Lamotrigine is used to control seizures, as a mood stabilizer, and for other conditions related to the nervous system. Learn how to use the medication, its common side effects, special precautions to watch out for, and more.

What is this medication for?

Lamotrigine is used to control seizures (commonly known as fits) and as a mood stabilizer to reduce mood swings in a condition known as bipolar disorder. It may also be used for other conditions related to the nervous system.

How should I take/use this medication? 

Follow the instructions on your medication label and take the medication as prescribed by your doctor.

You can take this medication with or without food.

Dispersible tablets can be chewed, swallowed whole or dispersed in room temperature water . To disperse the tablet, cover the tablet with one teaspoon of water and allow it to dissolve . The entire amount should then be taken/consumed.

You may not experience any benefits immediately after starting the medication as it may take up to a few weeks before this medication can exert its full effects. You should continue to take your medication regularly as instructed by your doctor even if you feel well. Stopping your medication without informing your healthcare professionals may cause your condition to worsen quickly.

Do not stop taking or adjust the dose of this medication without consulting your healthcare professionals. Do not change brands or dosage forms of the medication without informing your healthcare professional.

What should I do if I forget to take/use this medication?

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for your next dose, take only the usual dose. Do not double your dose or use extra medication to make up for the missed dose.

What precautions should I take? 

Inform your healthcare professionals if you have the following medical conditions before starting on lamotrigine:

• Liver problems
• Kidney problems
• Drug allergies 

For female patients of child-bearing age: Discuss with your doctor regarding family planning if you will be starting or currently taking lamotrigine.

Consult your healthcare professional immediately if your seizures get worse or become different after you start on this medication.

What are some common side effects of this medication?

Like all medicines, this medication may cause some possible side effects but not everyone experiences them. Consult your healthcare professional if any of the side effects lasts more than a few days or become severe and bothersome. 

The common side effects of Lamotrigine include:

• Dizziness or feeling lightheaded
  • Get up slowly from sitting or lying down position
• Drowsiness, fatigue
  • Avoid driving, operate machinery or engaging in physical activities that require great efforts
• Hard stools (Constipation)
  • Increase consumption of foods which are high in fibre such as fruits and vegetables, and ensure you are drinking sufficient fluid (i.e. 8 glasses or 2 litres of water daily)
  • Increasing daily activity may also help to improve constipation
• Nausea, vomiting
  • Take the medicine with or after food to reduce nausea and vomiting
  • Avoid food that is too rich, spicy or has strong smells
  • Take small and frequent meals, rather than 3 large meals
  • Do not take the medication with carbonated drinks
• Headache
  • Take paracetamol if needed to relieve headache
• Loss of appetite and weight loss
• Blurred or double vision or uncontrollable eye movements 
• Joint pain, neck pain, numbness in the hands and feet (“pins and needles” sensation”)
• Swelling of hands or legs from water retention - to inform doctor if bothersome or persistent
• Painful menstruation

What are some rare but serious side effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

• Swollen face / eyes/ lips / tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

If the following serious side effects happen, you should consult your healthcare professionals immediately:

• Blistering, peeling, red skin rash due to Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)
  • SJS is a rare and serious skin reaction. Symptoms include face swelling, blisters on skin, skin rashes that spread within hours to days. 
  • TEN is a more severe form of skin reaction. Symptoms include fever and flu-like symptoms, blisters on skin, skin rashes that spread within hours to days. Areas such as the mouth, eyes, genitals are commonly involved. 
  • It usually occurs within the first few months (monitor closely for the first 3 months) of treatment. 
  • As SJS and TEN progress rapidly, please consult healthcare professionals if you show first sign of rash.
• Blurred or double vision or abnormal eye movements
• Prolonged fever or chills, flu-like symptoms, sore throat
• Increase in seizures
• Unusual bleeding and bruising
• Liver problems: Dark-coloured urine or light-coloured stools, yellowing of your eyes or skin, severe loss of appetite, stomach pain, nausea, vomiting that does not go away, pain, tenderness or unusual swelling over the liver area in the upper right belly       

In rare cases, this medication may cause the following changes to a person’s mental condition, especially in the first few weeks of treatment or during dose changes: 

• Worsening agitation, restlessness, violent behaviour, or
• New or worsening thoughts of harming yourself or ending your life
• Other changes in mood or behaviour

Please inform your doctor as soon as possible, or for your family or caregiver to inform your doctor if you are unable to seek treatment on your own. 

Do not stop taking this medication on your own without discussing with your doctor. 

It is important to note that your doctor has prescribed this medication as he/ she feels you will benefit more from taking this medication over the possible risks that it may cause, which have a low chance of occurring, and most people take this medication without any of such problems.

What food or medication should I avoid when I take/use this medication?

Avoid drinking alcohol while taking this medication as it can cause excessive drowsiness.

Inform your healthcare professionals regarding your choices if you intend to use birth control while on lamotrigine.

Please consult your healthcare professionals before using any other medications, including over-the-counter medicines, vitamins and herbal products.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How should I throw this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing it into the rubbish chute or bin.

Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on May 2024