Lamelope

Lamolep is an anticonvulsant medication.

Indications Lamelope

The drug is used in monotherapy, as well as complex treatment of attacks of generalized and focal type (this includes epileptic seizures of a myoclonias-astatic nature) in adolescents and adults.

Children within 2-12 years old should take drugs as an adjunct to suppress seizure syndrome.

It is possible to use Lamolep for monotherapy only when control over the intensity and frequency of seizures occurs.

It is used in the treatment of typical forms of absences.

It helps to suppress depressive stages in adults suffering from bipolar disorders.

Release form

Release occurs in tablet form of 25, 50 and 100 mg.

Pharmacodynamics

The drug acts by blocking the activity of potential-dependent Na channels, and in addition to stabilizing the walls of neurons and suppressing the release of 2-aminopentaneic acid, which is the most important participant in the formation of epileptic seizures.

Pharmacokinetics

Intestinal absorption of lamotrigine is carried out fairly quickly and fully. The maximum level inside the plasma is noted about 2.5 hours after ingestion of the pill. The peak period is extended when consumed with food, but the rate of absorption does not change.

Oral dosage up to 450 mg has linear pharmacokinetics. Protein synthesis inside the plasma is approximately 55%, and the distribution volume is 0.92-1.22 l / kg.

The substance is metabolized by the enzyme glucuronyl transferase. The pharmacokinetic parameters of other anticonvulsants are not related to lamotrigine. The average level of clearance of a substance in adults is 39 ± 14 ml / minute.

In the process of metabolism, the substance disintegrates to glucuronides, which are excreted in the urine. Less than 10% of the unchanged substance is excreted in the urine, and another 2% is excreted in the feces. The half-life and the level of drug clearance do not depend on the portion of the substance consumed inside.

In children (especially under 5 years old) the clearance of the drug relative to weight is higher. In comparison with an adult, a child also has a shorter half-life of drugs.

The average values of the coefficient of clearance of the drug in people with renal insufficiency in a chronic degree, as well as those who undergo hemodialysis procedures, make up 0.42 ml / minute / kg (in people with chronic renal failure), as well as 0.33 ml / minute / kg ( if used between hemodialysis sessions) and 1.57 ml / min / kg (for individuals undergoing hemodialysis). In relation to this, the average half-life is 42.9 / 57.4 / 13 hours.

A 4-hour hemodialysis session allows you to withdraw about 20% of lamotrigine. Therefore, in the case of a person having renal diseases, the size of the initial dose of the drug is determined taking into account the standard scheme of use of anticonvulsants. If there are disorders in the work of the kidneys in a severe degree, the maintenance dose is reduced.

The average values of the drug clearance ratio in people with disorders in the liver (at stages A, B or C according to Child-Pugh) are, respectively, 0.31 / 0.24 / 0.1 ml / minute / kg.

Dosing and administration

It is required to use Lamolep, without chewing, swallowing the taken pill entirely. Since the tablets are soluble, you can wash them down with a small amount of liquid.

If the size of the dose in a child under 12 years old or when there are problems with the excretory function, that is, when the dose taken is different in size from the active component of the whole tablet, it is required to use minimally effective portions of drugs.

Monotherapy in the treatment of epilepsy in adolescents and adults is carried out according to the following scheme: in the initial 2 weeks of the course, take a single dose of 25 mg of drugs a day, and in the next 2 weeks, 50 mg of the same dose. After that, the dosage is titrated until the maximum significant drug effect is obtained. Maintenance treatment occurs with dosages of 100–200 mg / day, and in individual patients, it can go up to 500 mg.

When combined with sodium valproate during epileptic syndrome, a small dose reduction of Lamolep is necessary. It is necessary to take the medicine during the initial 2 weeks on 25 mg every other day, and then every day in the same dosage for 2 more weeks. After that, the daily dose of drugs is increased by 25-50 mg, and take it until improvement begins. The size of the stabilizing dosage is 100-200 mg / day (the portion is divided into 2 uses).

Complex treatment of epilepsy attacks, in which, apart from Lamolep, includes drugs that stimulate the activity of liver enzymes, during the initial 2 weeks, take 50 mg of the drug every day. In the period of a further 14 days, the serving size doubles. A month after the start of the course, the daily dosage of the drug comes up to 100 mg, which is taken in 2 doses. To maintain the medicinal effect, take 200-400 mg of medicine per day.

The size of the initial dosage of drugs for children 2-12 years in combination with sodium valproate or other anticonvulsants is 0.15 mg / kg per day. In such portions, the medication is consumed for 14 days. During the next 14 days, you need to take 0.3 mg / kg / day. Then the dosage of the drug is increased every day by 0.3 mg / kg, until improvements are noted. At the same time, the size of the maintenance portions reaches 1-1.5 mg / kg / day with a 2-time intake. For this category of treatment, the maximum daily dose should not exceed 200 mg.

With the combination of drugs with other anticonvulsants (among them, stimulators of hepatic enzyme activity), children 2-12 years old first (for 14 days) should be taken 0.6 mg / kg per day, and then, in the period 14 more ti days, 1.2 mg / kg per day. Next, the dosage is titrated until you get a lasting effect of the drug.

Combined treatment using Lamictal and anticonvulsant drugs (slowing down the activity of liver enzymes) in bipolar disorders for adolescents and adults begins with taking 25 mg of the drug every other day for 14 days. In the next 14 days, you must take the drug in the same dose, but every day. The stabilizing portion is 100 mg. It can not be higher than the maximum daily, which is 200 mg.

When a drug is combined with activators of liver enzymes, it is necessary to double its doses (compared with combination therapy with drugs that slow down liver proteases).

If the parameters of the interaction of the drug and other prescribed anticonvulsants are not known, it is required to use a treatment regimen similar to a monotherapeutic one.

[1]

Use Lamelope during pregnancy

The test results show that with monotherapy in the 1st trimester, there was no increase in the overall likelihood of developing congenital anomalies, but some sources show an increase in situations when anomalies are observed in the oral cavity. Because of this, the use of Lamolep in pregnancy is allowed only in cases where the probability of benefits for a woman is higher than the risk of negative effects in the fetus.

Different indicators of lamotrigine are noted inside the mother's milk, and the overall level of medication in a child at times reaches 50% of the indicator of the substance inside the mother’s body, which can be the reason for the development of the drug’s drug effects. In this regard, it is necessary to carefully evaluate the benefits of breastfeeding and the likelihood of the risk of negative symptoms in the infant.

Contraindications

The absolute contraindication to the use of drugs are people suffering from intolerance to the elements of the drug.

Caution Lamolep is prescribed for people with renal insufficiency.

Side effects Lamelope

Taking the medication may cause some side effects:

• skin lesions: allergic-type exanthema may develop, sometimes reaching PET or Stevens-Johnson syndrome;
• hematopoietic dysfunction disorders: decrease in cellular content in hemopoiesis sprouts;
• immune disorders: the development of lymphadenopathy, and in addition to this symptoms of EHRT;
• disorders of the central nervous system: problems with vision, consciousness and balance. With a sharp abolition of the use of drugs may be a withdrawal syndrome - in the form of an increase in seizures seizures;
• problems in the gastrointestinal tract and hepatobiliary system: disorders of the stool, manifestations of dyspepsia and a decrease in the activity of liver enzymes.

When receiving an insufficiently effective dose of drugs, it is possible to sludge blood cells inside the vessels and develop rhabdomyolysis or SPON.

Overdose

Lamolep poisoning can cause nausea with dizziness, problems with coordination or vision, cranial, and loss of consciousness.

To remove signs of overdose, it is necessary to perform detoxification procedures, including gastric lavage.

Interactions with other drugs

Due to competitive hepatic metabolism, use with sodium valproate reduces the rate of absorption of Lamolep.

The combination of medication with carbamazepine increases the likelihood of side effects.

Anticonvulsants, hormonal-type contraceptives, and paracetamol double the rate of metabolism and excretion of Lamolep.

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Storage conditions

Lamolep should be kept in a place closed to small children. The temperature level is no more than 30 ° C.

Special instructions

Reviews

Lamyctal has enough polar reviews, in which there is no unequivocally positive or negative opinion about the drug, its safety and effectiveness. This is due to the fact that lamotrigine is the constituent of drugs, and it is necessary to select similar preparations individually - both the sizes of doses, and the drugs themselves.

People who Lamictal approached, consider it a fairly effective tool. Of the negative aspects, often note negative reactions in the form of rashes on the skin, which usually pass on their own.

Shelf life

Lamolep is allowed to use in the period of 3 years from the date of manufacture of the drug.

Reviews

Lamolep has rather polar reviews, in which there is no unequivocally positive or negative opinion about the drug, its safety and effectiveness. This is due to the fact that the component of the drug is lamotrigine, and these drugs must be selected individually - as the size of the doses, and the drugs themselves.

People whom Lamolep approached, consider it a fairly effective means. Of the negative aspects, negative reactions are often noted in the form of lesions on the skin, which usually disappear on their own.