Lamictal contraindications and warnings


The following provides information on contraindications to the use of lamotrigine in general, pregnancy, breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).

When should Lamotrigin not be used?

The active substance should not be used in case of hypersensitivity to lamotrigine, phenytoin or carbamazepine. Allergic hypersensitivity reactions may include rashes with fever, lymph node disease, or altered blood and liver values

Lamotrigine should not be taken in patients with hepatic impairment, special care and careful medical control are required in case of renal impairment.

What should you watch out for during pregnancy and lactation?

Lamotrigine should be used during pregnancy only after careful consideration of the benefit-risk by the physician. The active ingredient lowers the folic acid blood level and could potentially lead to an increased risk of fetal harm. Especially in early pregnancy, an increased risk of malformations of the mouth and palate seems to exist with simultaneous inclusion of the drug.

Lamotrigine passes into breast milk and can thus reach levels of active ingredient in the breastfed infant that are within the range of typical therapeutic drug concentrations of the mother. Therefore, only after careful medical benefit-risk assessment should be breastfed. If breast-fed, the baby should be monitored for possible effects or side effects.

What should be considered in children?

Children under the age of two should not be treated with lamotrigine.

The initial treatment of epilepsy in children aged 2 to 11 years should be in a clinic with special experience in epileptic disorders in children. Likewise, the initial treatment in children over the age of twelve should only be performed by experienced doctors (for example, neurologists).

For depression, lamotrigine may only be used in persons over the age of 18.

Warnings and Precautions

  • If intolerance reactions occur, such as rashes, fever, lymph node disease, facial water retention, seek medical advice immediately.
  • Regular medical checks on blood counts and coagulation levels are recommended during treatment with the drug.
  • Pregnancy prevention by the pill may be impaired in its effect by the drug. Therefore, additional contraceptive measures should be taken.
  • The drug is not suitable for children under the age of two years.
  • The drug should only be used for the first time by a specialist physician experienced in the treatment of epilepsy.
  • The initial use of the drug in children 2 to 11 years of age should preferably be in the clinic.
  • For liver and kidney patients, the dosage may need to be reduced by about half to three quarters by the physician.
  • The medication should not be discontinued suddenly, but the therapy should “sneak out” with slowly diminished dosages.
  • If a rash has occurred during treatment with the drug, therapy should be continued only on medical advice.
  • Apparently taking the drug increases suicidal tendencies, so patients should be monitored carefully by the doctor and family members.
  • The drug increases the risk of osteoporosis during long-term treatment. This is especially true if the condition is pre-existing or concomitant with cortisone.
  • If rash increases, including blistering, treatment with the drug must be stopped immediately and should never be restarted.
  • Reactivity may be limited by the drug to the extent that driving or operating machinery is affected. This applies in particular to simultaneous consumption of alcohol.

Sometimes medications release allergic reactions.
If you notice signs of allergic reaction, tell your doctor or pharmacist immediately.