Epilepsy Adult >12 yr Monotherapy: Initially 25 mg once daily for 2 wk, followed by 50 mg once daily for 2 wk. Then increase by max of 50-100 mg every 1-2 wk until optimal response is obtained. Maintenance dose: 100-200 mg once daily or in 2 divided doses up to 500 mg daily. Add-on therapy: Initially 25 mg every alternate day for 2 wk, followed by 25 mg once daily for 2 wk, then increase dose by max 25-50 mg every 1-2 wk. Maintenance dose: 100-200 mg once daily or in 2 divided doses.
Patient taking concomitant antiepileptic drugs (AEDs) or other medications that induce lamotrigine glucuronidation w/ or w/o AEDs (except valproate) Initially 50 mg once daily for 2 wk, followed by 100 mg daily in 2 divided doses for 2 wk. Then, increase dose by max of 100 mg every 1-2 wk. Maintenance dose: 200-400 mg daily in 2 divided doses up to 700 mg daily.
Patient taking other medications that do not significantly inhibit or induce lamotrigine glucuronidation Initially 25 mg once daily for 2 wk, followed by 50 mg once daily for 2 wk. Then, increase dose by max 50-100 mg every 1-2 wk. Maintenance dose: 100-200 mg once daily or in 2 divided doses.
Childn 2-12 yr Add-on therapy:
Patient taking valproate w/ or w/o any other AEDs Initially 0.15 mg/kg once daily for 2 wk, followed by 0.3 mg/kg once daily for 2 wk. Then, increase dose by max of 0.3 mg/kg every 1-2 wk. Maintenance dose: 1-5 mg/kg once daily or in 2 divided doses. Max: 200 mg daily.
Patient taking concomitant AEDs or other medications that induce lamotrigine glucuronidase w/ or w/o other AEDs (except valproate) Initially 0.6 mg/kg daily in 2 divided doses for 2 wk, followed by 1.2 mg/kg daily in 2 divided doses for 2 wk. Then, increase dose by max of 1.2 mg/kg every 1-2 wk. Maintenance dose: 5-15 mg/kg daily in 2 divided doses. Max: 400 mg daily.
Patient taking other medications that do not significantly inhibit or induce lamotrigine glucuronidation Initially 0.3 mg/kg once daily or in 2 divided doses for 2 wk, followed by 0.6 mg/kg once daily or in 2 divided doses for 2 wk. Then, increase dose by max 0.6 mg/kg every 1-2 wk. Maintenance dose: 1-10 mg/kg once daily or in 2 divided doses. Max: 200 mg daily.
Bipolar disorder Adult (≥18 yr) Adjunct therapy w/ lamotrigine glucuronidation inhibitors eg, valproate Initially 25 mg every alternate day for 2 wk, followed by 25 mg once daily for 2 wk. Then, increase dose to 50 mg once daily or in 2 divided doses in wk 5. Usual target dose: 100 mg once daily or in 2 divided doses. Max: 200 mg daily.
Adjunct therapy w/ lamotrigine glucuronidase inducers in patient not taking inhibitors eg, valproate (should be used w/ phenytoin, carbamazepine, phenobarb, primidone, or other drugs known to induce lamotrigine glucuronidation) Initially 50 mg once daily for 2 wk, followed by 100 mg in 2 divided doses for 2 wk. Then, increase dose to 200 mg daily in 2 divided doses in wk 5. May be increased further to 300 mg daily in wk 6. Usual target dose: 400 mg daily in 2 divided doses for wk 7.
Monotherapy or adjunct therapy in patient taking other medications that do not significantly induce or inhibit lamotrigine glucuronidation Initially 25 mg once daily for 2 wk, followed by 50 mg once daily or in 2 divided doses for 2 wk. Increase dose to 100 mg once daily or in 2 divided doses for 2 wk. Then, increase dose to 100 mg daily in wk 5. Usual target dose: 200 mg once daily or in 2 divided doses.
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