Comparative Pharmacology
Head-to-head clinical analysis: DILANTIN versus LAMOTRIGINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILANTIN versus LAMOTRIGINE.
DILANTIN vs Lamotrigine
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Phenytoin stabilizes neuronal membranes and decreases seizure activity by increasing efflux or decreasing influx of sodium ions across cell membranes in the motor cortex during generation of nerve impulses. It acts by blocking voltage-dependent sodium channels, thereby inhibiting the spread of seizure activity.
Stabilizes neuronal membranes by blocking voltage-gated sodium channels and inhibiting the release of excitatory neurotransmitters, particularly glutamate and aspartate.
300–400 mg/day orally in 2–3 divided doses; IV loading dose 15–20 mg/kg at max 50 mg/min, then 300 mg/day IV divided 2–3 times daily.
Initial: 25 mg orally once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by 50 mg every 1-2 weeks. Maintenance: 100-200 mg twice daily (200-400 mg/day). Maximum: 400 mg/day.
None Documented
None Documented
Clinical Note
moderateLamotrigine + Fluticasone propionate
"The risk or severity of adverse effects can be increased when Lamotrigine is combined with Fluticasone propionate."
Clinical Note
moderateLamotrigine + Desmopressin
"The risk or severity of adverse effects can be increased when Lamotrigine is combined with Desmopressin."
Clinical Note
moderateLamotrigine + Erythromycin
"The metabolism of Erythromycin can be decreased when combined with Lamotrigine."
Clinical Note
moderateLamotrigine + Fluconazole
Average 22 hours (range 7-42 hours) in adults. Dose-dependent; increases with higher concentrations due to saturable metabolism. In neonates: 10-15 hours. In chronic use, half-life may increase.
25.4 h (range 24-31 h, prolonged to 59 h with valproate)
Primarily hepatic metabolism to inactive metabolites (p-hydroxyphenyltoin and glucuronide conjugate). Less than 5% excreted unchanged in urine. Fecal excretion minimal (<2%).
Renal (94% as metabolites, 10% unchanged; 2% fecal)
Category C
Category A/B
Anticonvulsant
Anticonvulsant
"The serum concentration of Fluconazole can be increased when it is combined with Lamotrigine."