Lamitril

Lamitril is an anticonvulsant, often used in the case of ineffectiveness of other drugs used in a variety of convulsive seizures.

Indications Lamitril

Among the indications: generalized, as well as focal tonic-clonic seizures (mainly used in the presence of resistance to other anticonvulsants).

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Release form

Produced in the form of tablets in a volume of 25 mg (in a vial of 30 such tablets) or 100 and 150 mg (in a vial of 60 such tablets).

Pharmacodynamics

Lamotrigine blocks the potential-dependent sodium channels located in the presynaptic neuronal membranes. This is due to slow deactivation, as well as suppression of excess released glutamate (this amino acid is one of the main factors provoking the development of an epileptic seizure).

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Pharmacokinetics

After oral administration, the drug is absorbed fairly quickly from the digestive tract, and the peak concentration in the blood plasma reaches 2.5 hours later.

The active substance is actively metabolized, the main product of disintegration is N-glucoronide. The average half-life is 29 hours. Excretion occurs mainly in the form of metabolites, and some part is excreted unchanged (mainly along with urine). The half-life of children is shorter than that of adult patients.

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Dosing and administration

The initial single dose for oral administration (children 12+ years, as well as adults) is 25-50 mg. With maintenance treatment, 100-200 mg per day. It is sometimes necessary to prescribe dosages of 500-700 mg per day.

The initial dosage for children of 2-12 years is 0.2-2 mg / kg per day, and with maintenance treatment 1-15 mg / kg per day. For a day children of 2-12 years old are allowed to consume no more than 200-400 mg (the exact dosage depends on the treatment scheme used).

The frequency of use, and in addition the intervals between doses in the case of an increase in dosage depend on which treatment regimen is used, as well as the patient's response to therapy.

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Use Lamitril during pregnancy

It is not recommended to prescribe Lamitril during pregnancy. Use it is allowed only in cases where the possible benefits for women exceed the possibility of negative consequences for the fetus. During the GW, the drug should also be used with caution.

Contraindications

Among the contraindications:

• severe disorders in the work of the liver;
• individual intolerance to the active component of the drug;
• children under 2 years old, as well as elderly people.

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Side effects Lamitril

Among the side reactions:

• CNS organs: dizziness with headaches, sleep disorders or vice versa sensation of drowsiness, fatigue, confusion, and aggression;
• organs of the digestive system: disorders in the work of the liver and nausea;
• organs of the hematopoietic system: leukopenia or thrombocytopenia;
• allergies: skin rashes (usually korepodobnye), edema Quincke, malignant exudative erythema, Lyell's syndrome, and in addition to this, lymphadenopathy.

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Overdose

Due to lamotrigine overdose, the patient experiences dizziness, ataxia, and also nystagmus, and in addition headaches, a feeling of drowsiness, widening of the QRS interval on the ECG, vomiting and coma. In some cases this led to death.

As a therapy, a gastric lavage procedure is used, as well as the use of activated charcoal. In addition, the patient must be hospitalized for symptomatic and supportive therapy.

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Interactions with other drugs

Valproates (including valproic acid) are competitive blockers of liver enzymes, and in addition suppress the process of glucuronization of the active substance. As a result, the metabolic rate decreases and the average half-life of lamotrigine increases (up to 70 hours).

Anticonvulsants inducing metabolic hepatic enzymes (among them carbamazepine with phenytoin, as well as primidone with phenobarbital, etc.), and in addition paracetamol increase the metabolic rate and glucuronization of the active substance. When combined with them, the average half-life of lamotrigine (up to 14 hours) is approximately halved.

Combination of carbamazepine with lamotrigine often leads to the appearance of negative manifestations from the side of the central nervous system (dizziness, ataxia, nausea, and in addition, loss of visual acuity and diplopia). These symptoms disappear soon after a reduction in the dosage of carbamazepine. A similar effect develops in the case of the appointment of a healthy person oxcarbazepine with lamotrigine (without studying the results of lowering dosages).

Oral contraceptive agents containing ethinylestradiol (30 μg) and levonorgestrel (150 μg) approximately twice the lamotrigine purification factor, resulting in a peak in its concentration and AUC decrease by 39% and 52%, respectively. During the week, free from the use of OK, the concentration of lamotrigine in the serum increases, and at the time of taking a new dose it becomes higher than during the treatment course, approximately 2-fold.

Rifampicin increases the indicator of the lamotrigine cleansing factor, and also reduces its half-life (stimulates the activity of hepatic enzymes involved in the glucuronization process).

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Storage conditions

Keep the medicine in a place that is out of the sunlight, out of the reach of children. Temperature conditions - no more than 25 ° С.

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Shelf life

Lamitril is allowed to be used for 5 years after the manufacture of the medicine.

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