Important Safety Information About LAMICTAL

Prescription LAMICTAL Tablets are not for everyone. Most people who take LAMICTAL tolerate it well. Common side effects with LAMICTAL include dizziness, headache, blurred or double vision, lack of coordination, sleepiness, nausea, vomiting, insomnia, tremor, and rash. LAMICTAL may cause other side effects not listed here. If you develop any side effects or symptoms you are concerned about or need more information, call your doctor.


Although most patients who develop rash while receiving LAMICTAL have mild to moderate symptoms, some individuals may develop a serious skin reaction that requires hospitalization. It is not possible to predict whether a mild rash will develop into a more serious reaction. Rarely, deaths have been reported. These serious skin reactions are most likely to happen within the first 8 weeks of treatment with LAMICTAL. Serious skin reactions occur more often in children than in adults.

Rashes may be more likely to occur if you: (1) take LAMICTAL in combination with valproate [brand names are Depakene®* (valproic acid) or Depakote®* (divalproex sodium)], (2) take a higher starting dose of LAMICTAL than your doctor prescribed, or (3) increase your dose of LAMICTAL faster than prescribed.

If you experience any of the following with or without a skin rash, tell your doctor immediately: hives, fever, swollen lymph glands, painful sores in the mouth or around the eyes, or swelling of lips or tongue. These symptoms may be the first signs of a serious reaction. A doctor should evaluate your condition and decide if you should continue taking LAMICTAL.

Serious blood problems or liver problems have been reported with LAMICTAL, so tell your doctor if you develop symptoms such as unusual bruising or bleeding, severe muscle pain, weakness, fatigue, yellowing of the eyes or skin, and/or frequent infections.

You should not take LAMICTAL if you had an allergic reaction to it in the past.

LAMICTAL-Prescription Medication for Epilepsy and Maintenance Treatment for Bipolar I Disorder

SERIOUS RASH REQUIRING HOSPITALIZATION AND DISCONTINUATION OF LAMICTAL, INCLUDING STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS, HAVE OCCURRED IN ASSOCIATION WITH THERAPY WITH LAMICTAL. RARE DEATHS HAVE BEEN REPORTED, BUT THEIR NUMBERS ARE TOO FEW TO PERMIT A PRECISE ESTIMATE OF THE RATE (see BOX WARNING).

Lamictal side effects (Lamotrigine) and drug interactions - prescription drugs and medications at RxList

In Stevens Johnson Syndrome, a person has blistering of mucous membranes, typically in the mouth, eyes, and vagina, and patchy areas of rash. In toxic epidermal necrolysis, there is a similar blistering of mucous membranes. However, in addition to blistering, the entire epidermis peels off in sheets from large areas of the body. Both disorders can be life threatening.Stevens Johnson Syndrome Symptoms & Treatment

Stevens Johnson Syndrome and toxic epidermal necrolysis usually begin with fever, headache, cough, and body aches, which may last from 1 to 14 days.
Then a flat red rash breaks out on the face and trunk, often spreading later to the rest of the body in an irregular pattern.
The areas of rash enlarge and spread, often forming blisters in their center. The skin of the blisters is very loose and easy to rub off.
In toxic epidermal necrolysis, large areas of skin peel off easily. In many people, 30% or more of the body surface peels away. The skin loss in toxic epidermal necrolysis is similar to a severe burn and is equally life threatening. Huge amounts of fluids and salts can seep from the large, raw, damaged areas. A person who has this disorder is very susceptible to infection at the sites of damaged, exposed tissues; such infections are the most common cause of death in people with this disorder.
The affected areas of skin are painful, and the patient feels ill with chills and fever.
The hair and nails sometimes fall out.
Blisters break out on the mucous membranes lining the mouth, throat, anus, genitals, and eyes. The damage to the lining of the mouth makes eating difficult, and closing the mouth may be painful, so the person may drool.
Ocular involvement includes severe conjunctivis, iritis, palpebral edema, conjunctival and corneal blisters and erosions, and corneal perforation. The eyes may become very painful, swell, and become so filled with pus that they seal shut. The corneas can become scarred and there may be loss of vision.
Esophageal strictures may occur when extensive involvement of the esophagus exists. Mucosal shedding in the tracheobronchial tree may lead to respiratory failure. Mucosal pseudomembrane formation may lead to mucosal scarring and loss of function of the involved organ system.
The urethra may also be affected, making urination difficult and painful. Vaginal stenosis and penile scarring have been reported. Renal complications are rare.
Sometimes the mucous membranes of the digestive and respiratory tracts are involved, resulting in diarrhea and difficulty breathing.
Stevens Johnson Syndrome Symptoms SJS TEN Treatment

Lamictal's Typical Side Effects: The usual for anticonvulsants. More so than any other anticonvulsant Lamictal (lamotrigine) is going to give you rashes.

This is a real problem, because Stevens-Johnson syndrome and assorted other serious rashes are bigger concerns with Lamictal (lamotrigine) than any other anticonvulsant, so often Lamictal (lamotrigine) therapy will end at the first sign of any rash. While any rash with Lamictal (lamotrigine) needs to be closely watched, it's the combination of an itching rash and fever with any anticonvulsant that needs immediate attention from a doctor, any doctor. Lamictal (lamotrigine) + itching rash + fever = trip to the emergency room with all of your meds in their original bottles. The following picture is what an actual case of Lamictal-induced Stevens-Johnson syndrome looks like:


Lamictal Rash Picture


Otherwise it's just call your regular doctor for the soonest appointment possible. Still, I wish everyone would just calm the hell down about The Rash. Yes, it can be fatal, but it usually takes forever to kill you! And I don't mean in a movie-of-the-week, slow, painful death way, I mean that the symptoms show up early and you usually have plenty of time to take action before it's too late. One member of a bipolar support group walked around with an itchy rash and a fever for two weeks before she saw a doctor and she's fine. That was stupid, but not really all that stupid. The rash is slow to kill. Once you see the first symptoms and stop taking Lamictal (lamotrigine), The Rash goes away and you're safe! Problem solved! OK, you'll have truly sucky problem of not being able to take Lamictal (lamotrigine), but that's something else altogether. That doesn't mean you should be lax about any itchy rash and fever, because these skin things have no fixed rate. But the math is pretty simple - if you live in a country where Lamictal is available, you live where the hospitals can deal with The Rash without it being a big deal. Really!

I've received two e-mails from people who have had to be hospitalized because of Stevens-Johnson syndrome. One sent repeatedly in an awful blue font on fuchsia (to either get my attention or just give me a headache) relating how this person ignored the combination of itchy rash and fever for more than three days and wound up in the hospital. And of course blamed Lamictal for all of her woes. The other person is the reason why there are black-box warnings. He added a single 25mg dose of Lamictal to his regimen of Depakote and had to be hospitalized immediately because The Rash hit swiftly. His is the one case in many tens of thousands where it happens that rapidly. In very rare cases The Rash can be a big ******* deal. That's why there's a black box warning on the PI sheet. More often than not it's stupidity that is the main problem people have. Be annoying with your doctor about rashes and Lamictal. Better safe than sorry.

Now when you look at the PI sheet and actually look at the odds you have a 1 in 10 chance of getting some kind of rash with Lamictal (lamotrigine). Not necessarily The Rash, just some random rash. So don't go trying out any new skin products. In fact you may want to start getting all hypoallergenic before even starting therapy, getting rid of scented soaps, fabric softeners and such like.