Manufacturer's Recommended Lamictal Dosages

Lamictal (lamotrigine) is used as a mood stabilizer for persons with bipolar disorder. While it is an anticonvulsant also used to treat seizure disorders such as epilepsy, this article only covers its recommended dosages when taken for bipolar disorder.

The brand Lamictal comes in four forms:

• Lamictal
• Lamictal ODT (orally disintegrating tablets)
• Lamictal CD (chewable/dispersible)
• Lamictal XR, which is not approved for use in treating bipolar disorder and is not covered here

Available Strengths

Lamictal comes in the following strengths. You should work with your doctor to figure out what dosage works best for you.

• Lamictal tablets: 25, 100, 150 and 200 mg
• Lamictal ODT tablets: 25, 50, 100 and 200 mg
• Lamictal CD tablets: 2, 5 and 25 mg

How to Take Lamictal

When taking Lamictal, it is important to follow any instructions your doctor has given you. In general, taking Lamictal is as follows:

• Lamictal tablets - Take as any other medication in pill form.
• Lamictal ODT - Orally disintegrating tablets should be placed onto the tongue and moved around in the mouth. The tablet will disintegrate rapidly, can be swallowed with or without water, and can be taken with or without food.
• Lamictal CD - Tablets may be swallowed whole, chewed, or dispersed in water or diluted fruit juice. If the tablets are chewed, consume a small amount of water or diluted fruit juice to aid in swallowing. To disperse Lamictal chewable dispersible tablets, add the tablets to a small amount of liquid (1 teaspoon, or enough to cover the medication). Approximately 1 minute later, when the tablets are completely dispersed, swirl the solution and consume the entire quantity immediately. No attempt should be made to administer partial quantities of the dispersed tablets.

Manufacturer's Recommended Lamictal Dosages

Starter kits are available from the manufacturer for Lamictal and Lamictal ODT, and your doctor may provide you with one, along with instructions for when to begin increasing to the next dosage level. The recommended dosage varies depending on whether you are taking or not taking certain other drugs. Those drugs, listed with US brand names in parentheses, are:

• Sodium valproate or valproic acid (Depakene, Depakote and other brand names)
• Carbamazepine (Tegretol)
• Phenytoin (Dilantin)
• Phenobarbital (Luminol)
• Primidone (Mysoline)

Note: Phenytoin, phenobarbital and primidone are anti-seizure drugs that are not used to treat bipolar disorder.

As the table shows, it is essential to tell your doctor about all other medications you are taking when starting Lamictal therapy AND to keep your doctor informed of changes in your other medications.

Lamictal Dosage Table

	For Patients TAKING Valproate	For Patients NOT TAKING Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate	For Patients TAKING Carbamazepine, Phenytoin, Phenobarbital, or Primidone and NOT TAKING Valproate
Weeks 1 and 2	25 mg every other day	25 mg daily	50 mg daily
Weeks 3 and 4	25 mg daily	50 mg daily	100 mg daily, in divided doses
Week 5	50 mg daily	100 mg daily	200 mg daily, in divided doses
Week 6	100 mg daily	200 mg daily	300 mg daily, in divided doses
Week 7	100 mg daily	200 mg daily	up to 400 mg daily, in divided doses
Note: The manufacturer recommends increasing Lamictal if you stop taking Valproate, and increasing if you stop taking carbamazepine, phenytoin, phenobarbital or primidone. Always follow your doctor's instructions regarding dosages - do not make changes on your own.
Note: Oral contraceptives containing estrogen may affect the efficiency of Lamictal and require a dosage adjustment. Always tell your doctor if you are taking, start taking, or stop taking oral contraceptives containing estrogen.