talk to your midwife and doctor about feeing options.

If you breastfeed while taking lamotrigine, seek urgent medical advice if your baby becomes restless, very sleepy or develops feeding problems.

Talk to your doctor or midwife about the benefits and risks of breastfeeding whilst taking this medication to help you make the decision that is best for you and your baby.

There is no evidence to suggest that lamotrigine will affect your fertility.

Talk to your doctor about your lamotrigine if you are trying to get pregnant or planning a family.

Lamotrigine is not a banned substance in sport.

Most people play sports as normal while taking lamotrigine, but if lamotrigine affects your concentration, eyesight or co-ordination, then you may want to wait to see if those effects go away before playing spots that need a lot of focus. If you have any concerns, discuss this with your doctor.

Lamotrigine may affect your concentration, give you blurred eyesight, and make you feel dizzy and tired.

Ideally it is best not to take lamotrigine for the first time just before your exams,

It’s not possible to predict how the medication will make you feel, and if you do get any side effects, these are more likely to occur when you first start taking lamotrigine.

You should talk to your doctor about any future exams if you are starting lamotrigine. You might decide together to delay starting it until you have done them.

If they are more than a month away, however, you might find that it is better to start lamotrigine to improve your sleep, motivation and ability to study.

Most people take exams as normal while taking lamotrigine, but if you have concerns, discuss this with your doctor.