Nursing2024 Drug Handbook

lamotrigine 841

• Teach parents or guardians signs and symp- toms of pancreatitis. Advise them to report signs and symptoms immediately.

tablet) no faster than 100 mg/day each week to achieve the monotherapy maintenance dosage of 250 to 300 mg/day. ➤ Conversion to monotherapy using extended-release formula in patients with partial seizures who are receiving adjunc- tive treatment with valproate Adults and children age 13 and older: Add 25 mg extended-release PO every other day for 2 weeks; then increase to 25 mg PO daily for weeks 3 and 4. Increase to 50 mg PO daily for week 5, 100 mg PO daily for week 6, and 150 mg PO daily for week 7. Maintain dosage at 150 mg PO daily while decreasing val- proate dosage by no more than 500 mg/day each week until 500 mg/day is achieved; maintain for 1 week. Then, simultaneously in- crease extended-release tablet to 200 mg/day while decreasing valproate to 250 mg/day; maintain for 1 week. Increase to 250 or 300 mg PO daily as maintenance dosage and discontinue valproate. ➤ Conversion to monotherapy using extended-release formula in patients with partial seizures who are receiving treat- ment with a single drug other than an enzyme-inducing AED or valproate Adults and children age 13 and older: Add 25 mg extended-release PO daily for 2 weeks; then increase to 50 mg PO daily for weeks 3 and 4. Increase to 100 mg PO daily for week 5. Starting with week 6, continue increasing dosage each week by 50 mg PO daily until a dosage of 250 to 300 mg PO daily is achieved; then withdraw concomitant AED therapy by 20% decrements each week over a 4-week period. No additional lamotri- gine (extended-release tablet) adjustment is needed. ➤ Adjunctive treatment of partial seizures or primary generalized tonic-clonic seizures caused by epilepsy or generalized seizures of Lennox-Gastaut syndrome Adults and children older than age 12 taking valproate: 25 mg immediate-release PO every other day for 2 weeks; then 25 mg PO daily for 2 weeks. Continue to increase, as needed, by 25 to 50 mg daily every 1 to 2 weeks un- til an effective maintenance dosage of 100 to 400 mg daily given in one or two divided doses is reached. When added to valproate alone, the usual daily maintenance dose is 100 to 200 mg. Adults and children age 13 and older taking valproate: 25 mg extended-release PO every

lamo TRI gine la-MO-tri-geen

LaMICtal, Subvenite

Therapeutic class: Anticonvulsants Pharmacologic class: Phenyltriazines AVAILABLE FORMS Tablets: 25 mg, 100 mg, 150 mg, 200 mg Tablets (chewable dispersible): 2 mg, 5 mg, 25 mg Tablets (extended-release) : 25 mg, 50 mg, 100 mg, 200 mg, 250 mg, 300 mg Tablets (ODTs): 25 mg, 50 mg, 100 mg, 200 mg INDICATIONS & DOSAGES Alert: Extended-release formula isn’t for use as initial monotherapy or for conversion to monotherapy from two or more concomi- tant AEDs. Adjust-a-dose (for all indications): Gener- ally, reduce initial, escalation, and mainte- nance doses by approximately 25% in patients with moderate and severe hepatic impairment without ascites and 50% in patients with se- vere hepatic impairment with ascites. May adjust escalation and maintenance doses ac- cording to clinical response. In patients with renal impairment, base initial doses on pa- tients’ concomitant medications; reduced maintenance doses may be effective for pa- tients with significant renal impairment. ➤ Conversion to monotherapy using extended-release formula in patients with partial seizures who are receiving treat- ment with a single enzyme-inducing AED (except valproate) Adults and children age 13 and older: Add 50 mg extended-release tablet PO daily to current drug regimen for 2 weeks, followed by 100 mg PO daily for 2 weeks. Then, in- crease by 100 mg every week until a dosage of 500 mg PO daily is reached. The concomi- tant enzyme-inducing AED can then be grad- ually reduced by 20% decrements each week over a 4-week period. Two weeks after com- pleting withdrawal of the enzyme-inducing AED, decrease lamotrigine (extended-release

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Canada

OTC Off-label use

Do not crush *Liquid contains alcohol

Genetic