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Lamotrigine for preventing seizures

This leaflet is about the use of lamotrigine to prevent epileptic seizures. (Seizures may also be called convulsions or fits.)

This leaflet has been written specifically about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

 

Name of drug

Lamotrigine

Brand name: Lamictal^®

Why is it important for my child to take this medicine?

It is important that your child takes lamotrigine regularly so that they have fewer seizures.

What is lamotrigine available as?

• yellow tablets (25 mg, 50 mg, 100 mg, 200 mg); these contain lactose
• white dispersible tablets (2 mg, 5 mg, 25 mg, 100 mg)

When should I give lamotrigine?

You will usually start by giving lamotrigine once a day, or every other day, while your child gets used to the medicine.

When your child is used to lamotrigine, you will usually give it twice a day: once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example sometime between 7 and 8 am and between 7 and 8 pm.

How much should I give?

Your doctor will work out the amount of lamotrigine (the dose) that is right for your child. The dose will be shown on the medicine label.

When you first start giving lamotrigine to your child, you will give them a small amount and then increase the dose bit by bit over a few days or weeks. This helps your child to get used to the medicine. Your doctor will explain what to do.

• It is important that you follow your doctor’s instructions about how much to give.

How should I give it?

	Yellow tablets These should be swallowed with a glass of water, milk or juice. Your child should not chew the tablets. You can crush a tablet and mix it with about 2 tablespoons of fruit juice or soft food (e.g. yogurt, honey or jam). Make sure your child swallows it straight away, without chewing.
	White dispersible tablets Dissolve the tablet(s) in water or fruit juice. Your doctor will have told you how much liquid to use, and how much of it to give your child. Give the right amount of mixture to your child straight away, using a medicine spoon or oral syringe. Your child can chew these tablets. They should then drink a glass of water, milk or fruit juice.

When should the medicine start working?

It may take up to 6 weeks for lamotrigine to work properly, so your child may still have seizures for a while. This is because the amount of medicine has to be increased slowly. Continue to give the medicine as you have been told to by your doctor.

What if my child is sick (vomits)?

• If your child is sick less than 30 minutes after taking a dose of lamotrigine, give the same dose again.
• If your child is sick more than 30 minutes after taking a dose of lamotrigine, you do not need to give them another dose. Wait until the next normal dose.

What if I forget to give it?

• If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at 7 am, you can give the missed dose at any time up to 11 am.
• If you remember after that time, do not give the missed dose. Wait until it is time to give the next normal dose.
• Never give a ‘double’ dose of lamotrigine.

What if I give too much?

If you think you may have given your child too much lamotrigine, contact your doctor or NHS Direct (0845 4647) or take your child to hospital.

Take the medicine container or pack with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they cause effects that we don’t want (side-effects).

Side-effects that you must do something about

• If your child develops a blotchy red skin rash, contact your doctor straight away, as your child may be allergic to lamotrigine. The rash may be anywhere on the body, and you may also see blisters in the mouth. This reaction is most likely to be seen during the first 8 weeks of taking lamotrigine. It is more likely if your child is already taking another medicine for epilepsy called sodium valproate.
• If your child has such a rash and is also generally unwell and has a fever (high temperature) or unusual bruises or bleeding, take them to your doctor or hospital straight away, as this may indicate a more serious reaction.
• Your child’s skin may become more sensitive to sunlight. Keep them out of strong sun, and use a high-factor sun block (at least SPF 15). It is particularly important to avoid sunburn. Your child should not go on a sun bed.

Other side-effects you need to know about

• Your child may be drowsy (sleepy) when they first start taking lamotrigine. This should get better. If it doesn’t, contact your doctor.
• If your child is dizzy, has blurred vision or develops a tremor (shakiness), contact your doctor.

Can other common medicines be given at the same time as lamotrigine?

• You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
• Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Epilepsy and pregnancy

• Pregnancy presents a risk to both the mother with epilepsy and her unborn baby. If your daughter has sex, it is essential that she uses adequate contraception to prevent an unplanned pregnancy.
• If your daughter is worried that she may be pregnant, it is important that she sees your family doctor as early as possible. Your daughter should keep taking her medication until she sees her doctor.

Lamotrigine and pregnancy

• Lamotrigine may harm an unborn baby.
• The oral contraceptive pill may not work properly in women or girls who are taking a high dose of lamotrigine.
• Lamotrigine may not work properly in those taking the oral contraceptive pill or in pregnancy.

General advice about medicines for seizures

• Do not suddenly stop giving any of these medicines to your child, as they may have a seizure. If you are worried, talk to your doctor but carry on giving the medicine to your child as usual.
• If your child seems to have more seizures than usual, contact your doctor or epilepsy nurse.
• If your doctor decides to stop a particular medicine, they will discuss this with you. You will usually reduce the dose bit by bit.
• Do not change the dose of any drug without talking to your doctor first.
• It is best that your child always has the same brand of each medicine, as there may be differences between brands. Keep a record of which medicines your child has.
• Try to give medicines at about the same times every day, to help you remember.
• Only give the medicine(s) to your child. Never give them to anyone else, even if their condition appears to be the same, as this could do harm.
• If you think someone else may have taken the medicine by accident, contact your doctor straight away.
• Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
• Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where I should keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight.
• Make sure that children cannot see or reach the medicine.
• Keep the medicine in the container it came in.