Manufacturer's Recommended Lamictal Dosages

How Lamictal is Prescribed for Bipolar Disorder

Lamictal 200 mb tablets
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There are so many different types and doses of Lamictal (lamotrigine) it can be confusing if you're prescribed this medication. While your doctor will prescribe your medication and instruct you in the proper use, it can be helpful to learn about the manufacturer's recommendations on dosing.

Lamictal (Lamotrigine) for Bipolar Disorder

Lamictal (lamotrigine) is used as a mood stabilizer for persons with bipolar disorder.

While it is an anticonvulsant also used to treat seizure disorders such as epilepsy, this article only covers its recommended dosages when taken for bipolar disorder.

In this article we will talk about what you need to know to make sure you receive the right dose of the medication. You may also wish to review some basic information about Lamictal for bipolar disorder, some of the more common side effects of the drug, as well as a description of the Lamictal rash warning.

Forms of Lamictal

The brand Lamictal comes in four forms:

  • Lamictal
  • Lamictal ODT (orally disintegrating tablets)
  • Lamictal CD (chewable/dispersible)
  • Lamictal XR, (extended release) - Lamictal XR is not used for bipolar disorder so is not covered in this article

Available Strengths of Lamictal (Lamotrigine)

Lamictal comes in the following strengths. You should work with your doctor to figure out what dosage works best for you.

  • Lamictal tablets: 25, 100, 150 and 200 mg
  • Lamictal ODT tablets: 25, 50, 100 and 200 mg
  • Lamictal CD tablets: 2, 5 and 25 mg

How to Take Lamictal

When taking Lamictal, it is important to follow any instructions your doctor has given you. In general, taking Lamictal is as follows:

  • Lamictal tablets - Take as any other medication in pill form.
  • Lamictal ODT - Orally disintegrating tablets should be placed onto the tongue and moved around in the mouth. The tablet will disintegrate rapidly, can be swallowed with or without water, and can be taken with or without food.
  • Lamictal CD - Tablets may be swallowed whole, chewed, or dispersed in water or diluted fruit juice. If the tablets are chewed, consume a small amount of water or diluted fruit juice to aid in swallowing. To disperse Lamictal chewable dispersible tablets, add the tablets to a small amount of liquid (one teaspoon, or enough to cover the medication). Approximately oneC minute later, when the tablets are completely dispersed, swirl the solution and consume the entire quantity immediately. No attempt should be made to administer partial quantities of the dispersed tablets.

Manufacturer's Recommended Lamictal Dosages

Starter kits are available from the manufacturer for Lamictal and Lamictal ODT, and your doctor may provide you with one, along with instructions for when to begin increasing to the next dosage level. The recommended dosage varies depending on whether you are taking or not taking certain other drugs. Those drugs, listed with US brand names in parentheses, are:

  • Sodium valproate or valproic acid (Depakote, Depakene, and others)
  • Carbamazepine (Tegretol)
  • Phenytoin (Dilantin)
  • Phenobarbital (Luminol)
  • Primidone (Mysoline)

Note: Phenytoin, phenobarbital, and primidone are anti-seizure drugs that are not used to treat bipolar disorder.

As the table illustrates, it is essential to tell your doctor about all other medications you are taking when starting Lamictal therapy AND to keep your doctor informed of changes in your other medications.

Lamictal Dosage Table

For Patients TAKING Valproate
For Patients NOT TAKING Carbamazepine, Phenytoin, Phenobarbital, Primidone, or ValproateFor Patients TAKING Carbamazepine, Phenytoin, Phenobarbital, or Primidone and NOT TAKING Valproate
Weeks 1 and 225 mg every other day25 mg daily50 mg daily
Weeks 3 and 425 mg daily50 mg daily100 mg daily, in divided doses
Week 550 mg daily100 mg daily200 mg daily, in divided doses
Week 6100 mg daily200 mg daily300 mg daily, in divided doses
Week 7100 mg daily200 mg dailyup to 400 mg daily, in divided doses
Note: The manufacturer recommends increasing Lamictal if you stop taking Valproate, and increasing if you stop taking carbamazepine, phenytoin, phenobarbital or primidone. Always follow your doctor's instructions regarding dosages - do not make changes on your own.
Note: Oral contraceptives containing estrogen may affect the efficiency of Lamictal and require a dosage adjustment. Always tell your doctor if you are taking, start taking, or stop taking oral contraceptives containing estrogen.


Lamictal Dosing in Pregnancy

For those who are pregnant, may become pregnant, or are near delivery, special care must be taken in the dosing of Lamictal. Studies have found that the serum to dose ratio usually decreases during pregnancy (in other words, a higher dose may be needed to get the same effect.) Dosing may change as well after the baby is delivered. One study found that plasma levels of the drug ranged from decreasing 30 percent to increasing 640 percent after delivery. The most dramatic change occurred around 1.5 weeks after delivery.