Comparative Pharmacology
Head-to-head clinical analysis: LAMICTAL CD versus VIGABATRIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMICTAL CD versus VIGABATRIN.
LAMICTAL CD vs VIGABATRIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Irreversibly inhibits GABA transaminase, increasing brain GABA levels.
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.
Adults: 500 mg orally twice daily; may increase by 500 mg/day every 7 days up to 1500 mg twice daily. For refractory complex partial seizures, maximum 3000 mg/day.
None Documented
None Documented
Clinical Note
moderateVigabatrin + Venlafaxine
"The risk or severity of adverse effects can be increased when Vigabatrin is combined with Venlafaxine."
Clinical Note
moderateVigabatrin + Nefazodone
"The risk or severity of adverse effects can be increased when Vigabatrin is combined with Nefazodone."
Clinical Note
moderateVigabatrin + Stiripentol
"The risk or severity of adverse effects can be increased when Vigabatrin is combined with Stiripentol."
Clinical Note
moderateVigabatrin + Clomipramine
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.
5-8 hours in young adults; 12-17 hours in elderly; prolonged with renal impairment.
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.
Renal: ~80% unchanged in urine; fecal: <5%.
Category C
Category A/B
Anticonvulsant
Anticonvulsant
"The risk or severity of adverse effects can be increased when Vigabatrin is combined with Clomipramine."