Comparative Pharmacology
Head-to-head clinical analysis: LAMOTRIGINE versus VALPROATE SODIUM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMOTRIGINE versus VALPROATE SODIUM.
Lamotrigine vs VALPROATE SODIUM
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.
Increases GABA levels by inhibiting GABA transaminase and blocking voltage-gated sodium channels; also modulates T-type calcium channels.
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.
10-15 mg/kg/day orally or intravenously in 2-3 divided doses; increase by 5-10 mg/kg/day weekly to therapeutic range of 50-100 mcg/mL. Maximum dose 60 mg/kg/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 9–16 hours in adults; may be shorter in children (5–12 hours) and prolonged in hepatic impairment or elderly (up to 18 hours). Neonatal half-life: 10–67 hours. Clinically, twice-daily dosing is typical.
Renal (94% as metabolites, 10% unchanged; 2% fecal)
Primarily renal (90% as glucuronide conjugates, 3-oxo derivative, and other metabolites; <3% unchanged). Biliary/fecal excretion accounts for <10%.
Category A/B
Category C
Anticonvulsant
Anticonvulsant
"The serum concentration of Fluconazole can be increased when it is combined with Lamotrigine."