8. Cautions with other medicines
Some medicines and Lafigin interfere with each other and increase the chances of side effects. Your doctor may need to change your dose of Lafigin.
Check with your pharmacist or doctor if you're taking:
- other medicines used to treat epilepsy, such as carbamazepine, felbamate, gabapentin, levetiracetam, oxcarbazepine, phenobarbital, phenytoin, pregabalin, primidone, topiramate, valproate or zonisamide
- aripiprazole, lithium, olanzapine or risperidone (used for mental health problems)
- bupropion, a stop smoking medicine
- rifampicin, an antibiotic usually given to treat tuberculosis (TB)
- medicines used to treat HIV
- hormonal contraceptives or hormone replacement therapy (HRT)
Before taking Lafigin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, a certain heart rhythm disorder (Brugada syndrome).
This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Children may be at greater risk for skin rashes while taking this drug. See also Warning section.
Older adults may be more sensitive to the side effects of this drug, especially dizziness, loss of coordination, or fainting. These side effects can increase the risk of falling.
During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. However, since untreated seizures or mental/mood problems (such as bipolar disorder) are serious conditions that can harm both a pregnant woman and her unborn baby, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately talk to your doctor about the benefits and risks of using this medication during pregnancy. Since birth control pills, patches, implants, and injections may not work if taken with this medication (see also Drug Interactions section), discuss reliable forms of birth control with your doctor.
This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
It's common to get a skin rash with Lafigin. Most skin rashes are not serious.
But if you develop a skin rash or redness, tell a doctor straight away, as this can develop into a life-threatening skin condition called Stevens-Johnson syndrome.
Stevens-Johnson syndrome is a rare side effect of Lafigin. It causes flu-like symptoms, followed by a red or purple rash that spreads and forms blisters. The affected skin eventually dies and peels off.
It's more likely to happen in the first 8 weeks of starting Lafigin, or when the dose is increased too quickly.
It can also happen if Lafigin is stopped suddenly for a few days and then restarted at the same dose as before, without reducing the dose and then increasing it slowly again.
Stevens-Johnson syndrome is more common in:
- people who developed a rash with a different epilepsy medicine in the past
- people who are allergic to an antibiotic called trimethoprim
- people also taking a medicine called sodium valproate
To help prevent the chance of you getting a rash that could be confused with Stevens-Johnson syndrome, it's best to not start any new medicines, foods or products during the first 3 months of treatment with Lafigin.
It's also best to not start Lafigin within 2 weeks of a viral infection, vaccination or rash caused by something else.
How it works
Lafigin belongs to a class of drugs called anticonvulsants or antiepileptic drugs (AEDs). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
For people with epilepsy, this drug reduces the release of a substance in your brain known as glutamate. This action prevents the neurons in your brain from becoming too active. As a result, you may have fewer seizures.
For people with bipolar disorder, this drug may affect certain receptors in your brain that help control your mood. This could decrease the number of mood episodes you have.
Lafigin oral tablet may cause drowsiness. Do not drive, use heavy machinery, or do other dangerous activities until you know how this drug affects you.
Lafigin can also cause other side effects.
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 Lafigin glucuronidation should prolong the half-life of Lafigin; discontinuing valproate should shorten the half-life of Lafigin.
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 .