Comparative Pharmacology
Head-to-head clinical analysis: CELONTIN versus LAMICTAL CD.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CELONTIN versus LAMICTAL CD.
CELONTIN vs LAMICTAL CD
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Increases levels of gamma-aminobutyric acid (GABA) in the central nervous system, possibly by inhibiting GABA transaminase or enhancing GABA release; also reduces calcium influx into neurons, stabilizing neuronal membranes.
Lamotrigine is a phenyltriazine anticonvulsant that stabilizes neuronal membranes by blocking voltage-sensitive sodium channels and inhibiting the presynaptic release of excitatory neurotransmitters such as glutamate and aspartate.
300 mg orally three times daily, increased by 300 mg every 3-4 days as tolerated; usual maintenance dose 900-2400 mg/day in divided doses.
Lamotrigine extended-release (LAMICTAL CD) for epilepsy: initial 50 mg orally once daily for 2 weeks, then 100 mg once daily for 2 weeks, then 200 mg once daily for 2 weeks, then 300 mg once daily for 2 weeks, then 400 mg once daily thereafter. For bipolar disorder: initial 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then 100 mg once daily for 2 weeks, then 200 mg once daily thereafter.
None Documented
None Documented
Terminal elimination half-life: 40-60 hours in adults, 30-45 hours in children; prolonged liver disease or renal impairment may increase half-life.
Terminal elimination half-life in adults is approximately 25.4 hours (range 14-50 hours) in healthy volunteers; reduced to 14.5 hours (range 12-20) with enzyme-inducing antiepileptics (e.g., carbamazepine, phenytoin), increased to 59 hours (range 30-90) with valproate, and prolonged in renal impairment.
Renal: approximately 40-60% as unchanged drug; hepatic metabolism accounts for the remainder, with metabolites excreted renally.
Lamotrigine is primarily eliminated by hepatic metabolism, with approximately 94% of the dose excreted in urine as glucuronide conjugates (10% as unchanged drug) and 2% in feces.
Category C
Category C
Anticonvulsant
Anticonvulsant