From the Research
Recommended Rate of Increase for Lamictal (Lamotrigine) Dosage
The recommended rate of increase for Lamictal (lamotrigine) dosage is a crucial aspect of its administration to minimize the risk of adverse reactions, particularly skin rash.
- The initial dosage schedule may start with 5 mg every day or every second day for 14 days, increased by 5 mg every 14th day to 25 mg a day, as indicated in the study 1.
- A new rapid titration protocol for lamotrigine that takes only 11 days to reach a daily dose of 200 mg has been investigated, with only two (6.9%) patients experiencing idiosyncratic skin rash before the first follow-up visit at 2 weeks, as reported in the study 2.
- The standard final dose is 200 mg/day to be achieved with slow titration, with the concomitant use of valproic acid requiring a reduction of the standard final dosage of lamotrigine to 100 mg/day, as stated in the study 3.
- Fast titration significantly increases the risk of rash development, while slow titration significantly decreases this risk, as found in the study 4.
- Strict adherence to manufacturer's dosing guidelines, particularly in patients who are at higher risk, such as those on concurrent valproate and in the pediatric population, may possibly lessen the risk of serious rash, as recommended in the study 5.