Lamotrigine and Carbamazepine

[Mapi]

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Can you give Lamotrigine and Tegretol together to a PT with General tonic clonic seizures? In other words can you use two drugs that are intended for monotherapy together ina patient is not controlled on one in place of addinf adjunct therapies such as Zonisamide or topamax? Thank you!

 

[JerryPharmD]

Efacts is your friend:

Effects: Serum LAMOTRIGINE levels and efficacy may be reduced. Serum levels of the active epoxide metabolite of CARBAMAZEPINE (CBZ) may be elevated, increasing CBZ toxicity.

LAMOTRIGINE may increase CBZ toxicity.

Management: It may be necessary to adjust the dose of LAMOTRIGINE when starting, stopping, or changing the dose of CBZ. Observe clinical response and adjust the LAMOTRIGINE dose as needed. When adding LAMOTRIGINE to regimens including CBZ, monitor for CBZ toxicity, and reduce the dose if noted.


Take it nice and easy with lots of monitoring from an experienced neurolgist...

link to the prescribing info http://us.gsk.com/products/assets/us_lamictal.pdf

lamictal is also indicated for adjunctive therapy

 

[genesis09]

Epilepsy is EVIL. It gave me nightmares.

 

[firefighter9015]

So if your using CBZ and lamictal together, do you just monitor blood levels, efficacy and toxicity to adjust the doses????

Also, is that true for most anti-epileptic medications??? We just did anti-epiletics in neuropharmacology, but the professor did not make a lot of things clear.