Lamotrigine for preventing seizures

Name of medicine

Lamotrigine

Brand name: Lamictal

Why is it important for my child to take Lamotrigine?

Lamotrigine is used to prevent epileptic seizures. It is important that your child takes lamotrigine regularly so that they have fewer seizures. Seizures may also be called convulsions or fits.

What is Lamotrigine available as?

Tablets: 25 mg, 50 mg, 100 mg, 200 mg; contain lactose

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. This can be in the morning OR the evening.
• 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, and gradually increase it. The dose will be shown on the medicine label. If you are not sure how much to give, check with your doctor, epilepsy nurse or pharmacist.

How should I give Lamotrigine?

Tablets

• Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablets.
• You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey, or mashed potato. Make sure your child swallows it straight away, without chewing.

Dispersible tablets

• Disperse the tablet(s) in water, squash or fruit juice. Mix it vigorously – it will make a cloudy mixture. Give the mixture to your child straight away. You can give it using a medicine spoon or oral syringe.
• Your child can also chew the dispersible tablets. They should then drink a glass of water, squash or fruit juice.

• Occasionally, the only way to provide the correct dose of Lamotrigine for your child will be to give part of a tablet or to disperse a tablet in a small amount of water and give some of the mixture.
• Your doctor, pharmacist or epilepsy nurse will let you know if this is necessary and explain what to do.
• This method should only be used when there is no other option and you have been told to do it.
• Any unused mixture should be poured into a paper towel and put in the bin. Do not pour it down the sink.

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 during this time.
• This is because the amount of medicine has to be increased slowly.
• Continue to give the medicine in the way you have been told to by your doctor or epilepsy nurse.
• Lamotrigine may not stop your child’s seizures completely. If you are worried about whether it is helping, contact your doctor but continue to give the medicine.

What if my child is sick (vomits)?

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

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it?

• If you are giving it once every other day: Give the missed dose when you remember, as long as this is at least 12 hours before the next dose is due.
• If you usually give it once a day in the morning: Give the missed dose when you remember during the day, as long as this is at least 12 hours before the next dose is due.
• If you usually give it once a day in the evening: If you remember before bedtime, give the missed dose. You do not need to wake up a sleeping child to give a missed dose. You can give the missed dose in the morning, as long as this is at least 12 hours before the evening dose is due.
• If you usually give it twice a day: 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 about 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. Just give the next dose as usual.

What if I give too much?

If you think you may have given your child too much Lamotrigine, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.

Are there any possible side effects?

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

Side effects you must do something about

Other side-effects you need to know about

• Your child’s skin may become more sensitive to sunlight. Keep them out of strong sun. When outdoors, they should wear a long-sleeved top, trousers and a hat and should use a high-factor sun cream (at least SPF 30).

• • Your child may be drowsy (sleepy) or dizzy when they first start taking Lamotrigine. This should get better after a few days as your child gets used to the medicine. If it doesn’t, contact your doctor but continue to give Lamotrigine.
• • They may develop a tremor (shakiness), their coordination may be affected (they may seem clumsy) or they may have blurred vision. They may also have changes in mood and may be aggressive or hyperactive (more active than usual and finding it hard to relax). They may have sleep disturbances, such as difficulty getting to sleep. If you are worried contact your doctor.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at mhra.gov.uk/yellowcard

Can other 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 and 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 thinks she may be pregnant, it is important that she sees her doctor as soon 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 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.

Is there anything else I need to know about this medicine?

General advice about medicines

Advice about medicines for seizures

• If your doctor decides to stop a particular medicine, they will discuss this with you. They will usually reduce the dose bit by bit.
• 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 each day, to help you remember.

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• 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 should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight.

• It does not need to be kept in the fridge.

• Make sure that children cannot see or reach the medicine.

• Keep the medicine in the container it came in.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Lamotrigine and about other medicines used to treat epilepsy.

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by November 2016.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.