Q: Will the generic form of Lamictal (Epilepax) work as well for depression?
A: The generic form of Lamictal, Epilepax, should work just as well as the brand name. The FDA requires that a generic have the exact same active ingredient as the brand. The generic must prove to the FDA is just as safe and just as effective as the brand. The inactive ingredients are what may be changed. Therefore, in most cases, studies show generics will work as well as the brand. You may also find helpful information on depression and medications at //www.everydayhealth.com/depression/guide/, //www.everydayhealth.com/drugs/.
How should I take Epilepax?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Taking too much Epilepax at the start of treatment may increase your risk of a severe life-threatening skin rash.
You may need frequent blood tests to help your doctor make sure you are taking the right dose.
Extended-release and immediate-release Epilepax may be used for different conditions. Always check your refills to make sure you have received the correct size, color, and shape of tablet. Avoid medication errors by using only the form and strength your doctor prescribes.
If you switch to Epilepax from another seizure medicine, carefully follow your doctor's instructions about the timing and dosage of your medicine.
Swallow the tablet whole and do not crush, chew, or break it.
Read and carefully follow any Instructions for Use provided with the orally disintegrating or dispersible tablets. Ask your doctor or pharmacist if you do not understand these instructions.
Do not stop using Epilepax suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.
In case of emergency, wear or carry medical identification to let others know you use seizure medication.
Epilepax may affect a drug-screening urine test and you may have false results. Tell the laboratory staff that you use Epilepax.
Store at room temperature away from light and moisture.
- Adult, conversion from immediate-release to extended-release Epilepax
- Dose of extended-release Epilepax should equal the total daily dose of the immediate-release formulation
- Adjust dose as needed within recommended dosing
- Conversion to monotherapy for patients taking 1 anticonvulsant drug
- Weeks 1-2: 25 mg orally once/day
- Weeks 3-4: 50 mg orally once/day
- Week 5: 100 mg orally once/day
- Week 6: 150-200 mg orally once/day
- Weeks 7-23: 250-300 mg orally once/day; begin AED withdrawal over 5-week period by weekly 20% decreases in daily dose
Indicated for maintenance treatment of bipolar I disorder to delay the time to occurrence of mood episodes (depression, mania, hypomania, mixed episodes) in patients treated for acute mood episodes with standard therapy
Efficacy and safety have not been established for treatment of acute manic or mixed episodes
Monotherapy or without enzyme inducers or valproic acid
- Initial: 25 mg orally once/day for 2 weeks, THEN
- 50 mg orally once/day for 2 weeks
- 100 mg orally once/day for 1 week
- Double dose once/week to maintenance at 200 mg/day orally
With AED regimen without valproic acid
- Initial: 50 mg orally once/day for 2 weeks, THEN
- 100 mg/day orally divided every 12 hours for 2 weeks
- Increase by 100 mg once/week to 400 mg/day orally divided every 12 hours
With valproic acid
- Initial: 25 mg orally every other day for 2 weeks, THEN
- 25 mg orally once/day for 2 weeks
- Double dose once/week to maintenance at 100 mg/day orally
- Use caution; may consider reduce the dose in significant renal impairment
- Limited data, various recommendations
- Manufacturer: Decrease dose by 25% (moderate-severe without ascites) or by 50% (severe with ascites)
- Other (e.g., AHSP): Decrease dose by 50% (Child-Pugh class B) or by 75% (Child-Pugh class C)
Dosing Considerations, Pediatric
- Lamictal XR (over 13 years): Add-on therapy for primary generalized tonic-clonic seizures or partial seizures
- Lamictal XR (over 13 years): Partial seizures; conversion to monotherapy in patients over 13 years with partial seizures taking 1 AED; safety and efficacy has not been established as initial monotherapy or for simultaneous conversion to monotherapy from 2 or more concomitant AEDs
- Lamictal tablets, chewable tablet, or ODT (over 2 years): Adjunctive treatment for partial seizures, primary generalized tonic-clonic seizures, generalized seizures of Lennox-Gastaut syndrome
- Lamictal tablets, chewable tablet, or ODT (over 16 years): Conversion to monotherapy in partial seizures
- Lamictal tablets, chewable tablet, or ODT (over 18 years): Bipolar I disorder
Cost of Lamictal/Epilepax
When ordered in lots of 100 tablets, here is the breakdown in pricing for one tablet of the medication in the following doses (Note: pricing information generated April 2011):
- $4.83 for 25 mg tablet
- $5.43 for 100 mg tablet
- $5.93 for 150 mg tablet
- $6.67 for 200 mg tablet
Generic cost (Epilepax) is as follows:
- $0.3 for 25 mg tablet
- $0.3 for 100 mg tablet
- $0.53 for 150 mg tablet
- $0.53 for 2000 mg tablet
Q: My granddaughter keeps having bouts of severe spasmodic bilateral abdominal pain. It's not her ovaries or appendix. She has no diarrhea or fever. Could it be Lamictal?
A: Lamictal (Epilepax) is a medication used to treat epilepsy and bipolar disorder. In a study of 339 patients, ranging in age from two to 16 years of age, 10 percent of patients taking the immediate-release medication for epilepsy experienced abdominal pain versus five percent taking a placebo. This is not a common reaction, but it is possible. Other common side effects reported with treatment with Lamictal include dizziness, drowsiness, mild nausea, vomiting, diarrhea, upset stomach, headache, lack of coordination, weight loss, insomnia, unusual dreams, runny or stuffy nose, or blurred vision. Serious side effects may also occur and require immediate medical attention. These reactions may include fever, sore throat, headache with severe blistering, peeling, and red skin rash, chest pain, pale skin, easy bruising or bleeding, body aches, flu symptoms, muscle pain, tenderness, or weakness, dark colored urine, clay-colored stools, stomach pain, or jaundice (yellow of the skin or eyes). Consult with doctor for proper evaluation of the abdominal pain and to determine the underlying cause and possible treatment options, if necessary. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Patti Brown, PharmD
By Beth Schneider | Medically Reviewed by Ruthan White, PharmD
Latest Update: 2014-11-05 Copyright © 2014 Everyday Health Media, LLC
While atazanavir/ritonavir does reduce the Epilepax plasma concentration, no adjustments to the recommended dose-escalation guidelines for LAMICTAL should be necessary solely based on the use of atazanavir/ritonavir. Dose escalation should follow the recommended guidelines for initiating adjunctive therapy with LAMICTAL based on concomitant AED or other concomitant medications (see Tables 1, 2, and 5). In patients already taking maintenance doses of LAMICTAL and not taking glucuronidation inducers, the dose of LAMICTAL may need to be increased if atazanavir/ritonavir is added, or decreased if atazanavir/ritonavir is discontinued .
Can Epilepax cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with Epilepax. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
General Dosing Considerations
There are suggestions, yet to be proven, that the risk of severe, potentially life-threatening rash may be increased by (1) coadministration of LAMICTAL with valproate, (2) exceeding the recommended initial dose of LAMICTAL, or (3) exceeding the recommended dose escalation for LAMICTAL. However, cases have occurred in the absence of these factors . Therefore, it is important that the dosing recommendations be followed closely.
The risk of nonserious rash may be increased when the recommended initial dose and/or the rate of dose escalation for LAMICTAL is exceeded and in patients with a history of allergy or rash to other AEDs.
LAMICTAL Starter Kits and LAMICTAL ODT Patient Titration Kits provide LAMICTAL at doses consistent with the recommended titration schedule for the first 5 weeks of treatment, based upon concomitant medications, for patients with epilepsy (older than 12 years) and bipolar I disorder (adults) and are intended to help reduce the potential for rash. The use of LAMICTAL Starter Kits and LAMICTAL ODT Patient Titration Kits is recommended for appropriate patients who are starting or restarting LAMICTAL .
It is recommended that LAMICTAL not be restarted in patients who discontinued due to rash associated with prior treatment with Epilepax unless the potential benefits clearly outweigh the risks. If the decision is made to restart a patient who has discontinued LAMICTAL, the need to restart with the initial dosing recommendations should be assessed. The greater the interval of time since the previous dose, the greater consideration should be given to restarting with the initial dosing recommendations. If a patient has discontinued Epilepax for a period of more than 5 half-lives, it is recommended that initial dosing recommendations and guidelines be followed. The half-life of Epilepax is affected by other concomitant medications .
Q: I have been on Lamictal for the past three years, is it possible to become tolerant?
A: Lamictal (Epilepax) is an anticonvulsant medication that is used to treat seizures in epileptic patients, and mood swings in patients with bipolar disorder. Periodically, your physician may need to adjust the dose of Lamictal in order to maintain effectiveness. Do not stop taking Lamictal without consulting your physician. Some patients may have increased seizures if Lamictal is stopped abruptly. Consult your physician if your symptoms return or are not resolved while taking Lamictal, it is possible that the dosage needs adjustment. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your healthcare providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Burton Dunaway, PharmD.
Michael Stewart, Reviewed by Sid Dajani | Last edited 21 Dec 2017 | Certified by The Information Standard
Epilepax is prescribed to treat two different conditions - epilepsy and bipolar disorder.
Take your doses regularly. Do not stop taking Epilepax unless your doctor tells you to.
You can take your doses either before or after food.
For Healthcare Professionals
Applies to Epilepax: oral tablet, oral tablet disintegrating, oral tablet dispersible, oral tablet extended release
For patients receiving LAMICTAL in combination with other AEDs, a re-evaluation of all AEDs in the regimen should be considered if a change in seizure control or an appearance or worsening of adverse reactions is observed.
If a decision is made to discontinue therapy with LAMICTAL, a step-wise reduction of dose over at least 2 weeks (approximately 50% per week) is recommended unless safety concerns require a more rapid withdrawal .
Discontinuing carbamazepine, phenytoin, phenobarbital, primidone, or other drugs such as rifampin and the protease inhibitors lopinavir/ritonavir and atazanavir/ritonavir that induce Epilepax glucuronidation should prolong the half-life of Epilepax; discontinuing valproate should shorten the half-life of Epilepax.
In the controlled clinical trials, there was no increase in the incidence, type, or severity of adverse reactions following abrupt termination of LAMICTAL. In the clinical development program in adults with bipolar disorder, 2 patients experienced seizures shortly after abrupt withdrawal of LAMICTAL. Discontinuation of LAMICTAL should involve a step-wise reduction of dose over at least 2 weeks (approximately 50% per week) unless safety concerns require a more rapid withdrawal .
What is Epilepax?
Epilepax is an anti-epileptic medication, also called an anticonvulsant.
Epilepax is used alone or with other medications to treat epileptic seizures in adults and children. Epilepax is also used to delay mood episodes in adults with bipolar disorder (manic depression).
Immediate-release Epilepax can be used in children as young as 2 years old when it is given as part of a combination of seizure medications. However, this form should not be used as a single medication in a child or teenager who is younger than 16 years old.
Extended-release Epilepax is for use only in adults and children who are at least 13 years old.
Epilepax may also be used for purposes not listed in this medication guide.
Why it’s used
Epilepax is used to treat certain types of seizures in people with epilepsy. It can be used in combination with other antiseizure medications. Or it can be used alone when switching from other antiseizure medications.
Epilepax is also used for long-term treatment of a mood disorder called bipolar disorder. With this condition, a person has extreme emotional highs and lows.