Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For lamotrigine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to lamotrigine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Lamotrigine has not been studied in pregnant women. However, if you might become pregnant while taking lamotrigine, your doctor may want you to take folic acid supplements. Studies in animals have shown that lamotrigine, even when given to the mother in doses smaller than the largest human dose, may cause some offspring to die. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding—Lamotrigine passes into breast milk. However, it is not known whether this medicine causes problems in nursing babies. Mothers who are taking lamotrigine and who wish to breast-feed should discuss this with their doctor.

Children—Skin rashes may be more likely to occur in children younger than 16 years of age than in adults. Some of these rashes may be serious and life-threatening. It is especially important that you discuss with the child's doctor the good that this medicine may do as well as the risks of using it.

Older adults—Lamotrigine is removed from the body more slowly in elderly people than in younger people. Higher blood levels of the medicine may occur, which may increase the chance of unwanted effects. Your doctor may give you a different lamotrigine dose than a younger person would receive.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking lamotrigine, it is especially important that your health care professional know if you are taking any of the following:

• Carbamazepine (e.g., Tegretol) or
• Phenobarbital (e.g., Luminal) or
• Phenytoin (e.g., Dilantin) or
• Primidone (e.g., Mysoline) or
• Valproic acid (e.g., Depakote)—These medicines may increase or decrease the blood levels of lamotrigine, which may increase the chance of unwanted effects; your doctor may need to change the dose of either these medicines or lamotrigine

Other medical problems—The presence of other medical problems may affect the use of lamotrigine. Make sure you tell your doctor if you have any other medical problems, especially:

• Heart disease—It is not clear if patients who have problems with heart rhythms will have increased problems while taking lamotrigine

• Kidney disease or
• Liver disease—Higher blood levels of lamotrigine may occur, which may increase the chance of unwanted effects; your doctor may need to change your dose

• Thalassemia—Lamotrigine may cause your body to stop making or to make fewer red blood cells