From the FDA Drug Label
The FDA drug label does not provide direct information about lamotrigine causing elevated liver function tests (LFTs) in the provided text.
The FDA drug label does not answer the question.
From the Research
Lamictal (lamotrigine) can cause elevated liver function tests (LFTs), though this is considered an uncommon side effect. Patients taking lamotrigine should be aware that liver enzyme elevations typically occur within the first 8 weeks of treatment but can happen at any time during therapy, as reported in a case of liver dysfunction induced by systemic hypersensitivity reaction to lamotrigine 1. The risk appears to be higher when lamotrigine is used in combination with other anti-seizure medications, particularly valproate (Depakote). Most cases of LFT elevations are mild and asymptomatic, not requiring discontinuation of the medication. However, patients should be vigilant for signs of liver problems such as jaundice (yellowing of skin or eyes), dark urine, right upper quadrant pain, or unusual fatigue, which can be indicative of more severe liver damage, as seen in a case of fatal progressive hepatic necrosis associated with lamotrigine treatment 2. These symptoms warrant immediate medical attention. The mechanism behind lamotrigine's effect on liver enzymes involves its metabolism in the liver, where it undergoes glucuronidation, a process that can occasionally lead to metabolic stress on liver cells, resulting in enzyme elevation. Regular monitoring of liver function is not routinely required for all patients on lamotrigine but may be recommended for those with pre-existing liver disease or taking multiple medications that affect the liver, as suggested by reports of reversible hepatotoxicity in patients treated with lamotrigine 3.
Some key points to consider:
- Lamotrigine can cause elevated LFTs, although this is uncommon
- The risk of LFT elevations may be higher when lamotrigine is used with other anti-seizure medications
- Patients should be aware of signs of liver problems and seek medical attention if they occur
- Regular monitoring of liver function may be recommended for certain patients, such as those with pre-existing liver disease
- The mechanism of lamotrigine's effect on liver enzymes involves its metabolism in the liver, which can lead to metabolic stress and enzyme elevation, as reported in cases of lamotrigine-associated hepatotoxicity 4, 5.