Epileptal

Epileptal belongs to a subgroup of medicines that are used to treat epilepsy. Its active ingredient is the substance lamotrigine.

The lamotrigine component has a pronounced anticonvulsant effect. It can be used not only as a means of monotherapy, but also in combination treatment with other anticonvulsants. The drug blocks the excessive release of neurotransmitters, mainly glutamic acid, which is a key element in the development of epileptic seizures. [1]

Indications Epileptal

It is used for therapy in such cases:

• as a means of monotherapy for epilepsy ;
• adjunctive treatment of epilepsy - for example, tonic-clonic, generalized or partial seizures, but also seizures caused by SLH;
• monotherapy for typical forms of minor epileptic seizures;
• in adults with bipolar disorders .

In addition, it is prescribed to prevent the development of emotional disorders (mania, depression, hypomania, mixed conditions) in people with bipolar disorders.

Release form

The release of a therapeutic substance is made in the form of tablets with a volume of 0.025, 0.05, 0.1 g, 30 pieces each inside a cell package.

Pharmacodynamics

Lamotrigine is able to block the activity of voltage-gated Na channels that reside within the nerve walls of the presynaptic. At the same time, the neural walls are at a stage during which slow inactivation occurs.

In addition, a volumetric release of glutamic acid is carried out in excess of normal values. [2]

Pharmacokinetics

When taken orally, the drug at high speed is fully absorbed inside the gastrointestinal tract. Plasma Cmax levels are observed after approximately 2.5 hours. The term for its achievement may increase after eating (the degree of absorption does not change). When consumed up to 0.45 g of the substance, the pharmacokinetic characteristics remain linear.

Protein synthesis - about 55%. Distribution volume indicators - within 0.92-1.22 l / kg. [3]

Intrahepatic metabolic processes occur with the help of the enzyme glucuronyl transferase with the formation of N-glucuronide. In an adult, the average clearance values are 39 ± 14 ml per minute. The substance is excreted in breast milk at a concentration of 40-60% of plasma values.

The half-life is 29 hours, regardless of the dose size of the drug. Excretion is mainly in the form of glucuronides; part of the substance is excreted in the urine unchanged (<10%). Another 2% is excreted in faeces.

Dosing and administration

You need to take Epileptal tablets with plain water. The portion size is selected and changed by the attending physician, taking into account the course of the pathology. The doctor also determines the form of treatment - mono- or combined therapy. The tablet, if necessary, can be divided into halves.

Adolescents over the age of 12 and adults are often prescribed a portion of 25 mg, used once a day, over a period of 14 days. Further, the dosage is increased to 50 mg, with the intake for another 14 days. Further, the portion is increased at 1-2 week intervals until the desired drug effect is obtained. The average maintenance serving size is 0.1-0.2 g per day (use in 1-2 applications). It is allowed to consume no more than 0.5 g of drugs per day.

For a child 2-12 years old, the portion is selected in a proportion of 0.3 mg / kg per day. Dosage increases by doubling are made at 2-week intervals. The serving is increased by 0.6 mg / kg. You need to use it in 1-2 applications. The maintenance dosage is in the range of 1-15 mg / kg per day. The portion can be increased as needed.

In the case of combined treatment, the initial portion used in monotherapy is used, but during the first 2 weeks it is consumed every other day. Further, the use is continued as in monotherapy - a daily intake of 25 mg. It is necessary to increase the portion by 25 mg at 2-week intervals, reaching a maintenance level of 0.1-0.2 g per day, which is used in 1-2 uses.

When using other anticonvulsants or other drugs that induce the secretion of lamotrigine, the portion can be increased to 50 mg per day; with a gradual increase, the dosage can reach the highest rate of 0.7 g per day.

For persons using oxcarbazepine (without any other inhibitors or inducers of lamotrigine glucuronidation), the size of the initial portion is 25 mg once a day for a period of 14 days; then - 50 mg once a day during the next 2 weeks. Then the dosage is increased (by a maximum of 0.05-0.1 g per day) at 1-2 week intervals until the optimal medicinal effect is obtained. The standard maintenance dosage is 0.1-0.2 g per day in 1-2 applications.

• Application for children

The medicine can be used in persons over 2 years of age.

Use Epileptal during pregnancy

Epileptal is not prescribed during pregnancy.

If you need to use the medication during lactation, you need to stop breastfeeding for the period of treatment.

Contraindications

It is contraindicated to prescribe with strong sensitivity in relation to any of the constituent elements of the medication.

Side effects Epileptal

The main side effects:

• epidermal rashes, heating elements, SSD;
• hematological disorders, including thrombocyto-, leuko-, pancyto- or neutropenia, agranulocytosis and anemia (also aplastic);
• lymphadenopathy, fever, hepatic dysfunction, changes in blood counts, facial edema, disseminated intravascular coagulation and multiple organ failure;
• irritability, confusion, aggressiveness, hallucinations, and tics;
• dizziness, ataxia, loss of balance, tremor, cephalalgia, movement disorders, insomnia, nystagmus, choreoathetosis, anxiety, increased frequency of attacks, extrapyramidal signs and exacerbation of tremors;
• "Veil" in the eyes, diplopia, conjunctivitis;
• diarrhea, nausea and vomiting;
• failure of the liver;
• arthralgia, fatigue, back pain.

Overdose

In case of poisoning, nystagmus, ataxia, coma and disturbance of consciousness can be noted.

It is required to perform gastric lavage, prescribe the intake of sorbents, monitor the patient's condition and, if necessary, carry out standard symptomatic procedures.

Interactions with other drugs

Valproic acid substances reduce the rate of metabolic processes of Epileptal, increasing its half-life to 45-55 hours in a child and 70 hours in an adult.

Carbamazepine, primidone, phenytoin, phenobarbital and paracetamol increase the rate of drug metabolism, reducing its half-life by half.

The use together with carbamazepine increases the incidence of certain side symptoms (ataxia, blurred vision, dizziness, nausea, diplopia). They disappear when the dosage of carbamazepine is reduced.

Storage conditions

The epileptal should be kept in a place out of the reach of children and moisture penetration. Temperature indicators - no more than 25 ° С.

Shelf life

Epileptal can be used within 36 months from the date of manufacture of the therapeutic substance.

Analogs

Analogs of the drug are Lamictal with Lamotrin, as well as Latrigil with Lamitril.