Comparative Pharmacology
Head-to-head clinical analysis: LAMOTRIGINE versus TOPAMAX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMOTRIGINE versus TOPAMAX.
Lamotrigine vs TOPAMAX
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Stabilizes neuronal membranes by blocking voltage-gated sodium channels and inhibiting the release of excitatory neurotransmitters, particularly glutamate and aspartate.
Antiepileptic; modulates voltage-gated sodium channels, enhances GABA-A activity, antagonizes AMPA/kainate glutamate receptors, weakly inhibits carbonic anhydrase.
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.
Initial dose 25 mg orally twice daily; titrate by 25-50 mg weekly to effective dose; usual maintenance dose 200-400 mg/day divided twice daily; maximum 1600 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
25.4 h (range 24-31 h, prolonged to 59 h with valproate)
Terminal elimination half-life is 21 hours (range 18-23 hours). Linear pharmacokinetics. Half-life is prolonged in renal impairment (CrCl <70 mL/min: ~35 hours).
Renal (94% as metabolites, 10% unchanged; 2% fecal)
Renal: ~70% (unchanged drug); remainder as metabolites. Biliary/fecal: minimal (<5%).
Category A/B
Category C
Anticonvulsant
Anticonvulsant
"The serum concentration of Fluconazole can be increased when it is combined with Lamotrigine."