Comparative Pharmacology
Head-to-head clinical analysis: LAMOTRIGINE versus VIMPAT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAMOTRIGINE versus VIMPAT.
Lamotrigine vs VIMPAT
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.
Selective enhancement of slow inactivation of voltage-gated sodium channels, resulting in stabilization of hyperexcitable neuronal membranes and inhibition of repetitive neuronal firing.
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.
Adults: 200 mg oral or IV as a loading dose, followed by 100 mg twice daily (200 mg/day) starting the day after loading. May increase by 50 mg twice daily every week up to 200 mg twice daily (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
25.4 h (range 24-31 h, prolonged to 59 h with valproate)
Terminal half-life: 13-16 hours (mean ~13 h at steady state); prolonged with renal impairment (CrCl <30 mL/min: ~22 h) and in patients with hepatic impairment (Child-Pugh B: ~17 h; Child-Pugh C: ~22 h).
Renal (94% as metabolites, 10% unchanged; 2% fecal)
Renal: ~95% (40% as parent drug, 39% as O-desmethyl metabolite, and ~15% as other minor metabolites); minimal biliary/fecal elimination (less than 1%).
Category A/B
Category C
Anticonvulsant
Anticonvulsant
"The serum concentration of Fluconazole can be increased when it is combined with Lamotrigine."